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Advanced Manual Treatment of the Thorax
   November 11-12th, 2022
                         --Instructor Neal O'Neal, PT

     Neural and biomechanical integration of the thoracic cage into breathing, complex or sustained movement, lymphatic, and cardiac function requires detailed knowledge of the anatomy, physiology, neurology, embryology and dynamic force relationships of the various structures and the complex ways in which they become dysfunctional.


This course provides the participant with an extensive knowledge of these areas as well as the intricacies of dysfunction of the ribs and manubrio-sternum as they relate to breathing, posture, movement, and health.

The thoracic spine, ribs, sternum, manubrium, clavicle, and diaphragm will be covered as well as the various cartilages, ligaments, muscles, fascia, vascular and neural components from embryological, vertebral, biomechanical and arthrokinematic standpoint. Assessment and treatment will include Muscle Energy Techniques, Joint Mobilization, Travell concepts, and Myofascial Techniques employed and demonstrated in laboratory session. Further, Zink patterning and complex reflex and dynamic force interactions will be studied.

Pain is the top reason patients seek treatment. Most pain is not due to acute trauma which poses a problem for the current medical system approach. To successfully treat non-acute onset of pain can be difficult. A deeper understanding of the neurological and biomechanical interaction of the thoracic cage must be used to understand the functional and dysfunctional interaction of these areas and how it strongly affects all other areas of the body.

This class will provide the practitioner the ability to mechanically assess / observe the patient's movement competence through clinical tests and develop an appropriate manual treatment regimen to optimize and improve that patient's relevant lack of range of motion and aberrant motor programming to return to full function. 

Advanced Thoracic Cage:

Ribs, Lymphatics,

Fascia, and Zink


November 11-12th, 2023




Myotherapy College | Utah's Therapeutic Massage Therapy School


3950 S 700 E Suite 100, Millcreek, UT 84107

Target audience: Licensed healthcare providers including, but not limited to:

PT, AT, DC, MT, RN, OT, LMT, and ND.

16 contact hours – 16 1-A hours anticipated  


Instructors: Neal O'Neal, PT

Class is held 9-6 Friday and Saturday.


Fees: $550/student


Learning Objectives: Upon course completion, the participant will be able to-

1) Palpate the discrete structures of the thoracic cage;

2) Ask appropriate patient history questions that take into account new, research-based understanding of thoracic function;

3) Identify, palpate and test motion or irritation of the thoracic cage to include joints, capsules, muscles, fascia, blood vessels, and lymphatic tissue.


4) Demonstrate various treatment strategies such as Muscle Energy Technique, Counterstrain-positional release, Neurolymphatic and Neurovascular Techniques, Zink Patterning, and NeuroDynamic Reintegration© (NDR©).


5) Perform appropriate Global and Regional provocation tests for the thoracic cage and diaphragm.


Materials Provided: A binder of the course materials will be provided to each student to follow along and take notes during the lecture and lab portions of the class.

Purpose: The purpose of this class is to provide the clinical practitioner with the knowledge of how recent research has changed current clinical treatment approaches to the biomechanical pelvis and lower extremity. 

Expected outcomes are to develop effective delineation and treatment strategies based upon an integration of new information and the extensive body of knowledge of the anatomy, physiology, and embryology of the thoracic cage. This class will enhance participant learning through the use of discussion, audio-visual materials, recent research evidence, and extensive lab-based learning.




9am – 12pm              Anatomy and Neurology of the Thoracic Cage and Diaphragm (Lecture)

12pm – 1pm              Lunch

1pm – 1:45pm           Global and Regional Provocation Tests (Lab)

1:45pm – 2:45pm      Relation and Testing of Chest dysfunction in relation to the Thoracic Cage (Lecture)

2:45pm – 6pm           Somatic Treatment of the Thoracic Cage- Counterstrain / Mobilization (Lab)



9am – 9:30am          Current Research discussion (Interactive Discussion)

9:30am – 10:30am   Somatic Treatment of the Thoracic Cage- MET assessment (Lab)

10:30am – 12pm      Somatic Treatment of the Thoracic Cage- Rib MET treatment (Lab)

12 – 1pm                   Lunch

1pm  – 2:30pm         Somatic Treatment of the Thoracic Cage and Diaphragm- STM treatment (Lab)

2:30pm – 6pm          Somatic Treatment of the Thoracic Cage- Neurologically based treatments (Lab)

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