Course Introduction

Presentations of the thoracic spine and ribs are frequently associated with altered movement, whole-body alignment and impaired respiratory function. They are widely recognised as being challenging to evaluate and manage. This course demonstrates innovative techniques for assessing uncontrolled movement associated with thoracic spine and rib presentations. It covers the evaluation and mobilisation of thoracic and rib dysfunctions while exploring cognitive movement control strategies.

Course Outline

Pain in the thoracic and rib region is often related to unwanted changes in the function of the costo-vertebral, cervico-thoracic, scapulo-thoracic and thoraco-lumbar regions. Successful management requires clinicians to recognise this complexity and follow a systematic assessment process to guide intervention. This assessment considers not only articular and myofascial restrictions but also the compensatory movement patterns that develop throughout the movement system. It also includes assessment for the presence of uncontrolled movement (UCM).

This intensive two-day course reviews the functional anatomy of the thorax. Functional classification of thoracic musculature is presented, identifying both local and global role synergy systems. Based on a systematic assessment and interpretation of each individual’s presentation, an integrated treatment approach is introduced. The course details retraining of both local and global role systems for the thoracic spine and rib cage, emphasising rehabilitation strategies based on a structured clinical reasoning framework. The programme is highly practical, using patient demonstrations wherever possible to develop hands-on assessment and movement retraining skills.

Key Features

• Positional diagnosis of thoracic and rib compensations associated with thoracic restrictions.
• Functional anatomy and classification of thoracic musculature, including local and global stabiliser role synergies.
• Application of muscle energy-based manual mobilisation techniques to address movement restrictions.
• A systematic and logical assessment process leading to integrated, individualised treatment plans.
• Retraining of movement impairments across three progressive levels.
• Direction-specific control of the site and direction of uncontrolled movement.
• Local stabiliser role synergist retraining to control thoracic and rib translation.
• Understanding the influence of inefficient recruitment between muscle synergists.
• Rehabilitation of both local and global movement control systems of the thoracic spine, with an emphasis on sound clinical decision making.

Learning Outcomes

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

• Demonstrate an understanding of the proposed development of uncontrolled movement.
• Analyse the relationship between movement restriction and compensatory changes within articular and myofascial tissues.
• Palpate the thoracic spine and rib cage to make a positional diagnosis of thoracic and rib compensations associated with restriction.
• Demonstrate manual techniques to mobilise thoracic and rib restrictions.
• Clinically assess movement strategies to identify the site and direction of uncontrolled movement and implement appropriate retraining strategies.
• Assess and rehabilitate local stabiliser role synergist recruitment efficiency within the thoracic spine.
• Discuss the influence of altered global role muscle synergies on thoracic movement and function.