Providers of Approved Continuing Education

The Brookbush Institute (BOC AP# P10038) is approved by the Board of Certification, Inc. to provide continuing education to Athletic Trainers (ATs). This program is eligible for a maximum of {{credits}} hours/ Category A CEUs. ATs should claim only those hours actually spent in the educational program.

Board Of Certification

The Brookbush Institute is an AOTA Approved Provider of professional development. PD activity approval ID# {{aotaCourseApprovalNumber}}. This distance learning-independent activity is offered at {{aotaCredits}} CEUs {{aotaLevel}} {{aotaCategory}}.  AOTA does not endorse specific course content, products, or clinical procedures.

American Occupational Therapy Association

This activity is provided by the Texas Board of Physical Therapy Examiners Accredited Provider 2309052TX and meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas.

Texas Physical Therapy Association

Australia Physiotherapists

New York Physical Therapist just a disclaimer The Brookbush Institute (B2C Fitness) is recognized by the New York State Education Department's State Board for Physical Therapy as an approved provider of physical therapy and physical therapist assistant continuing education.

New York State Education Department's State Board for Physical Therapy

Joint mobilizations for the hip and knee joint. Types of mobilizations, self-administered mobilizations, and interventions for lumbopelvic hip complex (LPHC) dysfunction. Optimal intervention for knee bow in, knee bow out, anterior pelvic tilt, excessive forward lean, and asymmetrical weight shift. The risk of adverse events, validity, efficacy, screening, and reliability of hip and knee mobs. 

Joint Mobilization: Hip Joint and Knee Joint

Access to all courses with monthly membership

Brookbush Institute

I have almost completed my CPT certification and am half-way through the Human Movement certification to inform my massage practice. The different modalities of reading, watching audiovisual materials, and attending live or recorded webinars have been important to my learning style and for review.

Brookbush Institute has the most detailed, specific and effective tools for online learning for movement and/or bodywork professionals. I love the combination of the videos as well as the text available online.

I recently completed the CPT course. It was demanding yet practical. I would highly recommend it for anyone wanting an education about human movement.

I have my personal trainer certificate through here and am almost finished my human movement specialist certification. Overall, the education that Brookbush has packaged together for clinicians and trainers is invaluable. I am a physio assistant so coming from more of a rehab background I appreciate that this education has been beneficial both as a trainer and in a rehab setting. I love that I have been able to do all learning at my own pace and able to work around my schedule. Thank you for setting up this platform! Highly recommend :)

I have been a massage therapist for 10 yrs and I feel like all the “pieces” I’ve learned throughout the yrs have been put into place and can see the full picture. I am also a member to tons of great content since I love to learn! I plan to get my CPT through them as well.

I have been following Brent Brookbush for nearly a decade- back when I was a personal Trainer and now as a Physical Therapist. BBI is an incredible resource for any movement nerds and corrective exercise specialists! The information is thorough with multiple real world applications. I am looking forward to an in-person Manual Therapist course the second they do one a little bit closer to Virginia ;)

I have taken both the Human Movement Specialist and Certified Personal Trainer certificate programs and have found the value in understanding the how and ways the body moves and functions and from evidence, non-biased, outcome, conceptual, theoretical, and practical approach to helping my clients/patients look better, feel better, and move better.

Over the last years I've returned time and again to Brookbush Institute for stellar coursework as I've worked toward a Human Movement Specialist certification. (I'm currently ACE CPT, and in training with Anatomy Trains for Structural Integration Manual Therapy.) Every Brookbush Institute module is fantastic and each one includes detailed informational videos, written descriptions of how to-do, and, more importantly, why to-do!

I am a 70 yr old chiropractor and no other healthcare provider was able to come up with an exercise protocol particular to my structural and balances and muscle deficits and keep me in the game. And as for continuing education on human skeletal movement, the website is phenomenal full of great exercises for particular mechanical dysfunction.

The H.M.S. is the most valuable certificate I have earned and was a fraction of the the cost of my others. Define the best bang for your buck!

Brookbush is the most efficient Personal Training Certification I have ever come across. All the lessons are well thought out and very straight to the point.

