Course in Spinal Manipulations

Complete CPD Courses on Manipulation Techniques

I. CPD Intensive Course in Spinal Manipulations (Foundation Level)
II. CPD in Spinal & Peripheral Manipulations Techniques: Manipulative and Articulation Therapy Techniques for Peripheral Joints (Intermediate Level)
III. CPD in Spinal & Vertebral Manipulations Techniques: Manipulative and Articulation Therapy Techniques for Vertebral Joints (Advanced Level)

Video:
1. Craniocervical Manipulation Technique C0 C1 C2
2. Craniocervical Manipulation Technique C0 C1 C2
Video:
Selective Atlas Manipulation Technique with the pulp of the finger and very little strength

I. CPD Intensive Course in Spinal Manipulations (Foundation Level)

Course Certificate: 16 Hours of Clinical Practice

Requisites: Previous Study in Anatomy Physiology & Pathology, or study in Health Care Subjects, or Studies in Health Therapies, or any related subjects in any other suitable Health Discipline. This Training Course is suitable, and useful for any professionals in the field of Physical Manual Therapy such as those in the field of Physiotherapy, Osteopathy, Chiropractic, Orthopaedic, etc... Thus, Student of Physiotherapy, Student of Osteopathy, Student of Chiropractic, Students of Orthopaedics, Sports and Remedial Therapists, Student of Sports Therapists, and other Healthcare providers. Please let us know if you have any training, or study in any health field, or have worked in any health related areas. If in doubt, don't hesitate to contact us for any clarification on eligibility to attend.

Course Details

Dates: 4, 5 June 2026
Times: 8 to 17:00
Free Morning Coffee: 10 to 10:15
Free Lunch Buffet: 12 to 12:45
Free Afternoon Tea: 15 to 15:15
Course Fees: £500
Location: Manchester, England
Contact: Ingrid Betancourt
WhatsApp: +44 7436 036323
WhatsApp: +44 7839 280373‬
Email: ingridbetancourt@gmail.com
Professor: Dr Juan José Boscà, DO, Director of the Physiotherapy and Osteopathy Clinic J.J. Boscà, Spain.

     Course description

Course Syllabus

Articulation and Manipulative Techniques

One of the physiotherapy techniques that most attracts our attention when applying a treatment to our patients is undoubtedly spinal manipulation with impulse. From a clinical point of view, we have been applying these techniques to joints with a significant restriction of the range of joint amplitude to what we call hypomobility zones. But the approach to the most recent research studies of these techniques allows us to know more precisely all the benefits of their use.

Course Objective
1. The objective of the course is focused on learning to assess through palpatory diagnosis and examination the main indications for vertebral manipulation techniques of the cervical, thoracic and lumbar spine, as well as their contraindications.

2. To manage to integrate the manipulative techniques with the rest of the physiotherapy techniques in order to optimize the results of the physiotherapist's treatment.

3. The course is eminently practical, an attempt will be made to establish a correlation of its applicability in the most frequent pathologies, such as degenerative arthropathies or disc dysfunctions.

Training Objective
Make known the effects of spinal manipulation, as well as its Indications and Contraindications. Learn the anatomy and biomechanics of each vertebral segment for a correct application of the different manipulative techniques. Learn the optimal positioning of both the patient and the physiotherapist to optimize success in spinal manipulation with the least possible effort. Learn the repercussion and immediate clinical benefits of these techniques, such as pain reduction, the neurovascular reflex, the influence on posture and especially on the gain in joint movement.

Clinical Training
We will address all the general effects of spinal manipulation as well as its indications and contraindications, and in each seminar we will try to achieve all the established objectives of a general nature as well as those specific to each anatomical region.

A - GENERAL INFORMATION ON VERTEBRAL MANIPULATIONS
1. Effects, indications and neurophysiologic mechanism of vertebral manipulations.

• Effects of vertebral manipulations.

• Objectives that vertebral manipulation seeks.

• Manipulation and neurovascular reflex.

• Indications for spinal manipulation.

• Action mechanisms.

• Muscular reflex action of a manipulation.

• Mechanical action of vertebral manipulation.

• Cavitation effect of vertebral manipulation.

