Module: Masterclasses

Thoracic Spine & Ribs


Thoracic spine and rib disorders are frequently associated with impairments of trunk movement, static postures and respiratory function. They can be difficult to evaluate and treat. This course demonstrates innovative techniques to evaluate movement impairments of the thorax and ribs. The evaluation and mobilisation of thoracic and rib disorders are detailed and movement control strategies explored.


Course Outline

Pain in the thoraxic and rib region can be related to costo-vertebral, cervico-thoracic, scapulo-thoracic and thoraco-lumbar dysfunction. Assessing the inter relationships between articular and myofascial restrictions and their corresponding compensations Uncontrolled movements (UCM) in these four regions is very complex.

This two-day course reviews the functional anatomy of the thorax. Functional classification of thoracic musculature is outlined with local and global stability systems identified. Based upon a systematic assessment and diagnosis of spinal movement dysfunction, an integrated treatment approach for mechanical dysfunction is presented. It details the retraining of control function at local and global levels for the thoracic spine and ribcage and emphasises rehabilitation strategies based on a clinical reasoning framework. This course is orientated to a ‘hands on’ practical application of movement control assessment and retraining using patient examples where possible.


Key Features

  • Positional diagnosis of thoracic and rib compensations for restrictions in the thorax.
  • The anatomy and functional classification of thoracic musculature is outlined with local and global stability systems identified.
  • The application of manual mobilisation (muscle energy based) techniques to mobilise the restrictions
  • Based upon a systematic and logical assessment of spinal movement dysfunction, an integrated treatment approach is presented.
  • The retraining of movement impairments is detailed at 3 levels
    1. Direction control of the site and direction of uncontrolled movement
    2. Local muscle retraining to control aberrant thoracic or rib translation
    3. Influence of recruitment imbalance between 1 joint stabilisers and 2 joint mobilisers in the thorax
  • The course details the rehabilitation of the movement control system at local and global levels for the thoracic spine and emphasises rehabilitation strategies for appropriate clinical decision making.


Learning Outcomes

At the end of this course the participant should be able to:
  • Understand the development of movement control impairments
  • Analyse the inter-relationship between restriction and compensation in articular and myofascial tissues
  • Demonstrate the ability to palpate the thoracic spine and rib cage to make a positional diagnosis of thoracic and rib compensation for restriction
  • Manual techniques to mobilise thoracic and rib restrictions
  • Clinically assess motor control strategies to identify and diagnose the site and direction of movement control impairments and retrain direction specific dysfunction in the thorax
  • Assess and rehab local stabiliser function in the thoracic spine
  • Discuss the influence of global imbalance in stabiliser - mobiliser function
The participant should demonstrate the ability to apply principles of assessment and motor control retraining to:
  • Develop an evidence based management plan to improve functional control
  • Use clinical reasoning to prioritize initial management and plan a progression of rehab
  • Apply rehabilitation strategies to manage stability dysfunction
  • Use re-assessment tools to guide the rate of progression of an individual patient through their rehab programme


Programme Outline

  • Movement Control Impairments Theory
  • Palpation & mobilisation of thoracic & rib restrictions
  • Palpation of ribs dysfunctions
  • Structural rib treatment
  • Thoracic control of direction
  • Thoracic control of translation (in neutral)
  • Thoracic control of global imbalance


Kinetic Control courses are designed for medical health professionals such as physiotherapists, osteopaths, chiropractors, podiatrists etc registered with the HPC. In exceptional circumstances experienced non medical health professionals may be allowed to attend Kinetic Control courses but these participants MUST be able demonstrate that the course material is within their scope of practice and that they have appropriate professional liability insurance to cover them for their attendance at the course and the course content.

This course has both theortical and practical elements. Please come prepared for the practical work.