Recommended Path for New Grads or Young PTs | Modern Manual Therapy Blog

Recommended Path for New Grads or Young PTs

I had a blog request from a DPT student reader sometime over the holidays. He wanted to know what my course recommendations for new grads were. I see the above fork in the road as having two paths, one is standard OMPT courses, like Paris, Grimsby, Maitland, and Evidence in Motion. The other is the McKenzie Institute USA.

Early on in my career, when I had taken all of Paris' courses first while in OMPT Fellowship/Residency (back then they were almost synonymous), I was turned off to the MDT approach. I had learned an MDT based spinal approach in my entry-level training. It was disconcerting to have my first course, two days after I graduated, start slamming the MDT approach.

I finished all of Paris' courses, got my DPT, and obtained MTC from the University of St. Augustine. It was hard work like any certificate that actually changes the way you practice. It was tough to integrate. Like any OMPT program, you are presented with a myrid of techniques and assessments. It is up to you to come up with how to integrate it into your practice. It took a few years and having more experience under my belt to really apply a lot of what I learned from that approach.

One year after my MTC, I went through all of the MDT courses and also got credentialed. Yes, back before I had kids, I just went to course after course and flew all around the country. The beauty about the MDT approach, is that you can go back and immediately apply what you learned from the first course. You see live patient exams and treatments from the faculty. You learn a reliable method of patient classification. Research shows better outcomes from patient classification.

The MDT approach gets criticized frequently. I understand why. It almost seems too simple. Or clinicians have "tried it" and just gave "McKenzie" press-ups to every lumbar patient. That works as well as giving every lumbar patient a thrust manipulation, or bird dog exercises. It's more than just extensions, just like Rocabado's approach is more than just 6x6 exercises!

So in the first 3-5 years of my career, I told the students I mentored to take OMPT courses and then MDT. That advice has reversed now 14 years after I graduated. I realize that many of you will struggle with a standard OMPT approach. I am not saying that you will not learn techniques/assessments that you can't use every day. However, very few courses present you with an easy system of classification, don't overwhelm you with dozens of techniques presented in 3-4 days, and enable you to instantly treat mechanical diagnoses.

The caveats are that when it doesn't work, you need something to fall back on. That's where soft tissue manipulation, neurodynamics, joint manipulation, functional release and functional exercise, and pain education come in. No one school of thought has all the answers, and you should be wary of those that claim to be the panacea.

On a quick note, if you're interested in functional release, you should absolutely check out the courses from the Institute of Physical Art. That is what "changed" my career by better integrating STM into my tool bag of treatments. They are immediately applicable, and you can use STM on more patients with less contraindications than JM. They also nicely integrate PNF and exercise into their courses.

Whatever road you choose, stick to it. I have seen many clinicians say they've tried McKenzie A, or the first two Maitland courses, but did not finish. You are just scratching the surface of any approach if you haven't taken all the courses, and gotten certification. It is also confusing to taken courses here and there, as they often contradict each other and unfortunately put down the other's approaches (that goes for MDT and OMPT). Good luck and remember you always have great online mentors if you end up in a facility where everyone just slings modalities.


  1. Current USA student. Nice to hear someone put all of this information into context and provide advice rather than just discrediting an entire school of thought because the nucleus doesn't centralize as MDT suggests.

  2. being out only 2+ years, i feel like maitland really helped me start to get patients better, and as i've gotten comfortable with their assessment and evals i've started to add more mckenzie (read the books haven't taken the courses yet) and manipulation and stm. I definitely agree that you have to start with a course of study that teaches you how to assess (maitland and mckenzie do a great job with these)

  3. did you take additional classes outside of USA while attending?

  4. At the time yes, just more manual therapy courses I had to take as electives at a local PT School in Buffalo, NY.