• Neurophysiological mechanism.

• Antalgic reflex action.

2. Contraindications of thrust techniques.

• Relative contraindications.

• Absolute contraindications.

• Post-manipulative reactions.

B - MANIPULATION OF THE LUMBAR SPINE
1. Anatomy of the articular facets.

2. Joint physiology and biomechanics of the lumbar interdiscosomatic segment.

3. Learning the positioning and parameters of the different techniques.

C - LUMBAR MANIPULATION TECHNIQUES

D - GENERAL INFORMATION ON VERTEBRAL MANIPULATIONS APPLIED TO THE DORSAL SPINE
1. Effects, indications and neurophysiologic mechanism of vertebral manipulations.
2. Contraindications of thrust techniques.

• Relative contraindications.

• Absolute contraindications.

• Post-manipulative reactions.

E - MANIPULATION OF THE DORSAL SPINE
1. Anatomy of the dorsal articular facets.

2. Joint physiology and biomechanics of the dorsal interdiscosomatic segment.

3. Learning the positioning and parameters of the different techniques.

F - BACK MANIPULATION TECHNIQUES
1. Direct techniques in prone position.

2. Sitting techniques.

3. Lateral decubitus techniques.

G - GENERAL INFORMATION ON VERTEBRAL MANIPULATIONS APPLIED TO THE CERVICAL SPINE
1. Contraindications of cervical thrust techniques.

• Relative contraindications.

• Absolute contraindications.

• Post-manipulative reactions.

2. Evaluation tests that contraindicate manipulation.

H - MANIPULATION OF THE MIDDLE CERVICAL SPINE
1. Anatomy of the cervical articular facets.

2. Joint physiology and biomechanics of the cervical interdiscosomatic segment.

3. Learning the positioning and parameters of the different techniques.

I - MIDDLE CERVICAL MANIPULATION TECHNIQUES
1. Techniques in the supine position.

2. Sitting techniques.

II. CPD in Spinal & Peripheral Manipulations Techniques

Manipulative and Articulation Therapy Techniques for Peripheral Joints (Intermediate Level)

Course Certificate 16 Hours of Clinical Practice

Requisites: I. CPD Intensive Course in Spinal Manipulations (Foundation Level) / or equivalent /or Student of any Healthcare Field Related to Physical Manual Therapy. This Training Course is suitable, and useful for any professionals in the field of Physical Manual Therapy such as those in the field of Physiotherapy, Osteopathy, Chiropractic, Orthopaedic, etc... Thus, Student of Physiotherapy, Student of Osteopathy, Student of Chiropractic, Students of Orthopaedics, Sports and Remedial Therapists, Student of Sports Therapists, and other Healthcare providers. Please let us know if you have any training, or study in any health field, or have worked in any health related areas. If in doubt, don't hesitate to contact us for any clarification on eligibility to attend.

Course Details

Dates: 6, 7 June 2026
Times: 8 to 17:00
Free Morning Coffee: 10 to 10:15
Free Lunch Buffet: 12 to 12:45
Free Afternoon Tea: 15 to 15:15
Course Fees: £500
Location: Manchester, England
Contact: Ingrid Betancourt
WhatsApp: +44 7436 036323
WhatsApp: +44 7839 280373‬
Email: ingridbetancourt@gmail.com
Professor: Dr Juan José Boscà, DO, Director of the Physiotherapy and Osteopathy Clinic J.J. Boscà, Spain.

     Course description

Course Syllabus

Peripheral Manipulations of the Upper and Lower Extremities

The purpose of this course is to introduce students to the main mobilization and manipulation techniques applied to the musculoskeletal system of the upper and lower extremities. This course serves to complement the training in Spinal Manipulations, so that we can have a more comprehensive view of musculoskeletal manual approaches, with high-velocity manipulations involving intra-articular cavitation taking the central role.

Objectives
1. To familiarize the student with the main syndromes or pathologies at the joint level that involve a decrease in mobility and/or joint pain, both in the upper and lower extremities.