I am getting my Master's degree in Kinesiology, and I would like to say that I have benefited greatly from the rich, comprehensive, well-documented scientific content of Brookbush Institute that links theory to practical applications. Proudly I've got my CPT certificate, and I am on my way to get my HMS certificate.

Having courses count towards different certifications makes it so users can transition seamlessly from one certification to another. In my case, going from earning the BI CPT to earning the BI HMS was an easy decision and I am proud to have earned both certifications. I have also had the pleasure of going to a Live HMS workshop that was well taught by Instructor Boettcher and that was excellent to see how the methods and techniques are implemented.



I have been a member of BBI for years and every course I have taken has been incredibly informative. I learn more from these courses than I do at local CEU courses for my PTA license. I also earned my CPT and HMS certifications through the platform. It was so convenient and the content was top notch! Forever member.

We learn principles in academia, we learn cool new modalities via whatever specialty certification, but BBI really concentrates on the nuances of passive treatment and they do a fantastic job. The format in which BBI instructs soft tissue specialists (DPTs, Chiros, ATs) like myself feels like almost like an apprenticeship. You get a thoroughly detailed explanation of the “why’s”, and a visual comprehension of how to apply. Personally, I believe application is where the good and the great are distinguished.

Brookbush has been incredibly helpful since I was in massage school and now as I’m in my career! I run my own practice and it gives me the resources I need to not only improve what I already know, but also help me navigate better, more efficient ways of treatment.

Totally loving the convenience and affordability of this program with my crazy lifestyle! I feel like I am getting a quality education without a massive cost! My favorite part is the videos I can watch in the courses. I learn so much better that way. Once I really spent more time on the site, I figured out how to maneuver around a lot better! I enjoy the sense of humor, as well as the easy explanation, and short tests. And if I am really tired, I can have the computer read me the lessons. 😁

Challenging concepts are explained in very understandable terms without dumbing down the material, and I find this program to be superior in quality to other personal training programs.

Home

Courses

Integrated Manual Therapist

This course describes joint mobilizations for the hip joint and knee joint (a.k.a. pelvifemoral joint, ichiofemoral joint, femorotibial joint, tibiofemoral joint, etc.). Several terms and definitions have been used to describe the "mobilizations" (e.g. mobilisations) that are taught in this course. The Brookbush Institute uses a conventional definition of "mobilization" that includes low amplitude, low-velocity, oscillatory techniques intended to reduce the stiffness of joints exhibiting a decrease in passive accessory range of motion (a.k.a. arthrokinematic motion and specifically glide or slide). Note, the term "manipulation" is reserved for high-velocity techniques taught in a separate set of courses.

This course includes several of the most commonly recommended techniques used to address hip joint and knee joint stiffness, and improve hip and knee range of motion (ROM). For example, research has demonstrated that hip joint mobilizations may be used to address a loss of hip rotation, increase gluteal muscle activity, and improve functional outcomes for hip osteoarthritis patients. These techniques may also be used in an integrated approach for 

lumbo pelvic hip complex dysfunctions (LPHCD)

 including iliotibial band syndrome, patellofemoral pain syndrome (PFPS), and hip impingement syndrome, and postural dysfunctions including knee valgus, knee varus, excessive forward lean, anterior pelvic tilt, or asymmetrical weight shift. Some evidence and clinical outcomes even suggest that addressing hip dysfunction can have a significant effect on ankle mechanics and heel strike during gait.

The techniques in this course are recommended for all clinical human movement professionals (physical therapists, physical therapy assistants, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.) with the intent of developing an evidence-based, systematic, integrated, patient-centered, and outcome-driven approach.

