Course description

This course will cover current best evidence in the use of thrust manipulation to treat common clinical syndromes. Laboratory sessions will focus on the safe and effective delivery of thrust manipulations to the lumbar spine, sacroiliac joint, thoracic spine, and cervical spine. Lecture material will focus on the developing body of literature regarding safety of thrust manipulation, neurological examination, and the use of thrust manipulations with commonly treated patient presentations. These presentations include, but are not limited to: cervicogenic headaches, acute and chronic neck pain, non-radicular mechanical low back pain, and sacroiliac joint dysfunction. Additional lectures will cover the neurophysiological effects of manipulation and the importance of understanding the neurophysiology of pain in treating patients.

Instructional Method: lecture with demonstration and hands on lab

Student to faculty ratio: 15:1 (maximum of 15 students to 1 faculty)

Target Audience: Physical Therapists / Doctors of Medicine / Doctors of Osteopathy /University Faculty

Contact Hours:
16 contact hours

Course Objectives

1. Understand the risk factors associated with spinal manipulation and be able to screen patients properly using a thorough history and targeted physical examination

2. Understand the distinct components of the subjective and physical examination that guide selection of each thrust manipulation instructed

3. Understand the strengths and weaknesses of literature support for HVLAT in syndromes commonly treated in the outpatient setting

4. Demonstrate to the instructor and class proper technique with lumbar, cervical, and thoracic HVLAT

5. Demonstrate to the instructor and class proper technique with lumbar, cervical, and thoracic mobility exercises and their home exercise counter parts

course schedule

Day 1

 8:00am-8:30: Overview of Subjective

Examination & Clinical Reasoning Framework

 8:30-9:30: Indications for HVLAT and Cervical


 9:30-10:00: Lab – Examination & Screening

 10:00-11:00: Contra Indications to OMT

 11:00-12:00: Lab – Mid Cervical HVLAT


 1:00pm-1:30: Neuro Exam

 1:30 – 2:00 Lab: Neuro/instability exam

 2:00-3:00: Lab – Supine upper thoracic and ribs


 3:00-4:00: Evidence surrounding cervical and

thoracic HVLAT

 4:00-4:30pm: Lab – Seated Cervical

 4:30-5:30pm: Lab – Round Robin

Day 2

• 8:00am-8:30: Q&A

• 8:30-9:15: Lumbar examination and

evidence for HVLAT

• 9:15–10:00: LAB Lumbar and SL TLJ


• 10:00–11:00: Neurophysiology of


• 11:00-11:30pm: Prone CTJ

• 11:30-12:00 Lab Supine mid/low thoracic;

TLJ Sit to supine


• 1:00pm – 1:30: Lab: Supine Lumbar

• 1:30 – 2:00: HA lecture

• 2:00-2:30: Lab A/A

• 2:30-3:00: Lab: Prone Thoracic and Ribs

• 3:00 – 3:30pm: SIJ exam lecture

• 3:30:4:00 LAB: SIJ exam and HVLAT

• 4:00-5:00 Round Robin

Speaker Bio: Dr. Justin Dunaway

Dr. Dunaway received his doctorate in physical therapy from Youngstown State University and has worked in outpatient physical therapy with special interests in orthopedic manual therapy, spine symptoms, and chronic pain. Justin has completed extensive training in manual therapies and received multiple certifications including: spinal manipulation (Cert-SMT), dry needling (Cert-DN), board certification as an Orthopedic Specialist (OCS), and a graduate diploma in Extremity Manipulation. Dr. Dunaway has experience teaching manual therapy seminars for the American Academy of Manipulative Therapy, The Manual Physical Therapy Alliance, and in Haiti through STAND: The Haiti Project.