Manual Therapy Forum


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Manual Therapy Foundations: Clinical Reasoning for Direct Access Including Safety, Palpation, and Tests – Anaheim, CA

Well, this post is a little late, but better late than never!  The weekend of May 4-6 I had the pleasure of flying down to Anaheim, CA to teach Manual Therapy Foundations:  Clinical Reasoning for Direct Access Including Safety, Palpation, and Tests at California Rehabilitation & Sports Therapy for Comprehensive Manual Therapy Seminars (CrunKeyser, LLC).  The course host, Jeremy Simmons, is a colleague (and dare I say pal) through the Institute of Physical Art and is always a good guy to spend time with.

I love teaching this course because we get to delve deep into anatomy, biomechanics, and safety screening for the spine, ribcage, and pelvis.  Honestly, instructing manual therapy these days seems to be getting more difficult if you’re trying to pass on an artform, or craft, instead of reciting data points from research and giving generalized treatments of mobilization or manipulation.  Hopefully, those in attendance picked up on some of the things we were trying to impart and gain an appreciation for this craft we call manual therapy.

Oh yeah, Jennifer from Cal Rehab set up an awesome celebration of Cinco de Mayo for us all.  So, thanks Jennifer!  And thanks to everyone that came out to take the course!

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Four days in San Francisco

Recently, I got to spend four days in San Francisco with Rachael (a physical therapist… and my wife) and Ray (you may remember him from here, here, and here).  We were all attending Visceral Manipulation 3:  The Pelvis presented by the Barral Institute.  The instructor, Peter Coppola was fantastic.  You may also remember a conversation I had with Gail Wetzler previously where we mentioned some of these courses.

The material covered is exactly what it sounds like (except for the manipulation part… we are not doing high-velocity thrust techniques on organs).  These courses are pretty fascinating because of the amount of detailed anatomy they cover… way more than we’re taught in school.  The amount of skill it takes to perform some of these techniques is impressive, as demonstrated by the instructor.  It may sound hokie from just thinking about it, but the courses are usually paired with before-and-after measurements (i.e. physiologic range of motion) that demonstrate what we just did in a lab really made a change in the patient’s body.  Overall, would certainly recommend manual therapists check them out and consider attending a seminar if interested.

Oh yeah, we got to eat at the famous House of Prime Rib, so there are some pictures of that too.  I’d also highly recommend dining there if you ever get the chance!

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Timothy W. Flynn, PT, PhD, OCS, FAAOMPT



“The noiseless, painless, restoration of maximum function.”

– Tim Flynn quoting Paul Kimberly, DO, FAAO for his definition of ‘manipulation’



Passion for the patients that we are able to work with… curiosity… humbleness… an open mind… and a commitment to always improve your skill set.

– Tim Flynn



The thoracic spine and ribcage… at the end of the day, breathing and dialing down the sympathetic nervous system is a game changer for the vast majority of patients.  So, if your thoracic spine and ribcage is not mobile, you cannot breathe.

– Tim Flynn



Today, we have the fortune to speak with Tim Flynn.  Tim is a well known figure in manual therapy, research, and education.  He is a former military man as well.  While Tim has received extensive training in traditional forms of manual therapy, and is open about how his overall manual therapy approach has evolved with reseearch findings over the years.  Recently, Tim has been an amazing advocate for our profession to be the front line of musculoskeletal care, especially as the opioid epidemic has become fully exposed for what it has done to patients.  Tim shares his wisdom with years of experience in multiple areas of physical therapy and manual therapy.  I hope you enjoy this time with Tim!



Pain does not equal damage.

– Tim Flynn



Never underestimate the power of the medical system to make you worse.

– Tim Flynn



Yes, we get together at conferences such as AAOMPT, CSM, etc.  We get together and that should nourish us, but if we’re only talking amongst each other we’ve literally failed to do what we’re called to do.  We should spend 95% of our time talking outside our profession and 5% of time within.  And of that 5% maybe arguing about 0.5% and the other 4.5% of that collaberating on how we’re gonna make this dysfunctional thing we call a heatlhcare system better for society.

– Tim Flynn



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Links of interest:

Michigan State University – College of Osteopathic Medicine

Colorado In Motion

Evidence In Motion

American Academy of Orthopaedic Manual Physical Therapists

South College

Baylor University

Pain Neuroscience Education

Tim Flynn (twitter)

Pain Reframed Podcast




Regaining Flexion/IR of the Hip



Ever have a patient with problems going into a deep squat (or even normal squat for that matter)?  What about someone having hip impingement?  Or just groin pain when sitting to prolonged periods of time?  The list could go on and on.  Usually, a lot of these patients improve well with regular mobilizations of functional mobilizations on and around the hip.  However, I’ve noticed that sometimes, there are other patients that don’t respond as well.  They tend to be the same patients with limited internal rotation while in a flexed hip position.  After playing around with it and thinking about the mechanics, I’ve started using this mobilization in the clinic and it seems to work really well.  Take a look and tell me what you think…