The Movement Solution 2

Masterclass solutions for Pelvis, SIJ, Thorax and ribs með Mark Comerford


  • Dagsetning:
    19. október 2023 - 23. október 2023
  • Staðsetning:
  • Tími:
    09:00 - 17:00
  • Bókunartímabil:
    12. júní 2023 - 7. október 2023
  • Almennt verð:
    176.000 kr.
  • Fagdeild verð:
    162.000 kr.





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.



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. 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 Movement Coordination and Control Impairments. This course reviews the functional anatomy of the thorax. Functional classification of thoracic musculature is outlined with local and global muscle 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.



  • 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 (modified 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 translation.
    • Influence of recruitment inefficiency between global 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 to identify and diagnose the site and direction of Movement Coordination and Control Impairments and retrain uncontrolled movement associated with the thorax.
  • Assess the influence of altered global role muscle synergies and local stabiliser role synergists and develop appropriate strategies to improve their recruitment efficiency in the thoracic spine.







The pelvis represents a complex link between the low back and hip. Understanding its function and related movement coordination and control is essential for the complete movement management of lumbo-pelvic presentations. This course details the evaluation of movement restrictions but also the identification and individualized retraining of

Movement Coordination and Control Impairments.



Traditionally, the sacro-iliac joint (SIJ) was considered not to ‘move’ and therefore is unlikely to contribute to lumbo-pelvic pain. This course considers this perspective and presents a contemporary clinical approach to the management of the SIJ and pelvic girdle, and patients’ presentations linked to it. The biomechanics of the sacro-iliac complex are integrated with contemporary osteopathic concepts. Myofascial restrictions, articular restrictions and mechanisms of what is typically referred to as ‘instability’ of the sacro-iliac joints are outlined. The diagnosis of mechanical ‘impairments’ of the sacro-iliac complex is developed around a systematic process of assessing restrictions and identifying the associated compensation within the movement system. An identification of movement coordination and control impairment is made, based of Kinetic Control's system of identifying the site (sacral, ilial or pubic) and the direction (rotation, shear, torsion or sidebend) of uncontrolled pelvic joint motion. Once the relevant (presentation associated) movement coordination and control impairment has been identified, specific techniques to mobilise myofascial and articular restrictions are demonstrated. These techniques include modified muscle energy techniques and direct manual mobilisation where appropriate. Based on a diagnosis of the site and the direction of uncontrolled sacro-iliac motion, specific global and local muscle system retraining is instituted to target mechanisms associated to sacral, innominate and pubic presentations.


This individualised rehabilitation, integrating both local and global systems, is supported by a rigorous clinical reasoning framework. The global muscle synergists are advantaged to maintaining control throughout functional activities and range motion. Strategies to facilitate and retrain the global system of lumbo-pelvic movement are detailed. Assessment of local stabilizer role synergist recruitment aims to identify and restore efficiency in these misunderstood contributors to Movement Health of the pelvis, low back and hip. While the local stabilizer role synergists possess the ability to manage intersegmental articular motion, they are effective in the control of hypermobile range. The assessment of sacro-iliac joint ‘instability’ includes a manual assessment of sacro-iliac joint segmental articular motion, ‘hypermobility’ of pelvic motion, and specific functional tests of 'self-locking failure'.


The course identifies how both their assessment and retraining is highly individual specific - what may work for one individual may not be effective in another. A unique clinical reasoning assessment process then matches the most appropriate recruitment strategies to regain control of different self-locking deficits. This course is orientated to a 'hands on' practical application of uncontrolled movement assessment and retraining, using patient examples where possible.



  • Perform a systematic movement assessment to identify uncontrolled movement in the SIJ and pelvis.
  • Understand the links between restrictions of motion, movement system compensation strategies and the development of uncontrolled movement.
  • Assess for pain related low threshold recruitment changes in local and global system muscle synergists.
  • Use evidenced based literature to support the choice of retraining strategies to these recruitment changes.


LEARNING OUTCOMES: At the end of this course the participant should be able to:

  • Understand the development of uncontrolled movement.
  • Analyse the inter-relationship between restriction and compensation in articular and myofascial tissues.
  • Identify and palpate all relevant landmarks, ligaments and muscles of the lumbopelvic region.
  • Understand how the articular structure, muscles and ligaments interact to optimise or compromise lumbo pelvic function.
  • Perform and interpret the relevance of tests of sacro-iliac complex mobility.
  • Based on a sequence of testing, be able to diagnose the site and direction of Movement Coordination and Control Impairments of sacro-iliac complex.
  • Perform and interpret tests of sacro-iliac articular hypermobility.
  • Perform and interpret tests of sacro-iliac self-locking to identify functional ‘instability’ within the sacro-iliac complex.
  • Based on a diagnosis of the site and direction of uncontrolled sacro-iliac complex motion, identify appropriate global and local stabilizer role synergists to address movement coordination and control of the pelvic complex.
  • Using a clinical reasoning process, demonstrate the ability to choose the appropriate muscle and recruitment strategy to more efficiently manage the identified functional self-locking problem.


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