Module: Masterclasses

Thoracic Spine & Ribs


Presentations of the thoracic spine and ribs are frequently associated with altered movement, whole body alignment and impaired respiratory function. It is generally acknowledged they can be difficult to evaluate and manage. This course demonstrates innovative techniques to evaluate uncontrolled movement related to presentations of the thorax and ribs. The evaluation and mobilisation of thoracic and rib presentations is detailed and cognitive movement control strategies explored.


Course Outline

Pain in the thoracic and rib region often appears related to unwanted changes in the function of the costo-vertebral, cervico-thoracic, scapulo-thoracic and thoraco-lumbar regions. Any desire to successfully manage patients’ presentations must therefore be considerate of this complexity and employ a systemized route of assessment to steer intervention. This assessment must be inclusive of not only considering articular and myofascial restrictions of these regions but also the associated compensations evident within the movement system. There is then the need to test for the presence of uncontrolled movement (UCM).   

This two-day course reviews the functional anatomy of the thorax. Functional classification of thoracic musculature is outlined with local and global ROLE synergy systems identified. Based upon a systematic assessment and interpretation of an individual’s specific presentation, an integrated treatment approach is presented. It details the retraining of local and global role systems for the thoracic spine and ribcage, emphasizing rehab strategies based on a rigorous 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 stabilizer role synergies identified.
  • The application of manual mobilisation (muscle energy based) techniques to mobilise restrictions
  • Based upon a systematic and logical assessment of alterations in spinal function, an integrated, individualized treatment approach is presented.
  • The retraining of movement impairments is detailed at 3 levels
    • Direction control of the site and direction of uncontrolled movement
    • Local stabilizer role synergist retraining to control thoracic or rib translation
    • Influence of recruitment inefficiency between muscle synergists
  • The course details the rehabilitation of the movement control system at local and global system levels for the thoracic spine with an emphasis on rehabilitation strategies for appropriate clinical decision making.


Learning Outcomes

At the end of this course the participant should be able to:
  • Demonstrate understanding of the proposed development of uncontrolled movement
  • Display an ability to analyse the association between restriction and potential compensations 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
  • Display an ability to demonstrate manual techniques to mobilise thoracic and rib restrictions
  • Clinically assess movement strategies strategies to identify and diagnose the site and direction of uncontrolled movement and retrain uncontrolled movement associated to the thorax
  • Assess and rehab local stabiliser role synergists recruitment efficiency in the thoracic spine


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.