Kim Robinson and Toby Hall are the coordinators and course developers. They have almost 50 years combined clinical experience and have taught manual therapy at an advanced post graduate university level as well as to physiotherapists around the world over the last 20 years. Toby and Kim are the educators for the program and guide participants through the comprehensive syllabus.

The course will cover the anatomical and functional basis to the evaluation of pain disorders of the spine. Of special interest will be clinical practice, emphasizing clinical examination, evaluation, interpretation, differential diagnosis and therefore classification and treatment. Classification of spinal pain disorders and subsequent sub-category based treatment strategies is the way forward in manual therapy, and there is increasing evidence to support this.

This course will be conducted in lecture, tutorial and workshop format for the clinician or academic who is interested in manual therapy, manual medicine or musculoskeletal medicine. It is anticipated that the course content will be suitable to individuals who are seeking new knowledge, to individuals seeking to expand their knowledge and to those individuals seeking the stimulation of clinical interaction. Whilst the course will be presented at a high level this should not be seen as a barrier to participation for those with little or with no previous experience in this special area. As a result of attending the course it is anticipated that participants will gain personal satisfaction as in a variety of ways that will enhance their individual requirements. There are therefore no pre-requisites for participation.

This syllabus will cover in detail the cervical, thoracic and lumbar spine regions with appropriate consideration of the shoulder girdle and pelvis.
Participants are provided with pre-course reading material and an extensive course manual to cover all aspects of the programme.
Varied teaching formats including powerpoint presentations, video and practical demonstrations facilitate the learning and clinical reasoning processes.

1. Anatomy, pathoanatomy, age related changes and biomechanics of the spine.

2. Regional assessment of the spine and pelvis.
o Obtain relevant information from the subjective history.
o Analyse posture types and the relationship of posture
o type to normal movement and specific spinal dysfunction
o Movement analysis and how this relates to specific spinal dysfunction.
o Clinical pattern recognition.
o Clinical reasoning.
o Physical examination procedures aimed at the joint, neural and muscle systems.
o Use of case histories, video, written and role play.
o Technique demonstration with closely supervised practical sessions.
o Evidence based practice.
o Clinical technique application.

3. Development of appropriate diagnostic specific treatment and management strategies and appropriate treatment technique application.
Varied teaching formats including powerpoint presentations, video and practical demonstrations facilitate the learning and clinical reasoning processes.

Course Philosophy
This manual therapy programme is aimed at merging the examination of the joint, muscle and neural systems into an integrated wholistic examination procedure. We place strong emphasis on teaching clinicians the ability to perform an accurate and specific manual therapy examination. The examination process developed by Manual Concepts draws on the work of Edwards, Monaghan, Elvey, O'Sullivan, Lee, Jull, Maitland, Mulligan and Mckenzie among others. We believe that the merger of various manual therapy approaches and techniques into one concept provides a more realistic, multifactorial approach to the examination and treatment procedure.

Joint System
As part of the assessment of the joint system we aim to teach a range of passive motion testing procedures to include provocative tests for specific structures as well as tests to determine specific motion segment dysfunction. Categorizing dysfunction into joint hyper or hypomobility is a basic requirement for diagnosis of the nature of the spinal disorder. A significant aspect of the assessment procedure is the use of combined movements as developed by Brian Edwards. Equally important is the use of specific passive segmental motion testing and provocative tests for pain reproduction.

Neural System
Neural tissue dysfunction is an important aspect of the physical examination. A comprehensive overview of neural tissue pain disorders, particularly with respect to recent developments in the understanding of pain physiology and neuropathic pain are developed. Assessment procedures and differential diagnosis for three types of neuropathic disorders are presented; nerve trunk sensitisation with axonal mechanosensitivity; denervation and axonal compromise; neuropathic pain associated with denervation and significant central and peripheral pain mechanisms. The clinical relevance of classifying neuropathic disorders into three sub-groups is in relation to providing appropriate treatment or management. Neural mobilisation techniques should only be used under appropriate circumstances. Case studies are presented to illustrate the classification process.

Muscle System
An emphasis of this programme is a functional approach to the assessment of the spinal muscle system and motor control. As well we address the theoretical concept of spinal instability and the signs and symptoms that are commonly found on clinical examination, including assessment procedures for the local muscle system. It is important to understand that not all patients require motor control retraining. There is ample evidence to suggest that only a small proportion of patients with low back pain have instability. Treating all chronic low back pain patients with stabilisation exercises involving multifidus and transversus abdominis is not appropriate and the literature shows this does not work. Determining which patients need a muscle retraining approach is an important part of this programme. Classification of spinal pain disorders into specific sub-groups is the latest hot topic in musculoskeletal medicine, in particular manual therapy. This course will teach participants how to identify patients with motor control impairments and classify these into specific sub-groups that can be managed with appropriate retraining. A systematic graded, functional approach to the management of patients with spinal motor control impairment will be taught.
This programme does not provide the participants with a recipe approach to treatment. Students will be able to develop though sound methodology, appropriate treatment strategies with logical progression over time.