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Aim & objectives ~


  • An Exploration of the Combined Movement Approach:

This course aims to provide participants with an opportunity to explore the treatment of spinal dysfunction using the Combined movement concept of treatment advocated by Dr Brian Edwards. This concept offers participants a rational way to select patient presentations suited to this method of treatment and a clinically reasonable way of incorporating manipulative thrust and end of range mobilization techniques into a passive movement treatment approach. The philosophy of the course is to facilitate the learning of participants by encouraging self directed exploration of the issues and avoidance of a didactic teaching style.


  • Selection of Type and Position of Treatment:

This course does not set out to provide participants with a handful of manipulative thrust techniques rather encourages participants to develop skills in the selection of mobilisation and manipulation techniques in the appropriate clinical scenarios. An important tenant of this course is the emphasis on CMT being a component of a holistic approach to spinal dysfunction and not that this approach is the panacea to all spinal pain.


  • The Development of Practical Handling Ability:

The course contains a large component of practical skill development however this element is grounded in the theoretical background of analytical assessment, validity of technique and risk /benefit. Before participants begin palpating the rational behind techniques are discussed.


  • Development of Clinical Reasoning Skills:

Participants will know when, where and how to achieve the benefits of effective mobilisation and manipulation. More importantly they will know why they would consider this approach and what they should expect from it.


Learning Outcomes of the Course

On completion of the courses participants will be able to;

  • Clinically reason what patient presentation type should be suited to the CMT approach.

  • Have developed the skills to determine primary movement patterns suggesting source structures and corresponding starting positions for treatment.

  • Developed skill in palpating the cervical spine anteriorly, and the rest of the spine posteriorly. The participant will be able to palpate muscle spasm and passive joint restriction.

  • Clinically reason the decision of when to mobilise and when to manipulate a spinal joint. Appreciate the complexities of the issues surrounding pre-manipulative screening and the risk/benefits of end of range mobilisation and SMTT’s.

  • Appreciate the evidence base behind mobilisation and manipulation in the treatment of spinal dysfunction.

  • Clinically reason progression and regression of treatment and be conversant with the notation of treatment.





9:00    Lecture: Introduction to COMBINED MOVEMENT Theory and Spinal Manipulation

10:00  Coffee

10:15 Practical: Examination of the Lumbar spine and SIJ

11:45  Practical: PAIVMS and PPIVMS (Grade IV+ mobilisation)

13:30  Lunch

14:00  Practical: Muscle Energy / PNF Techniques

15:30  Lecture: Spinal Manipulation – effects, effectiveness and objectives

16:00  Practical: Grade IV- Spinal Manipulation

17:00  Recap / Clinical Reasoning

17:30  Certificates – Photographs - Finish



Reference Material:


  • McCarthy, CJ (2001) Spinal manipulative thrust technique using combined movement theory. Manual Therapy: 6(4), 197-204.

  • McCarthy CJ (2003) Spinal Manipulative Thrust Technique Using Combined Movement Theory. In: Beeton,K.,  Manual Therapy Masterclasses: The Vertebral Column. Churchill Livingston, Edinburgh ISBN 978-0-443-07403-5

  • Potter,L., McCarthy C.J., Oldham, J.A. (2005) A Review of the Proposed Theories of the Physiological Effects of Spinal Manipulation. Physical Therapy Reviews. 10, 163-170.

  • McCarthy CJ (2006) Priorities for research into the neurovascular complications of cervical spine manual therapy. Manual Therapy. 11, 85-86

  • Kerry R, Taylor AJ, Mitchell J, McCarthy CJ (2008) Cervical arterial dysfunction and manual therapy:  A critical literature review. Manual Therapy 13(4) 278-288.

  • Kerry R, Taylor AJ, Mitchell J, Brew J, McCarthy CJ (2008) Manual Therapy and Cervical Artery Dysfunction – Directions for th Future. Journal of Manual and Manipulaive Therapeutics 16(1) 39-48.

  • McCarthy CJ (2010) Combined Movement Theory: Rational mobilization and manipulation of the vertebral column. Elsevier Science: Oxford UK ISBN: 978-0-443-06857-7. See

  • Stamos I, Heneghan N, McCarthy CJ, Wright C. (2012) Inter-examinaer reliability of active combined movements assessment of subjects with a history of mechanical neck problems. Manual Therapy 17:5, 438-444

  • McCarthy CJ (2013) Manual Therapy and Pain Perception. In. Pain: A Textbook for Therapists. Ed. Van Grievsen. Elsevier Healthscience. Oxford.UK

  • McCarthy CJ, Bialowsky J, Rivett D (2014) Manipulative Therapy. In Grieve’s Modern Musculoskeletal Therapy. Ed. Jull G, Moore A, Falla D, Sterling, Lewis J, McCarthy CJ. Elsevier Healthscience. Oxford UK.

  • Jull G, Falla D, O’Leary S, McCarthy CJ (2014) Idiopathic Neck Pain. In Grieve’s Modern Musculoskeletal Therapy. Ed. Jull G, Moore A, Falla D, Sterling, Lewis J, McCarthy CJ. Elsevier Healthscience. Oxford UK.

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