This blended online/onsite course is designed to provide the clinician with the skills to diagnose common thoracic spine pathologies, determine the necessary precautions and contraindications and design comprehensive treatment plans incorporating manual therapy, neurodynamics, pain neuroscience education and exercise.

Additionally, this course will blend pain neuroscience with manual therapy, providing a unique pain science view of thoracic spine disorders. New and updated clinical pathology of the thoracic spine, along with pain science form the framework from whichthoracic spine pathologies and pain patterns are discussed. Physical therapy treatments, as well as medical interventions and diagnosis will be discussed in relation to the new and updated research information.

The material covered in this course is immediately applicable in the clinic. Topics include common conditions such as disc lesions, nerve root pain, facet joint injuries, aging, spinal stenosis, rib dysfunctions, osteoporotic compression fractures, thoracic outlet syndrome and more. Clinicians will be instructed in safe and effective handling skills during the evaluation and treatment of the thoracic spine. Treatments covered include pain neuroscience education, joint mobilization, neural tissue mobilization, soft tissue treatment, trigger point therapy, spinal stabilization and more.

This course is open to physical therapists.


This course is delivered in a blended learning fashion, combining online and on-site learning experiences to facilitate participant learning. An interactive and media-rich online pre-course is provided to participants 30 days in advance of an intensive one-day on-site laboratory weekend.

The online pre-course provides an evidence-based overview of the management of thoracic disorders using a series of 12 web-based video presentations (30 minutes each), key evidence summaries, hand-outs and primary research articles. The pre-course provides the necessary foundation needed to execute the physical tests and treatments associated with the weekend intensive class.

The on-site lab intensive day provides participants with hands-on demonstration and practice of selected examination and manipulative techniques for the thoracic spine. A heavy focus is placed on the skill development and proficient use of mobilization, and manipulation interventions for this area of the spine. An online post-test and on-site skill assessment is used to reinforce course objectives and assess learning.

Successful completion of this course requires 80% or higher on post-test, instructor feedback and attendance at each onsite day.

Target Audience:  Intermediate level course open to licensed physical therapists

Credits: 20 contact hours (12 online and 8 on-site) from EIM Institutes of Health Professions

Prerequisites: None

Appropriate dress: Participants are asked to bring appropriate attire for lab sessions (i.e. shorts and t-shirts and sports bras for women) and air-conditioned environments throughout the day (i.e. warm-up or work-out clothes).


Upon completing this course, you’ll be able to:

  1. Identify and perform key elements of the cervical spine subjective and objective clinical examination, with particular emphasis on active and passive motion testing, clinical reasoning, differential testing and special tests.
  2. Synthesize and analyze data from the thoracic spine clinical examination based on signs and symptoms within a pain science paradigm.
  3. Determine a diagnosis and use sound clinical reasoning and pain science to guide patient/client management.
  4. Engage in the diagnostic process to establish differential diagnoses across systems and across the life span.
  5. Utilize a consistent clinical process to effectively screen for systemic disease and non-musculoskeletal pathology in patients with thoracic, cervical and shoulder pain.
  6. Justify the selection of manual therapy techniques, pain science education or integrated exercise using clinical reasoning and application of current best evidence.
  7. Perform selected cervical mobilization techniques in patients with thoracic pain or dysfunction when found justified.


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