In a study in the Journal of Spine, it is estimated that 60% of all Americans will develop back pain in their life. Duke University estimated the annual cost of back pain to the US economy is about 90 billion dollars! Additionally, a 1999 study found that 80% of all visits to a physician resulted in an incomplete and vague diagnosis as to the nature and cause of their pain. It is suggested that the lack of definitive cause of pain leads us to believe that the pain is caused by muscular tightness and spasm. With this prevalence, it is no wonder that the majority of clients that grace our doors have some sort of back discomfort as the major complaint and often the back is the major area of focus during a typical session.

In the PNMT for the Low Back and Thoracic Spine seminar, you will learn how to efficiently evaluate and treat people with various types of back pain involving the lumbar and thoracic area. In order to accomplish this, you will learn to clearly identify the anatomical landmarks necessary for great palpation, identify and address the correct soft tissue structures that affect the stated pain pattern, and review how these soft tissue restrictions are tied to movement and everyday complaints.

If a therapist is going to treat LBP, the most important task is to have a deep model of understanding of back pain, more important than learning techniques to apply to something not well understood. In the PNMT for the Low Back and Thoracic Spine seminar, participants will address fundamental issues such as:

* Red flags for treatment- when to refer because soft tissue won't help and could possibly be counter-productive
* How do identify true neural issues and how to treat them
* How to identify joint inflammation from muscular issues
* How to assess whether the source of LBP is instability or hypomobility. Should you up-regulate or down-regulate the muscles involved?
* How does one choose from the vast array of manual approaches- fascial, trigger point therapy, hypermyotonia, stretching, etc. Which one to choose when?

Participants in this seminar will learn to assess the spine in multiple movement planes (flexion, extension, lateral flexion, rotation) and correlate muscular treatments with movement restrictions. Rather than memorize one-size-fits-nobody routines, emphasis is on problem solving skills and clinical reasoning. 

PNMT is not a modality; it is an approach to soft-tissue therapy that is highly analytic and science based, but uses those skills to artistically create a wonderful treatment experience for the client. If your image of NMT is digging an elbow into the low back, think again. Think PNMT.

This seminar is designed to be a "hands on" experience and the style of therapy relevant to everyday practice; you can utilize the techniques taught in class immediately. At the same time, it will sharpen your anatomy skills and assist you in understanding spinal mechanics. This training is meant to teach you to see, touch, and understand the truly magnificent role that is the complex series of muscles we call "the back". At the end of the training, you will never see the spine in the same way.We will address clinical applications, review the functional applications that soft tissue plays in back pain, and address common clinical concerns.

Here are some of the issues you will learn. Do you know. . .

 * Your client presents with pain that is worse when getting up from a chair and this lasts for about the first five steps until it improves. Which muscle is it?
 * Your client presents with pain in the low back in the area of the QL on the right. You immediately assume it is the QL. Strange thing is, when you ask her to side-bend, there is no pain side-bending to the left, it hurts on the right when she side-bends right. Oops. It isn't the right QL. What is it (it isn't the QL at all)
 * Your client presents with pain when getting up from a chair. This pain is momentary and and is gone by the time they stand up straight. This is a totally different problem than the first. What is the problem?
 * How do you know when not to work muscles around the SI joint? What signs do they present?
 * How does restriction of the hip affect the low back?
 * Rotatores don't produce rotation in the spine. What do they do?
 * Your client can't rotate fully to the left but rotation to the right is fine. What muscles do you work and on what side?
 * What is the role of soft tissue therapy concerning disc pathology of the spine?
 * Your client has a pain pattern that is vertical up the lumbar spine. There are at least two causes, one is the psoas, the other not. If you guessed the psoas and were wrong, the results would be disasterous. What is the other problem? Hint- movement would be a big clue and the condition is life-threatening.