How it works
Your own movement is the diagnostic test.
Mechanical Diagnosis and Therapy (MDT) does not start with a scan or a guess. It starts by watching how your pain behaves when you move in specific, deliberate ways, and that behavior points to the fix.
Visit one: the assessment
About an hour. Brian takes your history, then guides you through a sequence of test movements on camera, asking what your pain does after each one: better, worse, moving closer to your spine, or unchanged.
That pattern of response is the finding. Most people leave visit one with one or two exercises and a clear posture plan.
Visits two and three: the adjustment
You report what happened at home. If your pain is retreating, we load the same direction further. If it is not, we change direction. This loop is what makes MDT fast. Every visit is driven by your last result.
Visits are usually spaced a few days apart, so a full course fits inside one to two weeks rather than three months.
Discharge: you take over
The goal is not that you feel better in the appointment. It is that you can stop your own pain when it flares, without booking anything.
If the mechanical approach turns out not to be right for you, your assessment still tells us something useful, and you will be pointed toward the right next step for care.
What you need on your end
- A phone, tablet or computer with a camera and a decent connection.
- Enough floor space to lie down and be seen on camera.
- Clothing you can move in.
- A physical address in New York State.
- About an hour for the first visit, less for follow-ups.
What you will not need
- Pills or prescriptions.
- X-rays or an MRI to get started.
- Injections or surgery.
- Gym equipment, machines or a long exercise program.
- A standing weekly appointment for the rest of the year.
Two minutes
Is this right for you?
Check anything that sounds like you. Nothing is saved and nothing is sent. This runs entirely in your browser.
Tell me a bit about your pain
This is a guide, not a diagnosis. Anything that worries you is worth a conversation with a clinician, including this one.
Questions
The things people ask before booking
Can physical therapy really work over video?
For mechanical pain, yes, because the assessment is about what your pain does when you move, not about what a therapist feels with their hands. Brian watches you perform specific test movements and tracks how your symptoms respond. The exercises you go on to do are ones you perform yourself anyway, at home, between visits.
What if my problem is not mechanical?
Then the assessment says so, usually quickly. Not every pain responds to position and movement. If yours does not, you will be told directly, and your assessment findings will be used to guide you toward the right kind of care next, rather than spending six weeks finding out.
How long until I feel a difference?
Many people notice a change during the first visit, because the assessment itself involves loading the direction that relieves your symptoms. A typical course is 3 to 5 visits across 1 to 2 weeks. What takes longer is building the habit that keeps the pain away.
Do I need an X-ray or MRI first?
No. Research published in Spine in 1997 found the mechanical assessment process distinguished painful from non-painful discs more reliably than MRI. Imaging has its place. It is just not the starting point for most mechanical pain. See the research →
Do you take my insurance?
Visits are self-pay at a flat $100, booked through the Sesame Care platform. No referral, no prior authorization, no surprise bill. A typical course of care costs $300 to $500 in total, often less than the out-of-pocket share of a conventional course of therapy. See the full cost breakdown →
What if it does not work for me?
You get your money back. If you have not achieved your pain relief goals by the time you are discharged, email or call and you will be refunded 100% of what you paid for your VMPT visits.
I am outside New York State. Can you still help?
Not yet. Physical therapy licensure is state by state, and VMPT is currently licensed to treat patients located in New York. Join the out-of-state list and you get the free videos now, a pointer to an MDT-certified clinician near you if Brian knows of one, and first word when your state opens. The states people ask for most are the ones VMPT pursues next.
Ready when you are
Book the visit that starts the clock.
Choose Online physical therapy session (new patient) on Sesame Care, pick a time, and bring your questions.