TM1: Thrust Manipulation 1 – Lower Extremity & Basic/Intermediate Spine
This course focuses on enhancing the participant’s background knowledge, clinical reasoning process, and technical skill set related to the use of high velocity low amplitude (HVLA) thrust manipulation techniques in the management of patients with spinal or lower extremity impairments. Participants can expect to become proficient with common manipulative techniques directed to the lower extremity joints and with basic and intermediate techniques directed to the cervical, lumbar, and thoracic spinal regions. Furthermore, evidence based approaches and reasoning related to the appropriate use of spinal manipulation will be emphasized.
Course Objectives
- Critically appraise the literature regarding evidence for thrust manipulation of the cervical spine, thoracic spine, lumbar spine, and joints of the lower extremity.
- Summarize the available body of evidence for thrust manipulation of the cervical spine, thoracic spine, lumbar spine, and joints of the lower extremity.
- Describe precautions and contraindications to thrust manipulation.
- Analyze a patient scenario and make a determination of whether thrust manipulation may be of benefit.
- Educate patients and colleagues and the role of thrust manipulation in the treatment of cervical spine, thoracic spine, lumbar spine, and lower extremity disorders.
- Summarize APTA and AAOMPT positions on thrust manipulation.
- Demonstrate thrust manipulation techniques directed to the cervical spine, thoracic spine, lumbar spine, and joints of the lower extremity in a safe and proficient manner.
- Formulate a plan for appropriate integration of thrust manipulation given a patient case scenario.
- Design a comprehensive treatment plan – including incorporation of thrust manipulation and appropriate matching exercise – given a patient case scenario.
- Evaluate the success of a thrust manipulation technique was successful utilizing the patient response model, and modify treatment as indicated.
- Articulate legal and ethical issues related to thrust manipulation.
General Schedule
Day 1
- 8:00-8:15 Faculty and Participant Intros
- 8:15-8:45 History of Thrust Manipulation
- 8:45-9:15 Brief Review of Precautions & Contraindications to HVLAT Techniques
- 9:15-10:15 Ankle and Foot Techniques – Part 1
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- TC Distraction
- MTP Distraction
- Sidelying ST Eversion
- 10:15-11:00 Hip Techniques
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- LAT
- Caudal from IR/ER
- 11:00-11:30 Technique Review and Rapid-Fire Practice
- 11:30-12:30 Lunch
- 12:30-1:15 Knee Techniques
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- Distraction
- Proximal TibFib
- 1:15-2:30 Lumbar Techniques – Part 1
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- Sidelying neutral rotation
- Hypomobile variation
- Hypermobile variation
- Sidelying neutral rotation
- 2:30-4:15 Thoracic Techniques – Part 1
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- Supine Upper
- Supine Mid
- Supine Lower
- 4:15-4:30 Scope of Practice Discussion
- 4:30-5:00 Technique Review and Rapid-Fire Practice
Day 2
- 8:00-8:15 Rapid-Fire Practice
- 8:15-9:00 Cervical Spine: Evidence Review and Screening
- 9:00-10:30 Cervical Techniques – Part 1
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- Upglide – occipital hold
- Downglide – occipital hold
- 10:30-10:45 Cavitation: Does it matter?
- 10:45-11:30 Thoracic Techniques – Part 2
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- Seated upper
- Seated mid
- 11:30-12:30 Lunch
- 12:30-1:00 Technique Review and Rapid-Fire Practice
- 1:00-1:45 Lumbar Techniques – Part 2
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- Supine SI Technique
- *Demo modified techniques w/ towel
- 1:45-2:30 Cervical Techniques – Part 2
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- Upglide – chin hold
- Downglide – chin hold
- Prone CTJ Manipulation
- 2:30-3:00 Foot and Ankle Techniques – Part 2
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- Cuboid Whip
- Plantar TMT
- 3:00-3:30 Thoracic Techniques – Part 3
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- Outsized supine mid – ipsilateral
- Outsized supine lower – foam roll
- 3:30-4:00 Technique Review and Rapid-Fire Practice