2. To learn how to diagnose and identify the technical needs for mobilization or high-velocity manipulation.

3. To learn the Clinical Diagnosis for each joint to select the most appropriate technique.

4. To plan an integrative manual therapy strategy to optimize clinical outcomes, while always respecting Neurophysiology.

Neurophysiological Effects of Manual Therapy

Basic anatomy and biomechanics of the Upper Limb to apply high-velocity joint and manipulative techniques.

Diagnosis and Joint Treatment of the Upper Limb:

Shoulder

Elbow

Wrist and Hand

1. SHOULDER JOINTS:

Glenohumeral

Acromioclavicular

Sternoclavicular

Scapulothoracic

Exploration and diagnosis of the main dysfunctions of the shoulder girdle.

GLENOHUMERAL JOINT

a. Superior

b. Anterior

c. Inferior

Evaluation, diagnosis, and treatment of each dysfunction.

Manual therapy techniques in sitting, supine, and prone positions.

Options for manual grips.

Techniques for subacromial impingement in the lateral decubitus position and capsular retraction.

Radiology of the omohumeral line in cases of humeral head inferiority.

Myotensive telescopic technique and the fascial system of the shoulder girdle.

Articular techniques for glenohumeral and scapulothoracic joints.

Technique for glenohumeral joint de-coaptation.

Technique for treating rotator cuff and triceps muscles.

2. ELBOW

Anatomy

Biomechanics

Dysfunctions of the Radial Head:

Posterior dysfunction (posterior subluxation)

Anterior dysfunction (anterior subluxation of the humeral head)

Drill dysfunction (inferior subluxation of the radial head).

Manual therapy and main joint manipulations for each dysfunction.

Manual therapy and main joint manipulations for each dysfunction.

Valgus-varus dysfunctions of the elbow (internal and external laterality)

Manual therapy and main joint manipulations for each dysfunction.

Elbow joint techniques.

Muscle and myotensive techniques.

3. WRIST AND HAND

Anatomy and biomechanics.

Treatment of posterior subluxation of the radiocarpal joint.

Treatment of dysfunctions of the carpal bones and wrist.

Manipulative techniques.

Articulation techniques.

Manipulation of the trapeziometacarpal joint.

Basic anatomy and biomechanics of the lower limb to apply joint and high-velocity manipulative techniques.

Diagnosis and joint treatment of the Lower Limb:

a. Hip

b. Knee

c. Ankle and Foot.

Anatomy and biomechanics of the lower limb joints to apply mobilization and joint manipulation techniques.

4. HIP – COXOFEMORAL JOINT

Anatomy and biomechanics of the coxofemoral joint

Iliofemoral injuries.

Anterior rotation dysfunction of the coxofemoral joint.

Posterior rotation dysfunction of the coxofemoral joint.

Coaptation or compression dysfunction of the coxofemoral joint.

Femoroacetabular impingement test.

Faddir test.

2 Patrick-Faber tests.

Longitudinal manipulation technique of the coxofemoral joint in supine and prone positions.

Pincer lesions.

CAM lesions.

Telescopic techniques for external and internal rotation.

Manipulations for internal and external rotation of the coxofemoral joint.

Post-isometric relaxation techniques.

Stretching and post-isometric relaxation techniques in lower limb extension.

Iliofemoral manipulation technique in prone position.

Iliofemoral manipulation technique in supine position.

Global Articulation technique in circular movements.

5. KNEE

Anatomy and biomechanics of the knee joint.

Knee injuries.

Meniscal injuries.

Different types of tears.

Injuries to the superior femorotibial joint.

- Injury to the posterior aspect of the fibular head
- Injury to the anterior aspect of the fibular head

Diagnostic tests.

Manipulation technique for posterior fibular head injury with body drop.

Prone variant.

Manipulation technique for anterior fibular head injury.

Injuries of the femorotibial lateral aspect.

- Femorotibial valgus injury
- Femorotibial varus injury

Diagnostic tests

Manipulation technique for internal femorotibial block.

Manipulation technique for external femorotibial block.

Injuries of the anterior and posterior tibial plateau.

Evaluation – diagnosis and treatment.

Meniscal injuries

Diagnostic tests.

Apley compression test for meniscal tears.

McMurray test for meniscal tears.

