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Advanced Spinal Mobilization and Manipulation

Course Description

Many clinicians lack the confidence to perform HVLA techniques to the cervical spine and rib cage. We break each technique down and spend an excessive amount of time practicing to ensure you can safely and confidently perform these techniques in the clinic.

This course was designed to give the clinician a practical approach to advanced spinal mobilization and spinal manipulation. At the completion of this course, each participant should feel comfortable with advanced spinal techniques that they can begin using Monday morning. Course material will include an overview of anatomy, normal and abnormal biomechanics, evaluation of the spine, and techniques for advanced spinal mobilization and spinal manipulation. 

Clinicians will develop an understanding of when to choose a spinal mobilization versus a manipulation, and a proficiency in advanced spinal techniques. As with all of our manual therapy courses, this seminar will follow a progression of principles that will be reinforced throughout the 16 hours. This course is at least 75% hands-on lab.

This course is not open to PTAs per the American Physical Therapy Association's stance on performing mobilizations.


What people are saying!

Top Takeaways

  • Deep dive into how important speed is for a HVLA thrust and how small the movement is for the patient.
  • Extensive review of relevant research for HVLA thrust techniques to the upper and lower cervical spine.
  • Almost 2 full days of time to practice Mobilizations and Manipulations for the entire spine.

What makes this course great?

We provide an optimal learning environment for clinicians to master spinal manipulations, a technique that is often not utilized due to poor comfort and confidence within the clinician.   

Course Objectives

At the completion of this seminar, the participant will be able to:

  1. Correctly and independently state the anatomy and physiology behind a joint cavitation
  2. Correctly and independently identify and palpate three specific spinal levels the cervical spine
  3. Correctly and independently identify and palpate three specific spinal levels the thoracic spine
  4. Correctly and independently identify and palpate three specific spinal levels the lumbar spine
  5. Correctly and independently perform 3 cervical mobilization/manipulation techniques
  6. Correctly and independently perform 3 thoracic mobilization/manipulation techniques
  7. Correctly and independently perform 3 lumbar mobilization/manipulation techniques
  8. Correctly and independently perform 3 sacral/pelvic mobilization/manipulation techniques

Course Instructors

John Duncombe


John received his Master’s of Physical Therapy degree from the University of Wisconsin – Madison in 2001. He obtained his Doctorate in Physical Therapy through the Evidence in Motion Institute of Health Professions (EIM) while simultaneously finishing a 2 year Orthopedic Residency program with EIM. He is board certified as an Orthopedic Clinical Specialist from the American Physical Therapy Association. While at the University of Wisconsin he became a Certified Strength and Conditioning Specialist with the National Strength and Conditioning Association as well as a Golf Conditioning Specialist. John treats a vast array of outpatient orthopedic dysfunctions, looking at a wide variety of structures, tissues, and systems that may be contributing to the source of symptoms. His special interests are in post-surgical shoulder and knee patients, cervical-thoracic injuries, and runners with varying types of lower extremity dysfunctions. John currently works for Team Rehabilitation Physical Therapy and is the clinic director and owner of an outpatient orthopedic clinic in the northern suburbs of Chicago. When any free time presents itself, you can find him running the trails training for his next Ultra Marathon or spending time with his wife and 2 children.

John Duncombe

Course Outline



Continental Breakfast


Lecture: Introduction, Overview of Mobilizations vs Manipulations


Lecture: Key Concepts – Cervical Spine


Lecture: Key Concepts – Thoracic Spine


Lecture: Key Concepts – Lumbar Spine


Lecture: Key Concepts – Sacrum


Lunch (on your own)


Lab - Cervical Spine


Case Study - Cervical


Review Questions and Self-Assessment





Continental Breakfast


Review Questions


Lab: Thoracic Spine


Lab: Lumbar Spine


Lunch (on your own)


Lab: Sacral/Pelvic


Case Study - Lumbar


Review/Critique of Skill in Manipulation in Each Area





Course PDF

Course Brochure PDF