Sample Intervention (Limited Hip Rotation ROM)

Tensor Fascia Latae and Gluteus Minimus Static Manual Release

Instrument Assisted Soft Tissue Mobilization

Joint Mobilizations: Ankle and Tibiofibular Joints

Joint Mobilizations: Lumbar Spine and Sacroiliac Joints

Joint Mobilizations: Cervical and Thoracic Spine

Joint Mobilizations: Shoulder, Sternoclavicular, and Acromioclavicular Joints

Joint Mobilizations: Elbow and Proximal Radioulnar Joints

For an introduction to joint mobilizations and manipulations:

Joint Mobilization and Manipulation: Introduction

Joint Mobilization and Manipulation: Reliability

Joint Mobilizations and Manipulations: Effects

Joint Mobilization and Manipulation: Risk of Adverse Effects

Joint Mobilizations and Manipulations: Evidence-based Teaching and Learning

Course Description: Hip Joint and Knee Joint Mobilizations

Introduction

Hip Internal Rotation Goniometry in Prone

Hip Internal Rotation Goniometry in Supine

Although it is counter-intuitive to think that over-active internal rotators would restrict internal rotation, in practice this is not only common, it may be the norm. The most likely hypothesis is related to alterations in arthrokinematics.

Hip External Rotation Goniometry in Prone

Hip External Rotation Goniometry in Supine

Gluteus Maximus Manual Muscle Testing (MMT)

 - Weak or With Compensation (Lumbar extension and/or knee flexion)

Gluteus Medius Manual Muscle Testing (MMT)

 - Weak or With Compensation (Lumbar lateral flexion and/or hip flexion)

Sample Intervention (Limited Rotation ROM)

Research Corner Summary

Hip Mobilization and Efficacy

Comparing and Combining Interventions

Muscle Activity and Self-Administered Hip Mobilizations

Research Corner: Hip

Research Corner: Knee 

Knee mobilization has demonstrated efficacy for the treatment of knee osteoarthritis, patellofemoral pain syndrome (PFPS), and post ACL surgical reconstruction. An RCT by Moss et al. compared knee mobilization, sham mobilization, and non-contact controls for the treatment of knee osteoarthritis, demonstrating that knee mobilization improved pain, pain pressure threshold at a distal site, and the timed up-and-go test (16). Zemadanis et. al demonstrated that the combination of knee MWM in conjunction with hip or knee strength exercise was significantly more effective than physical therapy modalities for the treatment of patellofemoral pain syndrome (PFPS) (17). Hunt et al. investigated the effect of knee joint mobilizations on knee extension ROM during gait in patients following anterior cruciate ligament (ACL) reconstruction. The study demonstrated that mobilization had a significant effect on passive knee joint ROM, as well as ROM during gait, and improved function including step length, stride length, and gait speed (18). These studies demonstrate that treating knee dysfunction (osteoarthritis, PFPS, post-ACL surgery) with knee mobilization may improve knee pain, knee ROM, knee ROM during gait, and functional tasks.

Comparing Interventions for the Knee

Combining Interventions for the Knee

Self-Administered Mobilizations and Taping for the Knee

Hip Mobilizations

Knee Mobilizations

Video Demonstration

Harding, L., Barbe, M., Shepard, K., Marks, A., Ajai, R., Lardiere, J., & Sweringa, H. (2003). Posterior-anterior glide of the femoral head in the acetabulum: a cadaver study. 

Journal of Orthopaedic & Sports Physical Therapy

Loubert, P. V., Zipple, J. T., Klobucher, M. J., Marquardt, E. D., & Opolka, M. J. (2013). In vivo ultrasound measurement of posterior femoral glide during hip joint mobilization in healthy college students. 

journal of orthopaedic & sports physical therapy

Ju, T., Choi, W., Yang, Y., & Lee, S. (2015). Effects of Hip Mobilization on Pain and Function for Chronic Low Back Pain Individuals with Limited Range of Hip Joint Motion. Indian Journal of Science and Technology, 8(26), 1-6.

Beselga, C., Neto, F., Alburquerque-Sendín, F., Hall, T., & Oliveira-Campelo, N. (2016). Immediate effects of hip mobilization with movement in patients with hip osteoarthritis: a randomised controlled trial. Manual therapy, 22, 80-85.

Cliborne, A. V., Wainner, R. S., Rhon, D. I., Judd, C. D., Fee, T. T., Matekel, R. L., & Whitman, J. M. (2004). Clinical hip tests and a functional squat test in patients with knee osteoarthritis: reliability, prevalence of positive test findings, and short-term response to hip mobilization. 

