• No matter what condition or injury you have, you are in good hands at The Hand & Physical Therapy Center of Marin. Our evaluation and treatment options include all forms of manual therapy, range of motion, therapeutic activities and exercise, neuro-reeducation and retraining; modalities such as electrical stimulation, light therapy and ultrasound as well as custom splinting.
  • Our highly trained group of therapists pride themselves in their ability to fabricate quality custom splints for a wide variety of conditions. This special skill is indicative of our dedication to the highest standard of care.
  • In order to further your understanding of the treatments you may receive from us, below is an explanation of the various kinds of services you may see in our practice.
    • We have both Occupational Therapists and Physical Therapists on staff  and all the therapists in the practice are hand therapists.
    • Custom splints are fabricated on site by your therapist and are used for protection, support, to provide an environment for healing and or to improve function.
    • Neurological Rehabilitation for all nerve and brain trauma, disease or degeneration
    • Wound care – We have had great success with promoting the healing of acute and chronic wounds.
    • Post operative care for traumatic and elective procedures for all parts of the body including fractures, surgical repairs of tendons/ligaments/joints, soft tissue injuries, joint replacements and reconstruction
    • Ergonomic Support and Evaluation
    • Custom home exercise programs
    • Spine care including the neck, upper back and lower back
    • Chronic pain management
    • Sports Rehabilitation
    • Energy conservation/joint protection techniques for such conditions as arthritis and autoimmune disorders
    • Rehabilitation for repetitive strain problems such as carpal tunnel syndrome
    • Integrative Manual Therapy™

Integrative Manual Therapy (IMT)

“I am so grateful to Karen Nugent.  Because of her work using IMT, I canceled my scheduled surgery for hip replacement.  I am walking
so much better since I started treatment and got rid of my cane as a result.
I have gone to many different Physical Therapists who used traditional physical therapy methods, and although highly regarded in their field, were not able to help me.  I believe IMT is a wonderful method to explore before
considering surgery.”
Rose A.

IMT is a powerful tool that helps individuals achieve optimal health. This is accomplished by techniques that are non-invasive, indirect and address imbalances in the body. With injury or illness, blockages and tissue dysfunction can reduce the body’s ability to self-heal. IMT is about creating the opportunity for self-healing to occur.

The body is made up of multiple systems. These systems are all interconnected and communicate between themselves. If there is a problem in one system such as the muscular system and only that system is addressed in therapy, then healing may be limited due to problems arising from the circulatory system, skeletal system or nervous system. IMT addresses the body as a whole and works with all involved systems to facilitate healing.

Traditional therapy (chiropractic, orthopedic physical therapy) tends to use a direct approach, thus moving the joints and soft tissue into the line of tension or direction of limited motion. The majority of IMT treatment techniques work indirectly by taking tension off the structure, facilitating the body’s healing ability. The techniques are gentle and non-invasive while the results can be profound.

The Hand & Physical Therapy Center of Marin has two therapists that utilize IMT techniques: Karen Nugent PT, CHT, IMT,C and Jilda Hellinga PTA.

For further information regarding IMT please visit their website at