#PTonICE Podcast Episode 1974 - Thrust manipulation: evolving our understanding & broadening our application
22 snips
Nov 6, 2025 
Dr. Justin Dunaway, a leading expert in thrust manipulation and the Total Spine division leader, shares insights on enhancing clinical practice. He discusses the efficacy of thrust manipulation for acute pain and radiculopathy, revealing short-term benefits in treatment. They dive into barriers clinicians face and the need for clearer research standards. The conversation shifts to innovative applications, including its role in handling hypermobility. Justin emphasizes the importance of positive patient narratives to enhance outcomes, presenting thrusts as a tool for improving the brain-body connection.
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Training Then Attrition On Rotations
- Students often learn manipulation in school but lose confidence during clinical rotations when supervisors don't perform it.
- Justin's survey across three schools found confidence rises after teaching then drops after rotations.
Guidelines Favor Early Use
- Clinical practice guidelines recommend thrust manipulation early for most conservatively managed neck and back pain.
- Despite guideline support, clinicians underuse manipulation in practice.
Train Setup, Not Sound Chasing
- Address psychomotor fear by training setup, lines of force, and body position rather than chasing joint specificity or loud cavitations.
- Prioritize speed and proper setup to produce neurophysiologic effects without excess force.