Comprehensive physiotherapy course

Stimulate your clinical practice and enhance your career with this comprehensive 4-week program.

The Certificate in Orthopaedic Musculoskeletal Therapy (COMT) provides clinicians with intensive tuition in an integrated and thoroughly modern, evidence-based approach in the assessment and management of the spine, pelvis, upper and lower limb disorders.

Manual Concepts offers this course exclusively in Australia and also partners with various professional education providers who host this course in countries including Italy, France, Argentina, Malaysia, Saudi Arabia and others.

This is a unique opportunity to be educated by our nationally and internationally respected team of clinical educators and expert local clinicians. Learn more about the presenters.

The primary aim of this intensive, evidence-based program is to develop broad state-of-the-art knowledge and skills in the examination and management of disorders affecting the joint, muscle and neural systems.

This highly practical course will enhance your clinical reasoning skills, confidence and competency in assessing variety of complex spinal and peripheral disorders, including headache, dizziness, whiplash, neck and back pain, spinal mediated neural tissue disorders as well as upper and lower limb injuries.

You will deepen your understanding of how biopsychosocial factors may contribute to persistent pain and disability and guide you in selecting the most appropriate therapy for each individual case.

What you’ll learn

At the completion of the four-week program, participants will:

• Have a good understanding of pain science and how to integrate this knowledge into clinical practise
• Understand the importance of subjective examination and interpretation of it
• Have a good understanding of mechanisms of manual therapy and how this therapy can be used within a patient-centred care model
• Be proficient in applying spinal, pelvic girdle, upper and lower limb articular, neural and motor (or movement) control examination procedures
• Be proficient in determining a differential diagnosis based on an integrated, clinical reasoning informed examination from biopsychosocial perspective
• Be able to formulate the most appropriate and effective management approach for a variety of musculoskeletal conditions
• Have a good understanding how to use and interpret screening tools to assess and monitor patient progress.

Pain science

It is now well recognised that pain intensity does not correlate well with the extent or seriousness of pathology, and that wide variation exists in the response to identical noxious/nociceptive input and to the provision of identical therapies and that susceptibility to develop certain painful disorders is also variable.

This means that we need to think much more broadly about pain than it simply being a consequence of presenting pathology and rather, consider ALL possible contributing factors in ANY pain state, regardless of whether it is acute or persistent. Many of the reasons for this variability are understood and the aims of this module on the COMT course are to demonstrate:

• The extraordinary complexity of pain and how to assess all aspects of this complexity, including baseline characteristics (modulators) that can influence pain outcomes, as well as the (often modifiable) factors that can mediate the relationship between an individual’s modulators and their outcome
• How to break this complexity down to the components of relevance so as then to more readily be able to provide strategies that more comprehensively and effectively manage somebody’s pain

Joint system

As part of the joint system assessment on the COMT course, we cover a comprehensive range of articular testing procedures, including active, combined movements, and pain provocation tests for the spine and peripheral joints. These procedures are designed to identify the nociceptive source of patients’ symptoms and determine whether manual therapy should be incorporated into a multimodal treatment approach. When indicated, a variety of manual therapy techniques will be employed to alleviate pain and promote faster recovery.

This part of the course focuses on the latest evidence supporting the role of manual therapy in the management of musculoskeletal conditions and its mechanisms of action within the musculoskeletal system. A thorough understanding of these principles is critical for effective patient care. Current clinical guidelines support the use of manual therapy, alongside education and exercise, as part of a multimodal approach to enhance patient recovery.

The course will also cover how to integrate manual therapy within a patient-centred care model, emphasizing the importance of individualized treatment plans based on patient needs, clinical findings, and the latest evidence-based practices.

Muscle system

An emphasis of this program in Manual Concepts’ COMT course is a functional approach to the assessment of spinal and peripheral joint motor control impairments. Determining which patients require motor control retraining will be based on clinical history and physical examination findings.

It is well-known that patients with persistent musculoskeletal pain often exhibit maladaptive movements driven by various factors, such as fear (leading to avoidance or guarded movement behaviours), muscle weakness, excessive load, and deconditioning, among others. Laird et al. (2019) identified four common movement patterns in persistent low back pain: standard, lumbar dominant, pelvic dominant, and guarded, which were more prevalent than in pain-free individuals.

In the 2023 RESTORE trial published in The Lancet, Professor Peter O’Sullivan and others demonstrated that Cognitive Functional Therapy (CFT) significantly improves pain and disability compared to usual care. This program will enhance participants’ ability to identify motor control impairments and their contributing factors, enabling optimal management through strategies such as exposure, pacing, targeted movement, and exercise therapy.

Neural system

Neural pain disorders require thorough evaluation, as not all cases necessitate neural mobilisation. Sub-classifying patients based on clinical examination findings helps clinicians better determine whether symptoms are of neuropathic origin. The International Association for the Study of Pain (IASP) classification system provides a framework to improve clinical confidence in assessing the likelihood of neuropathic pain.

This element of the COMT course focusses on evaluating the neural system and delves into various classification systems and tests. It offers clinicians deeper insights into differentiating neuropathic pain from somatic referred pain and centrally mediated pain, while understanding how these types may interact. The course updates and refines key practical skills for examining and managing neural health, focusing on skilled, safe, and appropriately timed handling techniques, which are thoroughly covered in the practical sessions.

If you have any questions, please email us at [email protected]