• Discuss the history behind the discovery of and development of releasing somatic dysfunction via positional release techniques via the work of Lawrence Jones, DO, George Goodheart, DC and others
• Discuss the basic concepts of how the body responds to stress and trauma  according to Irvin Korr and how slackening the dysfunctional muscle and joint tissues works to restore normal function.
• Apply anatomy and kinesiology as a means of finding and unwinding somatic dysfunction.
• Include the learned techniques into your practice.
• Compare and contrast the rapid thrust vs. positional release modes of releasing subluxations or somatic dysfunction. 

• Summarize the muscle spindle, specifically, the anatomy and physiology of the spindle subcomponents and how it regulates function of skeletal muscle.
• Breakdown the neural reflex mechanisms of the muscle spindle and appreciate how these mechanisms operate in both somatic function and dysfunction.
• Explain the hypothesis of the “facilitated segment” aka somatic dysfunction, explained both in terms of neurology and by analogies so as to be clear to both the doctor and the patient
• Identify somatic dysfunction via locating tender points and learn the mechanism of slackening in order to relieve the tender point reactivity and restore normal function to the muscle and joint.
• Identify and correct tender point locations and positional releases.

• Define and classify adverse events associated with manipulation and mobilization
• Review symptoms patients perceive as adverse
• Describe the incidence of severe adverse events among chiropractic recipients
• Outline adverse events in the pregnant and postpartum periods

Hour 1

• Review common hand, wrist and shoulder anatomy.
• Evaluate the hand write and shoulder.
• Perform physical and neurological examinations and tests related to hand wrist and shoulder.
• Identify uncomplicated common conditions during the evaluation of the hand wrist and shoulder

Hour 2

• Discuss evidence-based literature suggesting the practically of manipulation of the hand, wrist and shoulder.
• Perform adjustments of the hand.
• Perform adjustments of the wrist.
• Perform adjustments of the shoulder

Hour 3

• Describe the impact of disturbances on the determinant factors of health in the structures of the hand, wrist and shoulder
• Apply corrective and preventative measures to conditions affecting the health of the hand, wrist and shoulder
• Utilize evidence-based low technology rehabilitative methods to manage patient care of common hand, wrist and shoulder
• User strategies to address challenges patients have with adhering to rehabilitative programs.

Hour 1

• Review common foot and ankle anatomy.
• Evaluate the foot and ankle.
• Perform physical and neurological examinations and tests related to the foot and ankle.
• Identify uncomplicated common conditions during the evaluation of the foot and ankle.

 Hour 2

• Discuss evidence-based literature suggesting the practically of manipulation of the foot and ankle.
• Perform adjustments of the foot.
• Perform adjustments of the ankle.
• Utilize a speeder/toggle board for the foot.

 Hour 3

• Describe the impact of disturbances on the determinant factors of health in the structures of the foot and ankle
• Apply corrective and preventative measures to conditions affecting the health of the foot and ankle
• Utilize evidence-based low technology rehabilitative methods to manage patient care of common foot and ankle conditions.
• User strategies to address challenges patients have with adhering to rehabilitative programs.

• Examine the effect of chiropractic manipulation on reaction and response time in combat-ready special operations forces qualified personnel
• Assess the influence of chiropractic care on the strength, balance, and/or endurance in active-duty United States military personnel
• Evaluate the impact of upper- vs lower-extremity chiropractic manipulation on postural sway and dual task performance
• Provide an update regarding the mechanisms of action for manual therapy, the impact of manual therapy on pain management, health care conditions for which manual therapy may be beneficial and treatment plans

Hour 1

• Identify important spinal anatomy with relation to joint pain, degeneration and stabilization.
• Explain the efficacy of spinal manipulation (SM) for various clinical presentations
• Discuss current literature reviews regarding safety concerns and controversies with SM.
• Perform joint manipulative procedures to the spine and pelvis

 Hour 2

• Discuss common clinical anatomy related to the trunk and torso, with practically to joint manipulation.
• Examine the thoracic and lumbar spine through important clinical landmarks and topical anatomical structures.
• Perform alternative manipulative procedures to the spine and pelvis

 Hour 3

• Discuss common clinical anatomy related to the head, and neck.
• Examine the cervical spine through important clinical landmarks and topical anatomical structures.
• Perform joint manipulative procedures for cervical spine.
• Perform manipulative and mobilization procedures to the temporomandibular joints.

• Identify a sub-group of recurrent low back pain patients that might respond most favorably to a maintenance care schedule
• Summarize existing research literature on chiropractic maintenance care
• Investigate short-term changes in pain-pressure threshold (PPT) and temporal summation (TS) after lumbar spinal manipulation (SMT) compared to a credible sham intervention
• Determine whether cervical spinal manipulation leads to meaningful changes in vertebral and cerebral hemodynamics, compared to neutral or end-range neck rotation postures in adults with chronic neck pain
• Summarize the current state of the literature regarding the neurophysiological effects of high-velocity, low-amplitude spinal manipulative therapy (HVLA-SMT) in asymptomatic and symptomatic humans
• Critique the existing, sham-controlled literature evaluating the acute changes in autonomic nervous system (ANS) markers and function in patients receiving manipulation to spinal or peripheral joints

• This contains all courses with the educational objectives listed from Manipulation 117 through Manipulation 122

• Critique the state of the evidence for manual therapy interventions in the treatment of cervical radiculopathy
• Compare two common interventions – spinal manipulation and nerve root injection – for patients with MRI-confirmed lumbar disc herniation
• Critique the state of the evidence for spinal manipulation (specifically) in the treatment of cervical radiculopathy
• Interpret the results of a cohort study of MRI-confirmed symptomatic cervical disc herniation patients treated with cervical manipulation
• Compare isolated cervical SMT versus a combination of cervical, cervico-thoracic and thoracic SMT in patients with chronic mechanical neck pain

• Compare the efficacy of standard medical care (SMC) alone versus chiropractic spinal manipulation + SMC for acute low back pain patients
• Discuss the value of a combined (pragmatic) chiropractic approach for treating low back pain
• Analyze the state of the research literature directly comparing spinal manipulation, exercise and acupuncture as treatments for low back pain
• Update your understanding of joint cavitation during side posture lumbar manipulation
• Critique the only study (to date) on maintenance care for low back pain including spinal manipulation

• Outline the limitations of a recent trial on preventive treatments including spinal manipulation for neck pain and how they contribute to our interpretation of the results of the study
• Interpret results of an important trial on spinal manipulation and exercise for neck pain
• Discuss recent evidence comparing spinal manipulation to mobilization for recent onset neck pain
• Use recent evidence to justify manipulating various spinal regions for patients with neck pain
• Critique the potential for chest and neck mobilizations to affect spirometric performance (breathing)

• Describe spinal manipulation use by time, place, and person, identify predictors of the use of spinal manipulation
• Review cost-effectiveness of SMT compared to other treatment options for people with spinal pain of any duration
• Describe the current literature on patient-centered outcomes following a specific type of commonly used SM, high-velocity low-amplitude (HVLA), in patients with LBP
• Review the putative mechanical features of the subluxation and three theories that form the foundation for much of chiropractic practice

• Determine the effect of chiropractic on movement time
• Assess the effects of spinal manipulation and ultrasound on chronic low back pain
• Describe heart rate variability as a measurement tool
• Assess the effects of chiropractic on heart rate variability