SMT-4: Certification in Spinal Manipulative Therapy (Cert. SMT): Comprehensive Review & Comprehensive Oral, Practical & Written Examination


Upon successful completion of SMT-4, candidates are awarded the Certification in Spinal Manipulative Therapy (Cert. SMT) credential.  This certification recognizes those practitioners (PT, MD or DO) that have demonstrated:

  1. Safe and competent performance in the delivery of HVLA thrust manipulation procedures in all spinal, pelvic and thorax regions.
  2. An in depth understanding of the rationale for and against the use of HVLA thrust manipulation.
  3. An understanding of the empirical evidence surrounding the use of HVLA thrust manipulation in a variety of neuromusculoskeletal conditions.

This is a two-day (15 contact hours) course consisting of:

  1. Review of the biomechanical theory and neurophysiological effects of HVLA thrust manipulation.
  2. Review of the evidence underpinning the practice of HVLA thrust manipulation and its effectiveness (and limitations) in the management of cervicogenic headaches, idiopathic neck pain, whiplash associated disorder, post-partum pelvic pain, sacroiliac joint dysfunction, and facet and rib syndromes of the cervical, thoracic, lumbar and four spinal junctional zones.
  3. Comprehensive oral, practical and written examination of all materials in all three prerequisite courses (SMT-1, SMT-2, and SMT-3).

Successful candidates must be able to demonstrate mastery in the performance of HVLA thrust manipulation procedures to the cervical, thoracic, lumbar & pelvic regions, and all four junctional zones; furthermore, they must demonstrate an ability to articulate their diagnostic and treatment decisions with sound clinical reasoning and the use of current research.

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