TM2: Thrust Manipulation 2 – Upper Extremity & Advanced 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 upper 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.

  • Independently perform a Cervical Assessment screen using evidence based techniques.
  • Defend the use of a thrust manipulation technique with current evidence.
  • Correctly describe the scope of practice for thrust manipulation in the participant’s licensed state
  • List 5 contraindications to thrust manipulation.
  • List 5 indications for the use of thrust manipulation techniques.
  • Independently perform a lumbar assessment for appropriateness of thrust manipulation.
  • Independently describe the APTA and AAOMPT positions on thrust manipulation.
  • Correctly perform a thrust manipulation technique reviewed in the course given a body region.
  • Given a case example, independently integrate appropriate thrust manipulation as part of a comprehensive treatment program.
  • Independently describe 2 legal and ethical issues related to thrust manipulation.


Day One

  • 7:30-8:00 Breakfast
  • 8:00-8:30 Lecture: Course Introductions, Objectives, and Pre-Test
  • 8:30-9:00 Lecture: Brief Review of Manipulation History and Scope Considerations
  • 9:00-10:00 Lab: Review and Refinement of Basic Spine Techniques and UE Techniques
  • 10:00-10:30 Lab: Review and Refinement of Basic Spine Techniques and UE Techniques: continued
  • 10:30-11:30 Lecture: Upper Cervical Risk Assessment: Evidence Review
  • 11:30-12:00 Lab: Upper Cervical Risk: Practical Assessment Strategies
  • 12:00-1:00 Lunch on your own
  • 1:00-2:00 Lab: Cervical Assessment and Techniques
  • 2:00-3:00 Lab: Cervical Assessment and Techniques: Various Patient Positions
  • 3:00-4:00 Lecture: Mobilization versus Manipulation Discussion
  • 4:00-5:00 Lab: Shoulder Assessment and Techniques
  • 5:00-5:30 Lab: Technique Review and Rapid-Fire Practice

Day Two

  • 7:30-8:00 Breakfast
  • 8:00-9:00 Lab: Thoracic/Rib Cage Assessment and Techniques
  • 9:00-10:00 Lab: Thoracic/Rib Cage Assessment and Techniques: Various Patient Positions
  • 10:00-11:00 Lab: Lumbar Assessment and Techniques
  • 11:00-12:00 Lab: Round Robin: Review of Techniques
  • 12:00-1:00 Lunch on your own
  • 1:00-2:00 Lab: Junctional Zones (Cervicothoracic, Lumbopelvic, Thoracolumbar Junction) Assessment and Techniques
  • 2:00-3:00 Lecture: Scope of Practice and State Practice Act Discussion
  • 3:00-4:00 Lab: Other Upper Extremity Assessment and Techniques
  • 4:00-4:30 Lecture: Patient Case Example
  • 4:30-5:00 Lab: Rapid-Fire Practice, Skills check
  • 5:00-5:30 Lecture: Q&A, Course Wrap Up- self reflection


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Currently, there are no TM2: Thrust Manipulation 2 – Upper Extremity & Advanced Spine courses available. Please contact us for more information or to request a course.

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