Currier, L. L., Froehlich, P. J., Carow, S. D., McAndrew, R. K., Cliborne, A. V., Boyles, R. E., … & Wainner, R. S. (2007). Development of a clinical prediction rule to identify patients with knee pain and clinical evidence of knee osteoarthritis who demonstrate a favorable short-term response to hip mobilization. Physical Therapy, 87(9), 1106-1119.

Hoeksma, H. L., Dekker, J., Ronday, H. K., Heering, A., Van Der Lubbe, N., Vel, C., … & Van Den Ende, C. H. (2004). Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: a randomized clinical trial. 

Arthritis Care & Research: Official Journal of the American College of Rheumatology

Darnell, K., Harland, J., Casner, A., Kimball, T., & Tuong, D. (2017). A comparison between hip internal rotation mobilization to posterior glide and their effects on hip internal rotation.

Vaarbakken, K., & Elisabeth Ljunggren, A. (2007). Superior effect of forceful compared with standard traction mobilizations in hip disability?. Advances in physiotherapy, 9(3), 117-128.

Estébanez-de-Miguel, E., Fortún-Agud, M., Jimenez-del-Barrio, S., Caudevilla-Polo, S., Bueno-Gracia, E., & Tricás-Moreno, J. M. (2018). Comparison of high, medium and low mobilization forces for increasing range of motion in patients with hip osteoarthritis: A randomized controlled trial. Musculoskeletal Science and Practice, 36, 81-86.

Bade, M., Cobo‐Estevez, M., Neeley, D., Pandya, J., Gunderson, T., & Cook, C. (2017). Effects of manual therapy and exercise targeting the hips in patients with low‐back pain—A randomized controlled trial. Journal of evaluation in clinical practice, 23(4), 734-740.

Blackman, F., & Atkins, E. (2014). The effect of adding grade B hip mobilization to a muscle strengthening home exercise programme on pain, function, and range of movement in adults with symptomatic early-stage hip osteoarthritis: A pilot study for a randomized controlled trial. International Musculoskeletal Medicine, 36(2), 54-63.

Yerys, S., Makofsky, H., Byrd, C., Pennachio, J., & Cinkay, J. (2002). Effect of mobilization of the anterior hip capsule on gluteus maximus strength. 

Makofsky, H., Panicker, S., Abbruzzese, J., Aridas, C., Camp, M., Drakes, J., … & Sileo, R. (2007). Immediate effect of grade IV inferior hip joint mobilization on hip abductor torque: a pilot study. 

Walsh, R., & Kinsella, S. (2016). The effects of caudal mobilisation with movement (MWM) and caudal self-mobilisation with movement (SMWM) in relation to restricted internal rotation in the hip: A randomised control pilot study. Manual therapy, 22, 9-15.

Moss, P., Sluka, K., & Wright, A. (2007). The initial effects of knee joint mobilization on osteoarthritic hyperalgesia. 

Zemadanis, K., Sykaras, E., Athanasopoulos, S., & Mandalidis, D. (2015). Mobilization-with-movement prior to exercise provides early pain and functionality improvements in patients with patellofemoral pain syndrome. 

Hunt, M. A., Di Ciacca, S. R., Jones, I. C., Padfield, B., & Birmingham, T. B. (2010). Effect of anterior tibiofemoral glides on knee extension during gait in patients with decreased range of motion after anterior cruciate ligament reconstruction. 

Narang, S., & Ganvir, S. (2014). Efficacy of Kaltenbohn Mobilization on Patients with Osteoarthritis of Knee Joint. Indian Journal of Physiotherapy and Occupational Therapy, 8(3), 162.

Raghav, S., Singh, A., Tyagi, G. P., & Rastogi, K. The Effect of Mobilization with Movement versus Conventional Treatment on Range of Motion in Patients with Post-Traumatic Stiffness of Knee Joint: A Randomized Clinical Trial.

Lalit, S. Y., Suhas, M. B., & Amita, M. (2012). Effect of Manual Therapy Techniques on knee Proprioception in Patients with Osteo-arthritis of knee. 

Indian Journal of Physiotherapy and Occupational Therapy

Sambandam, C. E., Sailor, S. N., & Alagesan, J. (2011). Effect of Mulligan Mobilization and Maitland Mobilization in Subjects with Unilateral Tibiofemoral Osteoarthritis-Randomized Controlled Trial. Journal of Pharmaceutical and Biomedical Sciences, 11(11), 1-4.