Articular technique for meniscopathies.

6. FOOT AND ANKLE

Anatomy and biomechanics.

Foot and posture.

Biomechanical adaptations of the valgus and varus foot.

Dysfunction in tibio-tarsal compression.

Diagnostic tests for compression and decompression.

TUG technique for tibio-astragalian–tibiotarsal joint block.

Injuries of the inferior fibulotalar joint

Infero-external dysfunction of the inferior fibulotalar joint (anterior).

Diagnostic tests.

Whip technique for anterior fibula.

Whip technique for posterior fibula.

Supero-internal dysfunction of the inferior fibulotalar joint (posterior).

Anterior dysfunction of the tibia.

Tibio-astragalian mobility test.

Manipulation technique for anterior tibia.

Manipulation of the scaphoid.

Manipulation of the cuboid.

III - CPD in Spinal & Vertebral Manipulations Techniques

Manipulative and Articulation Therapy Techniques for Vertebral Joints (Advanced Level)

Course Certificate 16 Hours of Clinical Practice

Requisites: II. CPD in Spinal & Peripheral Manipulations Techniques, Manipulative and Articulation Therapy Techniques for Peripheral Joints - Intermediate Level / or equivalent /or Student of any Healthcare Field Related to Physical Manual Therapy; Or Students of Physiotherapy, Student of Osteopathy, Student of Chiropractic, Students of Orthopaedics, Sports and Remedial Therapists, Student of Sports Therapists. This Training Course is suitable, and useful for any professionals in the field of Physical Manual Therapy such as those in the field of Physiotherapy, Osteopathy, Chiropractic, Orthopaedic, etc... Please let us know if you have any training, or study in any health field, or have worked in any health related areas. If in doubt, don't hesitate to contact us for any clarification on eligibility to attend.

     Course description

Course Details

Dates: 8, 9 June 2026
Times: 8 to 17:00
Free Morning Coffee: 10 to 10:15
Free Lunch Buffet: 12 to 12:45
Free Afternoon Tea: 15 to 15:15
Course Fees: £500
Location: Manchester, England
Contact: Ingrid Betancourt
WhatsApp: +44 7436 036323
WhatsApp: +44 7839 280373‬
Email: ingridbetancourt@gmail.com
Professor: Dr Juan José Boscà, DO, Director of the Physiotherapy and Osteopathy Clinic J.J. Boscà, Spain.

Course Syllabus

Vertebral Manipulations

The Advanced Vertebral Manipulation course aims to improve the technique of Vertebral Manipulation, focusing the main objectives on:

Improve Manual Sensitivity and palpatory dexterity in the different regions of the Vertebral Column.

Learn to identify the main Mobility Dysfunctions of the Skull-Cervical, Cervico-Thoracic, Dorso-Lumbar and Lumbo-Sacral transition zones.

Learn the main Vertebral Manipulations of the Regions previously described.

Course Objectives
Today we have clear evidence of the important effects and benefits of Vertebral Manipulations. In addition, it improves the balance and homogenization of loads of the different joint planes on which we act with our techniques, which is why any Physiotherapist dedicated to the field of Manual Therapy should know these techniques to optimize the results of their treatments.

Program

1. TECHNIQUES OF THE CRANIO-CERVICAL REGION

a. Manipulation of Dysfunctions of the Occipito Atloid Joint

b. Manipulation of the Atlas

c. Atlo-Axoid manipulation

d. Manipulation in Cervical Skull Decompression

e. Aschmorl Cervical Skull.

F. Global Manipulation C0, C1 , C2

2. MANIPULATION OF THE LUMBO SACRAL REGION AND THE SACRAL

a. Traction manipulation with quik

b. push manipulation with quik

c. Sacrum Manipulation

3. MANIPULATIONS OF THE CERVICO-DORSAL TRANSITION ZONE C7 – D1 AND 1ST RIB

a. Manipulation of C 7 and D1 Sitting, Prone

b. 1st Rib manipulation. Supine, prone, sitting

4. MANIPULATION OF THE TRANSITION ZONE D12 – L1

a. Lumbar Roll Manipulation

b. Dog handling

c. Seated Manipulation (Bear Hug)

5. MANIPULATION OF THE RIBS

a. Manipulation of the Transverse Costo Joint (Dog and sitting position)

6. MANIPULATION OF THE PUBIS

Clinical Health Research

Spinal Manipulation Therapy

Spinal Manipulation Therapy (SMT) is a technique that treats back pain, neck pain and other musculoskeletal conditions via the application of force to the spinal joints, with the idea being that such treatment of dysfunctional areas in the spine can restore the spine’s structural integrity, reduce pain and initiate the body’s natural healing processes.

