Seminar Description

SMT-1: High-Velocity Low-Amplitude Thrust Manipulation of the Cervical, Thoracic, Lumbar & SI Joints

TWO-DAY SEMINAR FOR PT, DO, or MD practitioners

C1-2 HVLA Thrust Manipulation

C4-5 HVLA Thrust Manipulation


This two-day seminar includes 70% hands-on practical training and 30% didactic lecture instruction.  The content of the seminar highlights the biomechanical principles and practical hands-on skills required to perform high-velocity low-amplitude (HVLA) thrust manipulation techniques in a competent and safe manner for all of the spinal regions.  Clinical case studies are presented for discussion of diagnosis and management based upon clinical reasoning and the best available empirical evidence.   Course tuition includes 110 page booklet with detailed description and pictures of all HVLA thrust techniques, current evidence underpinning the use of spinal manipulation in cervicogenic headaches, acute and chronic low back pain, sacroiliac joint dysfunction, and idiopathic neck pain.


At the completion of this course, participants will be able to:

  1. Describe the indications, precautions and contra-indications (relative and absolute) of high-velocity low-amplitude thrust manipulation.  Demonstrate pre-manipulative screening tests for cervical artery dysfunction (Vertebro-Basilar-Insufficiency) and upper cervical instability and understand their limitations.
  2. Improve the use of body and posture in application of high-velocity low-amplitude thrust, making them an integral part of technique delivery.
  3. Start combining leverages using multiple components in order to focus forces and build “mechanical barriers” at target motion segments.
  4. Develop the psychomotor skills necessary to appreciate the pre-manipulative barrier (end-feel) utilized in minimal leverage or momentum induced manipulative technique by concentrating on combining multiple leverages in order to minimize the overall amplitude and force required to achieve cavitation.
  5. Facilitate sound clinical reasoning processes behind the choice (or not) of high-velocity low-amplitude techniques and an appreciation of the current evidence base behind their application.
  6. Demystify the delivery of high-velocity low-amplitude thrust manipulation and develop an appreciation of its merits and limitations in every day clinical practice.
  7. Utilize clinical reasoning skills in the selection of high-velocity low-amplitude thrust manipulation techniques for a variety of neuromusculoskeletal dysfunctions.
  8. Demonstrate safe, competent and proficient performance of HVLA thrust manipulation techniques, including pre-thrust positioning and actual thrust application of mid and lower cervical, thoracic, rib, lumbar and sacro-iliac regions.
  9. Describe and demonstrate HVLA thrust manipulation for the junctional zones:  upper cervical, cervicothoracic, thoracolumbar and lumbosacral regions.
  10. Learn how to effectively diagnose and treat upper, mid, and lower cervical joint dysfunction, sacro-iliac joint dysfunction, lumbar spine facet syndromes, second and third rib syndromes, and cervicothoracic joint dysfunction.


Day One:

 7:45 am  Registration
 8:00  Indications, precautions, contraindications for use of HVLAT manipulation
 9:00  Cervical (C2-7) rotatory HVLA thrust manipulation technique 
 10:00  Break
 10:15  Cervicothoracic junction (C7-T3) HVLA thrust manipulation technique
 11:00  Evidence based diagnosis and management of cervicogenic headaches
 12:00 pm  Lunch (on own)
 1:00  Upper cervical HVLA thrust manipulation of Atlanto-Axial (C1-2) joint
 2:00  Evidence for use of HVLA thrust manipulation in acute and chronic LBP
 3:00  Break
 3:15  Mid-lumbar (L2-4) HVLA thrust manipulation technique
 4:00  1st rib HVLA thrust manipulation technique
 4:30  2nd & 3rd rib HVLA thrust manipulation technique
 5:00  Conclusion of day one

Day Two:

 7:45 am  Sign-in
 8:00  Upper thoracic (T1-3) HVLA thrust manipulation technique
 9:00  Cervical (C2-7) lateral-flexion translatory HVLA thrust manipulation technique 
 10:00  Break
 10:15  Lumbo-sacral junction (L5/S1) HVLA thrust manipulation technique
 11:00  Mid-thoracic (T4-9) HVLA thrust manipulation technique
 12:00 pm  Lunch (on own)
 1:00  Upper cervical HVLA thrust manipulation of Occipito-Atlantal (C0-1) joint
 2:00  Evidence based diagnosis of sacro-iliac dysfunction            
 3:00  Break
 3:15  Sacro-iliac joint HVLA thrust manipulation technique
 4:00  Thoraco-lumbar junction (T11-L1) HVLA thrust manipulation technique
 4:30  Rib 4-8 HVLA thrust manipulation technique
 5:00  Conclusion of course & issue of certificates