A Systematic Manual Therapy Approach to the Thoracic Spine

Course Outline

This two-day seminar is designed to provide the medical professional with the information, evaluation skills, and treatment techniques to effectively manage disorders of the thoracic spine. Course participants will learn a systematic approach for evaluating and treating dysfunctions of the thoracic spine. Instruction begins with anatomy, physiology and biomechanics and progresses to assessment of soft tissue, joint motion, and the interrelationship between biomechanical motions in the thoracic region. The participants will be led through the specific evaluation and treatment plans using and applying manual techniques as well as learning to utilize the most appropriate therapeutic exercises to maximize outcomes. Thorough discussion and laboratory time will provide the tools necessary to identify the underlying mechanism of thoracic dysfunction when dealing with hypomobility, compression fractures, scoliosis, positional faults, disc, joint, and rib motion dysfunctions and pain. In depth understanding of the thoracic region will enable the participants to fully participate in the treatment discussion and lab sessions detailing differential diagnosis, manual techniques, therapeutic exercises and home maintenance programs for specific disorders. The interrelationship between the cervical-thoracic, thoracolumbar and shoulder complex will also be examined.
Participants will gain the skills necessary to identify the underlying mechanism of injury and treat appropriately. A comprehensive course manual with illustrations and step-by-step instructions will assist the clinician in their understanding of the material. The skills and techniques learned in this class can be immediately applied in the clinical setting.


Course Objectives

• Understand the functional anatomy, physiology and normal biomechanics of the thoracic spine and ribs.
• Perform palpation to determine normal and abnormal biomechanics.
• Identify the interrelationship between the cervical/thoracic region, thoracic region and shoulder, thoracic spine and ribs and the thoracic/lumbar region.
• Be capable of performing a thorough evaluation of joint motion in the thoracic and rib region in supine, prone, and sidelying and be able to differentiate between muscular and joint restrictions.
• Perform specific muscle techniques to decrease hypomobility at specific segments.
• Understand when to utilize thoracic disc traction, thoracic facet traction and joint gliding techniques.
• Identify appropriate breathing patterns and how they affect the thoracic spine and ribs.
• Perform provocation alleviation tests and special tests to identify the source of dysfunction.
• Identify which segmental level is the source of dysfunction and develop an appropriate treatment plan utilizing joint mobilizations, muscle energy, and exercise to achieve positive outcomes.
• Develop comprehensive treatment programs for the thoracic spine and ribs to restore normal function.
• Develop home maintenance programs to maintain patient results.
• Utilize appropriate terminology when discussing evaluation and treatment programs.

Schedule of instruction

  Day One   Day Two
7:30 8:00 Registration 8:00 8:30 Review
8:00 9:00 Anatomy and Physiology 8:30 10:00 Treatment Joint: Mobilizations
(Lecture and Lab)
  - Disc, facet joint and capsule   - Disc traction
  - Vertebrae and ribs   - Facet traction and glide of thoracic spine
  - Blood supply, nerves   - Traction and glide of ribs
  - Muscles and ligaments   - Home exercise program
  - Biomechanical terms 10:00 10:15 Break
9:00 10:00s
 Biomechanics 10:15 12:30 Treatment: Therapeutic Exercises (Lecture and Lab
  - Coupled vs. noncoupled movement patterns   - Stretching of paraspinals
  - Disc and rib movement active vs. passive   - Joint and muscle mobility exercises
  movement   - Stabilization of thoracic spine or ribs
  - Importance of thoracic spine movement with glenohumeral, cervical and lumbar motion   - Home exercise program
10:00 10:15 Break 12:30 1:00 Lunch (on your own)
10:15 11:15 Assessment Lecture 1:00 2:45 Case Studies
  - History 2:45 3:15 Review and Questions
  - Posture    
  - AROM    
  - Provocation/alleviation    
  - Palpation -joint play    
  - Passive Intervertebral Movement (PIVM)    
  - Muscle testing (flexibility and strength)    
11:15 12:30 Assessment (Lab)    
  - AROM    
  - Provocation/alleviation    
12:30 1:30 Lunch (on your own)    
1:30 3:30 Assessment (Lab-continued)    
  - PIVM: flexion, extension, side bending and rotation    
  - Facet traction and glide
    
  - Rib traction and glide    
  - Disc traction    
3:30 3:45

Break    
3:45 4:15 Assessment (Lab-continued)
Muscle Testing		    
  - Strength testing    
  - Muscle tightness    
  - Segmental stability if hypermobile    
4:15 6:00 Treatment Lecture and Lab Soft Tissue Techniques    
  - Paraspinals    
  - Rhomboids; upper, middle and lower traps    

Downloads

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Course Brochure for A Systematic Manual Therapy Approach to the Thoracic Spine

Scheduled Dates and Locations

 

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Course Instructor
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Brian Nalazek, OMPT, PT, CWT, graduated with department honors with a Bachelor of Science in Physical Therapy from the Oakland University in Rochester, MI in 1990. He completed his orthopedic manual physical therapy residency program (based from the Kaltenborn/Evjenth Nordik System) in 1999. He received his certificate of completion from the IWA as a certified weight trainer in October of 2003. He is also in the process of completing his advanced masters degree in orthopedics. Brian combines his extensive orthopedic background to the systematic approach of his teachings. He has been educating in a variety of orthopedic topics for over eight years. Brian successfully set up an orthopedic clinic and has established a community network of physicians and therapists. He has set up a consistent referral base with local physicians due to the successful outcomes he obtains with his orthopedic clients.

Brian’s approach to orthopedic dysfunction combines an eclectic approach of joint mobilizations, muscle reeducation, manual therapy, exercise and education.
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