SMT-2 is a two-day (15 contact hours) course with an emphasis on upper cervical, mid-cervical and upper thoracic spine dysfunction, as it relates to cervicogenic headaches, whiplash associated disorders, and idiopathic neck pain diagnosis and management.

Advanced HVLA thrust manipulation techniques for the occipito-atlantal (C0/1), atlanto-axial (C1/2), C2/3 articulations (in supine and sitting positions) along with a focus on 1st, 2nd and 3rd rib articulation HVLA thrust manipulation procedures (costotransverse and costovertebral articulations). A special emphasis will also be given to a variety of HVLA thrust manipulation procedures used to treat the cervicothoracic junction (C7-T3) including side-lying, prone, sitting and supine variations of such.

An evidence-based approach to the diagnosis and management of deep cervical flexor dysfunction will be undertaken; in addition, the best way to train the deep neck flexors will be instructed. Furthermore, the inter-relationship between arthrogenic muscle inhibition of the craniocervical flexors and the immediate changes in motor control post HVLAT manipulation of specifically the upper cervical spine (C0/1 and C1/2) articulations will be explored.

A comprehensive literature review of the neurophysiological effects of HVLAT manipulation will be presented and will include evidence to support alterations post-HVLAT manipulation in feed-forward activation times, isometric muscle strength, resting EMG activity of segmentally associated muscles, and passive range of motion. An exploration of pain physiology as it applies specifically to post manipulation hypoalgesic effects will be presented, and an overview of the sympathoexcitatory effects seen in the upper limbs following spinal manipulation will be explored.

Current research (RCTs and systematic reviews) to support the effectiveness of HVLAT and exercise in the treatment of cervicogenic headaches, idiopathic neck pain and whiplash associated disorders will be presented. This course is 70% hands-on and 30% didactic instruction. SMT-1 must be completed prior to taking SMT-2.