Manual NVR course series and certification program

Continuing education for licensed manual therapists, including massage therapists, structural integrators, and physical therapists

The Manual NVR curriculum integrates techniques, perspectives, and practices from structural integration, osteopathy, and clinical massage. In this six-course series you will learn to improve structural and functional balance by implementing techniques and strategies for working with tension in the artery network, fascial restriction of peripheral and cranial nerves, dural restrictions in the spinal column and head, and neural and vascular tension affecting the viscera. After the Intro course, the next four courses each have a regional focus, and the final course is a capstone that brings together all you have learned.  

Introduction to Manual NVR for Structural and Functional Balance can stand alone or prepare you for the advanced study offered in the next five courses of the Manual NVR curriculum. The techniques and the approach you learn in this course will help you improve left-right and front-to-back balance throughout the body rather than focusing on functional balance within one body region. This lays the foundation for understanding how to work effectively with the nerves and vessels that weave through the fascial layers. For this optional but highly recommended introductory course, we will lean into the practices and perspectives used by structural integrators, and you will begin to work with osteopathic subtlety and precision.

If you like to work myofascially (with a heavier hand than an osteopath), then you need the Intro course. This course will help you finesse your work to better tend the neurovascular network while using a broad, firm touch. It will also help you integrate a lighter osteopathic style touch into your practice. 

Part 1 may be taken first without taking the Intro course, but please refer to the FAQ for guidance and check with Kier before deciding to skip the Intro course.

Manual NVR Part 1: Neck, Upper Thorax, and "Roots of Arms" provides you with important skills for working with the nerves, arteries, and dura of the neck, head, and upper thorax region, including the shoulder girdle, the rib cage, and its neural, vascular, and visceral contents. 

If you specialize in therapeutic work for people who have sustained whiplash injuries, either recent or historical, or who have neural symptoms or orthopedic problems associated with the shoulders, Part 1 provides you with essential skills for working with the peripheral nerve roots and dura associated with the upper thoracic and cervical spine and the vessels associated with the shoulder girdle and thorax. 

Manual NVR Part 2: Lower Thorax, Pelvis, and Hips provides a deep dive into working with the pelvis and hips and allows us to complete our work with the spine and thorax. You will gain skills and strategies for balancing pelvic torsion, improving hip function, and addressing left-right asymmetry in the pelvis, hips, and thorax. We will review Part 1 techniques as we tend the central nervous system. 

Parts 1 and 2 are a set, and your clients will benefit the most if you take these two classes within 3-6 months of one another. Together, Manual NVR Parts 1 and 2 will transform what you are already doing with your clients.

The first three courses (Intro course, Part 1, and Part 2) together are considered "Level One" in the Manual NVR curriculum. After Part 2, you may want to take a pause before continuing on to Part 3, especially if you know you will benefit from time to process and integrate this work into your practice.

Manual NVR Part 3: Lower Extremities offers a detailed study of the lower legs and feet, with special consideration for common problems within the foot, and strategies for improving support and adaptability within each lower limb. We will utilize skills you have learned in Parts 1 and 2 as we consider body-wide postural patterns with specific attention to functional balance in the lower body. (Working with neural and dural restrictions in the cervical and thoracic regions may be part of your strategy for working with lower extremity nerve symptoms.) Think of this course as the beginning of your "Level Two" NVR studies.

Manual NVR Part 4: Upper Extremities revisits the territory of the upper thorax, neck, and shoulder girdle as we add details for the arms, hands, and viscera. 

Throughout Parts 3 and 4, we will build your assessment skills and consider whole-body patterns.

Manual NVR Part 5: Assessment and Strategy Practicum is a clinic-style class where we bring in outside models to receive full sessions. Our focus will be on assessment, strategy, and the flow of each session. We will consider client goals and concerns, client history, what you see, and what you learn through palpation and movement pretests. There will be opportunity to review and refine techniques taught in previous classes as the need arises during each session. You will form your session strategies under Kier’s guidance with the collaborative support of your classmates, and you will experience "four-handed work."

Movement-Based NVR home study courses, small group mentoring, and certification program

Neurovascular anatomy, self-treatment, and guided practice for movement teachers and manual therapists, including yoga teachers, Pilates instructors, structural integrators, and physical therapists

Kier began developing the Movement-Based NVR curriculum from their Manual NVR techniques (converted into self-treatment techniques) during the first two years of COVID, for the purpose of working with clients and colleagues online. Their approach to guided self-treatment has since evolved into its own study program for movement teachers and manual therapists who work with clients while they are moving. 

The self-treatment techniques and teaching strategies will provide you with new ways of improving your client's movement range, fine-tuning their structural balance, and cultivating their interoceptive ability. 

Initially, you will learn to work on your own body’s structural balance, opening it up to freer movement. You will build your own internal map of the neurovascular network through anatomy lessons that are coupled with guided practice, and you will practice listening to and witnessing your body’s subtle responses. Discussion and homework will focus on how to guide clients through a similar discovery and embodiment process.  

You and your clients or patients will experience:

  • improved range and quality of movement
  • better functional and structural balance
  • a better-regulated nervous system with improved vagal tone.


Movement-Based NVR will also prepare your clients and students for other forms of manual therapy or movement training and will help them become more resilient and less susceptible to injury.