Kostov, R., & Ilieva, B. (2016). Results of implementation of the joint mobilization techniques to restore mobility of the knee complex in patients after partial meniscectomy. Scripta Scientifica Medica, 48(1), 30-35.

Oskay, D., Altmış, H., Düzgün, I., & Elbasan, B. (2015). THU0618-HPR Immediate Effects of Mulligan's Concept Mobilization with Movement on Knee Pain and Functions in Patients with Knee Osteoarthritis.

Demirci, S., Kinikli, G. I., Callaghan, M. J., & Tunay, V. B. (2017). Comparison of short-term effects of mobilization with movement and Kinesiotaping on pain, function and balance in patellofemoral pain. Acta orthopaedica et traumatologica turcica, 51(6), 442-447.

Giri, P. (2019). THE EFFECT OF MULLIGAN TECHNIQUE IN COMPARISON WITH MAITLAND MOBILIZATION AND KINESIO TAPING IN PATIENTS WITH OSTEOARTHRITIS OF KNEE JOINT.

Mutlu, E. K., Ozdincler, A. R., & Ercin, E. (2015). Comparison of two different mobilization techniques in the management of osteoarthritis of the knee: A randomized clinical trial. Osteoarthritis and Cartilage, 23, A391-A392.

(also used below) Kaya Mutlu, E., Ercin, E., Razak Ozdıncler, A., & Ones, N. (2018). A comparison of two manual physical therapy approaches and electrotherapy modalities for patients with knee osteoarthritis: a randomized three arm clinical trial. 

Rao, R. V., Balthillaya, G., Prabhu, A., & Kamath, A. (2018). Immediate effects of Maitland mobilization versus Mulligan Mobilization with Movement in Osteoarthritis knee-A Randomized Crossover trial. Journal of bodywork and movement therapies, 22(3), 572-579.

Jadhav, V. S., & Anap, D. B. (2019). Effectiveness of Mulligan Mobilization Versus Mckenzie Exercises in Knee Osteoarthritis: A Single Blind Randomized Controlled Trial. Physiother Rehabil, 4(177), 2.

Rangey, P. S., Sheth, M. S., & Vyas, N. J. (2015). Comparison of Immediate Effect of Two Different Maitland Mobilization Protocols on Pain and Range Of Motion in Subjects with Osteoarthritis of Knee. Pain, 6, 8.

Razek, R. A., & Shenouda, M. M. (2014). Efficacy of mulligan's mobilization with movement on pain, disability, and range of motion in patients with knee osteoarthritis: A randomized controlled pilot study. Indian Journal of Physiotherapy and Occupational Therapy, 8(1), 242.

Ko, T., Lee, S., & Lee, D. (2009). Manual therapy and exercise for OA knee: effects on muscle strength, proprioception, and functional performance. 

Dwyer, L., Parkin-Smith, G. F., Brantingham, J. W., Korporaal, C., Cassa, T. K., Globe, G., … & Tong, V. (2015). Manual and manipulative therapy in addition to rehabilitation for osteoarthritis of the knee: assessor-blind randomized pilot trial. 

Journal of manipulative and physiological therapeutics

Kappetijn, O., van Trijffel, E., & Lucas, C. (2014). Efficacy of passive extension mobilization in addition to exercise in the osteoarthritic knee: an observational parallel-group study. The Knee, 21(3), 703-709.

Singh, D. (2012). An Experimental Study on effects of Mulligan Mobilization Technique and Isometric Exercises in Patients with Osteoarthritis Knee. Indian Journal of Physiotherapy & Occupational Therapy, 6(4).

Deyle, G. D., Henderson, N. E., Matekel, R. L., Ryder, M. G., Garber, M. B., & Allison, S. C. (2000). Effectiveness of manual physical therapy and exercise in osteoarthritis of the knee: a randomized, controlled trial. Annals of internal medicine, 132(3), 173-181.

