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[Music] were gonna start talking about the different types of manipulation talking about manipulation manipulation is a class its not a specific approach it can include seven different types of manipulation that are taught in do schools and sometimes some approaches work for some things and other approaches work for other things but its not one treatment for all one-size-fits-all its multiple different approaches so the osteopathic medical schools got together and said what do we teach there are many different types what is it we have in common and the commonalities are all medical schools that give the do degree teach seven different types of manipulation all of them start with an osteopathic neuromusculoskeletal exam all of them teach counter strain which used to be called strain counter strain or spontaneous release by positioning all teach HVL a from the beginning eighty still started teaching high velocity low amplitude thrusting as a way of treating musculoskeletal disorders