Exam and Treatment of the Lumbosacral Spine – Mennell/Travell Approaches to Joint Dysfunction and Trigger Points


Exam and Treatment of the Lumbosacral Spine – Mennell/Travell Approaches to Joint Dysfunction and Trigger Points



This course is intended for Chiropractors only – 16 CEUs. The Institute for Continuing Education is an Approved Sponsor/Provider with the NJ Board of Chiropractic Examiners.

Regular Tuition: $495.  Early Bird Discount through August 7: $470.

Please dress comfortably for class.


This course draws attention to certain frequently overlooked diagnosable conditions which are readily treatable by the chiropractor. Essentially the course provides a new appreciation of the musculoskeletal system in medicine.


At the conclusion of this seminar-workshop, the participants should appreciate and accept the responsibility for making a structural diagnosis/assessment of the musculoskeletal system of the lumbosacral spine. Evidence based outcomes will be stressed as it is both beneficial to the patient’s well being but also cost effective for the patient as well.

  • The participants will be able to differentiate between the lumbar and sacral joint complex dysfunction as per Dr. John Mennell’s model.
  • The participants will be able to differentiate which muscles are affected by myofascial trigger points as Dr. Janet G. Travell’s Model for the lumbosacral region and lower quarter.
  • The participants should be able to identify as to whether their choice of treatment, they are promoting healing as opposed to the promotion of the restoration of function which can only be undertaken when healing has taken place.
  • The participants should be able to demonstrate and explain the useful properties of any physical therapy technique they elect to use in their treatment program.
  • The participants will be able to identify the principles which guide them in their choice of said treatment, especially when treating the patient during the healing phase.
  • The participants should be able to design a treatment program based on a realistic diagnosis.
  • The participants will be able to teach their patients how to self manage the condition with an appropriate home program.
  • The participant should identify the concepts of orthopedic medicine in soft tissue treatment and the diagnosis of referred pain from the joints as well as associated musculature.
  • They should appreciate the integrated approach to evaluation and treatment and the skills learned should be immediately utilized in the clinical setting.
  • The participant should demonstrate all the techniques taught and pass a practical and written test given at the conclusion of the seminar.
  • The participant should be able to identify the prognosis for the patient and give measurable time frames for their outcome.


Day One

7:30-8:ooam            Registration and Pre-Test

8:00-10:00am         Overview of the musculoskeletal system, structural examination of the system concept of mechanical pain from synovial joints: Clinical importance of the case history; Join play-joint dysfunction-joint manipulation; Demonstration: Practice; Concepts of “Acute” and “Chronic” in patient analysis; Recognition of “healing” and “healed”; Rules for manipulative examining techniques; Three “NEVERS”.

10:00-10:15am         Break

10:15am-12:00pm   Workshop: Examining mobilization techniques of the joints of the lumbar spine

12:00-1:00pm           Lunch

1:00-2:00pm             Workshop: Examining Mobilization Techniques of the lumbar and pelvic joints differential tests of the lumbosacral and S.I.

2:00-2:15pm              Break

2:15-3:30pm               Assessment and treatment of Illiotibial Band Insufficiency

3:30-5:00pm              Specific therapeutic manipulative techniques

5:00pm                        Adjourn

Day Two

7:30-8:00am             Sign in

8:00-10:00am           Workshop: Lumbosacral exam procedures and case presentations. Applying the techniques Random vs. Block training. Palpation of the seven structures.

10:00-10:15am           Break

10:15am-12:00pm      Clinical overview of myofascial trigger points Dr. Travell’s Model

12:00-1:00pm             Lunch

1:00-2:00pm               Alternate treatment techniques for treating myofascial trigger points

2:00-2:15pm                Break

2:15-3:30pm                Myofascial Trigger Point workshop: palpation assessment and practice utilizing the spray and stretch technique and other alternative techniques

3:30-4:30pm                Rehabilitation exercises for strength, stability and mobility

4:30-5:00pm                Practical/written examination

5:00pm                          Adjourn



Robert Ruffalo, PT, DC, CCSP, is  Founder and President of CESI Continuing Education Seminars Incorporated, and Owner/Director of A T.E.A.M. Approach Physical Therapy Center in Bloomfield, NJ, which he established in 1990.

Dr. Ruffalo is a physical therapist (PT), doctor of chiropractic (DC), certified chiropractic sports physician (CCSP), and is also a certified golf fitness instructor/medical professional, Level 3 by the Titleist Performance Institute (TPI CGFI-MP3), and a TPI Junior Level 2 Coach (JR2). At A T.E.A.M. Approach Physical Therapy Center, he brings together his diverse expertise, vast experience, and personal interests to deliver a unique multi-disciplinary health care practice. Dr. Ruffalo specializes in manual therapy of the cervical spine and extremities and is trained in a variety of treatment approaches and techniques.

In addition to his work as a physical therapist and chiropractor (one of only few dual licensed practitioners in NJ), Dr. Ruffalo has a passion for educating his peers by providing continuing education courses to physical therapists, chiropractors, physical therapy assistants, athletic trainers and insurance industry professionals.

Many of the seminars are based on the advanced work of two medical pioneers: the late Dr. John Mennell, an orthopedist and founder of the joint dysfunction model for diagnosis and treatment, and the late Dr. Janet Travell, who founded the trigger point (myofascial pain) model of diagnosis and treatment. Dr. Ruffalo was fortunate to have lectured and taught with these practitioners and researchers.


Saturday, August 21 and Sunday, August 22, 2021, 8:00am-5:00pm each day