Deyle, G. D., Allison, S. C., Matekel, R. L., Ryder, M. G., Stang, J. M., Gohdes, D. D., … & Garber, M. B. (2005). Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program. Physical therapy, 85(12), 1301-1317.

Mobilization and Conventional Physical Therapy

MN, N. A., & LYN, K. (2011). Effects of passive joint mobilization on patients with knee osteoarthritis. Sains Malaysiana, 40(12), 1461-1465.

Kulkarni, A. V., & Kamat, M. M. (2017). A Study to Determine the Effectiveness of Mobilization with Movement Techniques in Knee Osteoarthritis Pain. International Journal of Health Sciences and Research, 7(4).

남용이, 춘숙권, & 현승송. (2015). The effect of manual joint mobilization on pain, ROM, body function and balance in patients with knee osteoarthritis. Korean Society of Physical Medicine, 10(4), 91-99.

Pollard, H., Ward, G., Hoskins, W., & Hardy, K. (2008). The effect of a manual therapy knee protocol on osteoarthritic knee pain: a randomised controlled trial. 

The Journal of the Canadian Chiropractic Association

Fish, D., Kretzmann, H., Brantingham, J. W., Globe, G., Korporaal, C., & Moen, J. R. (2008). A Randomized Clinical Trial to Determine the Effect of Combining a Topical Capsaicin Cream and Knee-Joint Mobilization in the Treatment of Osteoarthritis of the Knee. 

Journal of the American Chiropractic Association

Lluch, E., Duenas, L., Falla, D., Baert, I., Meeus, M., Sanchez-Frutos, J., & Nijs, J. (2018). Preoperative pain neuroscience education combined with knee joint mobilization for knee osteoarthritis. The Clinical journal of pain, 34(1), 44-52.

Park, S. J., & Lee, J. H. (2016). Effect of joint mobilization and kinesio taping on pain, range of motion, and knee function in patients with knee osteoarthritis. The Journal of Korean Physical Therapy, 28(5), 279-285.

Park, S. J., & Kim, D. D. (2017). The impact of joint mobilization with an elastic taping on immediate standing balance in patients with knee osteoarthritis. Journal of the Korea Convergence Society, 8(7), 295-304.

Altmış, Hülya, Deran Oskay, Bülent Elbasan, İrem Düzgün, and Zeynep Tuna. "Mobilization with movement and kinesio taping in knee arthritis—evaluation and outcomes." International orthopaedics 42, no. 12 (2018): 2807-2815.

Courtney, C. A., Steffen, A. D., Fernández-De-Las-Peñas, C., Kim, J., & Chmell, S. J. (2016). Joint mobilization enhances mechanisms of conditioned pain modulation in individuals with osteoarthritis of the knee. 

Courtney, C. A., Witte, P. O., Chmell, S. J., & Hornby, T. G. (2010). Heightened flexor withdrawal response in individuals with knee osteoarthritis is modulated by joint compression and joint mobilization. The Journal of Pain, 11(2), 179-185.

Ghanbari, A., & Kamalgharibi, S. (2013). Effect of knee joint mobilization on quadriceps muscle strength. International Journal of Health and Rehabilitation Sciences (IJHRS), 2(4), 186-91.

Takasaki, H., Hall, T., & Jull, G. (2013). Immediate and short-term effects of Mulligan's mobilization with movement on knee pain and disability associated with knee osteoarthritis–A prospective case series. Physiotherapy theory and practice, 29(2), 87-95.

Bibliography

Questions, comments and critiques welcomed and encouraged

Joint Mobilization: Hip Joint and Knee Joint

Related Courses:

Course Description: Hip Joint and Knee Joint Mobilizations

Introduction

Research Corner Summary

Research Corner: Hip
3 Sub Sections

Research Corner: Knee
3 Sub Sections

Video Demonstration
2 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Joint Mobilization: Hip Joint and Knee Joint

Related Courses:

Course Description: Hip Joint and Knee Joint Mobilizations

Introduction

Research Corner Summary

Research Corner: Hip3 Sub Sections

Research Corner: Knee 3 Sub Sections

Video Demonstration2 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Research Corner: Hip
3 Sub Sections

Research Corner: Knee
3 Sub Sections

Video Demonstration
2 Sub Sections