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The Lumbar Spine: From Manipulation to Stabilization and Everything In Between
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Jeff Schmidt, PT, OCS, SCS, MTC, Cert. DN

Scott Brown, PT, DPT, OCS, SCS, Cert. DN

Course Description:  

Low back pain (LBP) accounts for 3% of all physician visits annually in the United States with direct healthcare costs estimated to be over 85 billion dollars.1, 2  Additionally, patients with low back pain make up the largest group of people seeking care from a physical therapist.3  This course focuses on evaluation and management of lumbar spine disorders based on the strongest and most recent medical and physical therapy evidence.  Because manipulation is under-utilized by physical therapists despite high-level evidence to support its use, 4,5 several applications and techniques will be emphasized.   This 15 hour course will include a combination of lecture, demonstration and lab that will prepare the attendees to more effectively treat lumbar spine disorders.  Credit hours are approved from the MN and ND Boards of Physical Therapy.


  1. Deyo RA, Mirza SK, Martin BI.  Back pain prevalence and visit rates: estimates from U.S national surveys, 2002.  Spine (Phila Pa 1976). 2006;31:2724-2727., brs0000244618,06877cd.
  2. Martin BI, Deyo RA, Mirza SK, et al.  Expenditures and health status among adults with back and neck problems. JAMA. 2008; 299: 656-664.
  3. Jette AM, Smith K, Haley SM, Davis KD.   Physical therapy episodes of care for patients with low back pain.  Phys Ther. 1994;74(2):101-110.
  4. Jette AM, Delitto A. Physical therapy treatment choices for musculoskeletal impairments. Phys Ther.


  1. Delitto A, George SZ, Van Dillen L, et al.  Clinical guideline: low back pain.  JOSPT. 2012; 42 (4): A1-A57. Doi:10.2519/jospt.2012.0301


Course Objectives:

  1. Apply the treatment-based classification system to patients with low back pain
  2. Understand red and yellow flags associated with low back pain and appropriate referrals
  3. Learn the principles of manipulation including general rules
  4. Demonstrate competence in thoracolumbar manipulation techniques
  5. Develop and evidence-based stabilization program
  6. Demonstrate competence in lumbar manual distraction techniques in multiple positions
  7. Become familiar with indications for lumbar imaging and pitfalls associated with over-utilization
  8. Correlate examination findings with an impairment-based treatment model for lumbar spinal stenosis
  9. Recognize unique aspects of chronic low back pain and the clinical implications
  10. Discuss post-operative rehabilitation for lumbar surgical procedures


Day 1

Morning Session

8:00-8:45    What Does Evidence-Based Practice Really Mean?

8:45-9:30     Practical Lumbar Examination

9:30-10:30   Treatment Based Classification for Patients with LBP

10:30-10:45  Break

10:45-11:30  Exercise for the Patient with LBP

11:30-12:00  Exercise Lab and Brainstorming

12:00-2:00    Lunch (extended for SDPTA Board Meeting)

Afternoon Session

2:00-2:15     Morning review, questions

2:15-3:00     Lumbar Mobilization and Manipulation Evidence Update 

2:00-3:00     Lumbar Mobilization and Manipulation Lab

3:00-3:15     Break

3:15-4:00     Considerations for the Patient with SI Joint Pain

4:00-5:00     SI Joint Special Tests and Mobilization


Day 2

Morning Session

8:00-8:15     Day 1 Review

8:15-8:45     Lumbar Imaging: Harmful or Helpful? 

8:45-9:30     Lumbar Technique Round Robin 

9:30-10:00   Traction/ Spinal Unloading

10:00-10:15  Break 

10:15-10:45  Spinal Unloading Techniques: Lab

10:45-11:15  Directional Preference 

11:15-12:00  Thoracic techniques for the Patient with LBP

12:00-12:30   Lunch

Afternoon Session

12:30-12:45   Morning review, questions

12:45-1:30     The Hip and Low Back Pain 

1:30-2:30       Hip Mobilization Lab

2:30-4:00      Thoracolumbar Review and Skill Practice

4:00-5:00       Education for the Patient with LBP


Credits: 15 contact hours



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