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MASTERING THE SHOULDER™
SERIES

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THE SPINE

MTS™ LEVEL 5

THE SPINE takes an advanced look at manual therapy techniques, stability training and integrating spinal rehabilitation for solving chronic shoulder pain.


A must do course for those looking to offer specialty practice in upper quadrant disorders.


Introduction

THE SPINE completes the MTS™ Series offering a unique and detailed course for solving complex upper quadrant complaints in clinical practice.


Approximately 30% of  shoulder pain patients presenting to specialty MSK practice require integrated spinal manual therapy and exercise strategies for a successful outcome. 


Day 1 begins with a review of applied anatomy and pathology of the cervical and thoracic spine and matching common pain referral patterns. We’ll review the management of nerve root, discogenic complaints and non-radicular referral patterns affecting the upper limb. 


We’ll practice specific MSK techniques for anterior, posterior and suboccipital muscle training, incorporating research and clinical practice iterations.


Day 2 starts with managing complex upper quadrant pain patterns, methods for correction and the twin circles concept for resolving long term shoulder pain.


Methods for integrating spinal therapy and shoulder rehabilitation will be discussed, along with case studies to help illustrate the clinical process towards a successful outcome. 


We’ll then complete the course with athletic progressions for cervical and thoracic spine conditioning and high performance activity.


All sessions include lecture, case studies, group discussion and practical components.

For Physiotherapists

  • Introduction
  • Syllabus Outline
  • Learning Objectives
  • Try A Clinical Case


Pre-requisites


  • Physiotherapy degree
  • Successful completion of MTS™ LEVEL IV / CASP certification


Course Fees (Sat & Sun 8:30am - 4:30pm)


  • $895 CAD Early  (> 60 days)


  • $1095 CAD Regular (60-7 days)


REGISTER HERE

Level 5 syllabus - the spine

MTS™ LEVEL 5 - THE SPINE - DAY I


CLINICAL ANATOMY & PATHOLOGY


  • Clinical disorders & classifications related to shoulder pain
  • Cervical spine - common disorders affecting the shoulder
  • Thoracic spine - differentials to explore


TOPIC 15A - CERVICAL STABILIZATION TRAINING


  • Current research findings and outcomes
  • Anterior cervical spine techniques & progressions


Practical session


TOPIC 15B - CERVICAL STABILIZATION TRAINING


  • Posterior cervical spine techniques & progressions


Practical session



MTS™ LEVEL 5 - THE SPINE - DAY 2


TOPIC 16 - MANUAL THERAPY & STRETCH TECHNIQUES  


  • Recommended integration with stabilization
  • Options for manual therapy - what's effective & safe ?
  • Stretch techniques - clinical pearls and pitfalls


TOPIC 17 - COMPLEX UPPER QUADRANT PAIN PATTERNS


  • Case series of pain patterns in clinical practice
  • Differentials - what is my working list ?
  • Unravelling the disorder
  • Twin circles concept for solving chronic disorders


TOPIC 18 - ATHLETIC CONDITIONING FOR THE SPINE


  • Stability vs movement - how to integrate
  • Recommended cervical and thoracic progressions
  • High performance athletes & training implications
  • Injury prevention & ongoing training


Learning objectives

Applied Anatomy & Pathology

  • Appreciate the key structures of the cervical and thoracic spine commonly involved in shoulder pain.


  • Update your knowledge on the current research findings


  • Understand the anatomy and rationale behind cervical stability training


  • Review the clinical anatomy for manual therapy applications, stretch and stabilization.

Cervical Stabilization Training

  • Demonstrate skills in teaching, correcting and modifying cervical stabilization drills for the anterior and posterior musculature.


  • Understand the clinical role and expected outcomes of cervical stability training.

Manual Therapy & Stretch Techniques

  • Demonstrate key stretch techniques, clinical pearls and pitfalls of stretching for the cervical spine.


  • Perform a selection of techniques for mobilization of the thoracic spine.


  • Understand the application of stretch techniques vs spinal mobilization  

Complex Upper Quadrant Patterns

  • Appreciate the clinical differences between  nerve root, discogenic and facet based disorders


  • Recognize common referral patterns and clinical signs of various cervical and thoracic disorders that can affect the shoulder


  • Determine the sequencing of treatment and progressions for complex upper limb complaints


  • Discuss the current pharmaceutical and injection recommendations for use in complex upper quadrant pain


  • Understand the surgical options for non-responsive disorders and when they might be indicated

Athletic Conditioning for the Spine

  • Evaluate the need for cervical and thoracic stability training in the athlete


  • Appreciate the need for further conditioning beyond cervical spine stability training


  • Demonstrate a variety of strengthening methods and exercises for the cervical and thoracic spine


  • Understand how to incorporate these strength the conditioning movements into a seasonal program


STARTING 2026

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SELECT HERE FOR LEVEL 5 - THE SPINE

MTS™ CLINICAL CASE

27 y/o male rigger with broad bilateral upper quadrant pain

A young male presents with complaints of daily pain for the past 4 years, with broad ache throughout the torso and both arms, exacerbated by rigging activities. He complains of strong forearm pain and fatigue bilaterally, making his work difficult with prolonged grasping. Temporary improvements with NSAIDs and gabapentin 400mg tid. No sleep disturbance. Exercise levels have reduced with 50% loss of strength in most upper body exercises over the past year.


He has spent the past 2 years in therapy with various therapists including massage, chiropractic and osteopathic treatments. Physiotherapy has involved postural correction, strength training, stretching the upper limb and torso but with minimal improvement. Examination reveals good muscle bulk, normal shoulder movement, strength and no neurological loss. No GHJ instability signs or symptoms. X-ray and ultrasound via the family physician reveal normal intervals & bony geometry, no calcification and mild tendinopathy in SSP (only US finding).


The patient is seeking assistance for diagnosis and treatment.


  • What are the potential differentials for this patient ?
  • What other regions require examination and what are you looking for ? 
  • Are there any matching non-MSK disorders ?  
  • How would you best interpret the problem ?
  • How would you begin and progress treatment ? What are the missing components ?
  • When and why would you use medication to assist the diagnosis / treatment ?


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