Manipulative Therapy Neuroscience

"Manipulative therapy refers to the application of various techniques to treat movement dysfunctions and alleviate pain in patients. These techniques are selected based on the evaluation of the patient's pain and movement signs, and can involve passive movements performed by the clinician or with active contribution from the patient. The therapy targets both the specific region of dysfunction and other contributing regions, aiming to restore proper movement and function. Care is taken to avoid provoking symptoms or causing harm, especially in cases of acute or severe pain." - in "Whiplash, Headache, and Neck Pain", 2008.

Is Spinal Manipulative Therapy Really Necessary?

"The answer is undoubtedly, yes. The most immediate and important effect of Spinal Mobilisation and Manipulation Therapy is the increase of range of movement at any joint to which the techniques are applied. The effectiveness of various procedures is based on the assumption that flow, or displacement of fluid, nucleus or sequestrum can occur within the intact annulus of the intervertebral disc as a result of prolonged or repetitive loading. Displacement most commonly, but not exclusively, occurs with flexion loading. To treat such displacements we must apply well-defined compressive forces, in order to reverse the direction of flow or displacement. Physiotherapists worldwide are now using Spinal Mobilisation and Manipulation Therapy as the main treatment for mechanical spinal disorders." - in "A Perspective on Manipulative Therapy", Physiotherapy, August 1989.

Efficacy and Effectiveness of Mobilization/Manipulation

"Published peer-reviewed research on the efficacy and effectiveness of mobilization/manipulation interventions provided by physical therapists has repeatedly demonstrated the effectiveness of such interventions for a variety of conditions and regions of the body." - in "Physical Therapists and Direction Of Mobilization/Manipulation", American Physical Therapy Association, September 2013.

Neurophysiological Effects

An experimental body of evidence exists indicating that spinal manipulation impacts primary afferent neurons from the erector spinae), the motor control system and pain processing.

Biomechanical changes caused by spinal manipulation are thought to have physiological consequences by means of their effects on the inflow of sensory information to the central nervous system

Central sensitisation (defined as an increased responsiveness of nociceptors in the central nervous system to either normal or sub-threshold afferent input) results in hypersensitivity to stimuli, responsiveness to non-noxious stimul and increased pain response evoked by stimuli outside the area of injury. Spinal manipulation may effect the central sensory processing by removing subthreshold mechanical or chemical stimuli from the erector spinae, so reducing this phenomena.

Muscle spindle afferents and Golgi tendon organ afferents are stimulated by spinal manipulation. These two components belong to the nervous system and function to influence movement, playing a role in flexibility.

Mechanical and chemical changes in the intervertebral foramen caused by a herniated intervertebral disc can affect the dorsal roots and dorsal root ganglia DRG (cells in the DRG act as sites of perception of a painful stimulus). It is not known if spinal manipulation directly affects these changes in the DRG. Individuals with herniated lumbar discs have shown clinical improvement in response to spinal manipulation.

Spinal manipulation is also thought to affect reflex neural outputs to both muscle and visceral organs. Substantial evidence demonstrates that spinal manipulation evokes erector spinae muscle reflexes and alters motoneuron excitability.

Contraindications

Contraindications to low back pain:

Any pathology that leads to significant bone weakening.

Neurological: cord compression, cauda equina compression, nerve root compression with increasing neurological deficit.

Vascular: aortic aneurysm, bleeding into joints.

Lack of diagnosis.

Patient positioning can not be achieved because of pain or resistance."

- in "Spinal Manipulation", Physiopedia 2025.

Manipulation Education Manual

Manipulation Education Manual For Physical Therapist, 2004

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