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- 14-15 July 2012 -
Physical Edge attends revolutionary PIM (Physiotherapy Instrument Moblisation) course for spinal and peripheral joint pain
Physical Edge sends Rhys Chong on the 2 day PIM (Physiotherapy Instrument Mobilisation) course. This is a new concept created by Tim Mann and Pam Mann (Physiotherapists) and uses a fantastic mobilisation tool to help mobilise joints of the body including the spine.

Rhys has been looking for a tool which gets fast results and is backed by research evidence. It is painless, safe and gets similar results to spinal or peripheral joint manipulation. The research shows it is more reliable than conventional hands on joint mobilisation and is also more specific to the level being treated.

Clients enjoy having treatment and are surprised at the functional changes they experience. Physical Edge will be using PIM to help clients get faster pain relief. If you would like to find out more do email or call us.


Read below for more information on PIM and testamonials


- 13-06-2012 -
Hi Pam and Tim,
I have been intergrating PIM into majority of my treatments since going on the course in Singapore, with successful outcomes. More so recently I was working at the Rugby World Cup Qualifing Tournament in Malaysia, and the PIM was so incredably useful!! Seeing rugby guys who had chronic neck issues and being able to treat them quickly made me a massive hit at the tournament and I have you guys to thank. So thank you so much for a fresh outlook on a new treatment tool which has motivated me to improve and develop as a Physio in so many ways!

Kat Lenan


- 20-03-2012 -
Hi Tim,
Just thought you might like to hear this story. I have been using the pim now for a year (since May 2010) or so quite regularly. Last week I treated a gentleman with Bell's Palsy (?). He had had paralysis of his facial muscles on the right side of his face for a week. I used the pim on his R TMJ (PA) and on C1(Lateral) and sent him home with the usual facial exercises, and thought I could see an improvement in his facial muscles almost immediately after treatment. Thought i might have been imagining it until he returned today for review and he has almost complete recovery already. Needless to say both him and I were very impressed. Hope this email finds both you and Pam well.
Wendy Lukas


- 22-05-2012 -
Hi Tim and Pam,
Many thanks for the reply. I am finding the PIM instruments and concepts are fantastic tools of our trade. I must confess that the upper limb PIM is absolutely invaluable for the upper cervical region. I have had a number of people referred to me following treatments by osteopaths and chiro's with no joy. They have had primarily C0-1 C1-2 problems with severe blocks. I have had instant results with complete ease and safety. I wish I had thaught of designing the PIM first.
Take care for now,
Charles M Danby Chartered Physiotherapist Boston Physiotherapy Ltd Bsc.Hons, M.C.S.P, HPC, OCPPP, AACP



Some webpages from Physio practices successfully incorporating PIM
www.physioworks.com.au/treatments-1/physiotherapy-instrument-mobilisation-pim www.bostonphysioltd.co.uk/Services/page17/page17.html www.northcoastphysiotherapy.com.au/physiotherapy-services-buderim/physiotherapy-instrument-mobilisation-pim/ www.elgarphysio.com/matt_elgar.php www.scorpioclinics.co.uk/pim.php www.corrimalphysiotherapy.com.au/index.php?/Corrimal-Physiotherapy-Our-Team.html



Evidence Base underpinning the course content
The PIM: Physiotherapy Instrument Mobilisation Concept (PIM) addresses problems with reliability and specificity of manual mobilisation techiques, safety of mobilisation of the cervical spine and physiotherapist thumb injury in the performance of manual techniques.Physiotherapists demonstrate poor intratherapist and worse intertherapist reliability for the basic palpation skills of correctly assessing properties of movement of a vertebra and reliably applying mobilising forces to it (Matyas and Bach 1985,Hardy et al 1991, Binkely 1993, Levin 2000, Harlick 2007, Robinson 2009). It has been consistently demonstrated that the majority of manual therapy physiotherapists eventually suffer from thumb damage to the extent that that it impairs their ability to continue manual therapy (Wajon et al 2007, Snodgrass 2002).

In addition to the problems of reliably locating and accurately assessing joint properties, there is good evidence to demonstrate that passive accessory movements applied by physiotherapists are not specific to the stated levels (Lee 1995) and higher velocities of mobilisation, particularly instrument mobilisation, result in higher relative inertia of adjacent vertebra and therefore a more specific accessory mobilisation (Keller 2002). Additionally, higher velocities of instrument mobilisation have a range of spindle-modulated afferent barrage effects that give physios access to a variety of beneficial neurophysiological effects.

Manipulation of the cervical spine is not without its dangers (Mann 2001). Instrument mobilisation has documented equal effectiveness compared to manipulation of the cervical spine, lumbar spine and sacro-iliac joints (Gemmell 1995, Shearar 2005, Wood 2001) and has greater safety with only one documented major incident (in chiropractic hands) in over 40 years (Taylor 2004, Nykoliation 1999). The benefits of cervical manipulation are not proven whilst the risks of serious injury are, leading some to conclude that cervical manipulation should no longer be performed (Leaver 2010). Physiotherapy Instrument Mobilisation is proven to be more reliable, more specific, far safer, far more efficient, less injurious to the therapist and equally effective compared to manipulation and mobilisation. It is a useful option for physiotherapists.

Binkely et al 1993 Diagnostic classification of patients with low back pain: report on a survey of physical therapy experts. Physical TherapyMarch 1993 vol. 73 no. 3 138-150

Gemmell HA, Jacobson BH. The immediate effect of Activator vs Meric adjustment on acute low back pain: a randomised controlled trial. JMPT 1995 18:453-456

Hardy GL, Napier JK. Inter and intratherapist reliability of passive accessory movement technique. N Z J Physiother1991;19:22-4.

Harlick J, S. Milosavljevic, P. Milburn Palpation identification of spinous processes in the lumbar spine, 2007, Manual Therapy, Volume 12, Issue 1, Pages 56-62

Kawchuk G., N. Prasad, R. McLeod, T. Liddle, T. Li, Q. Zhu 2006 Variability of Force Magnitude and Force Duration in Manual and Instrument-Based Manipulation Techniques

Journal of Manipulative and Physiological Therapeutics, Volume 29, Issue 8, Pages 611-618

Keller TS. Force-deformation response of the lumbar spine: a sagittal plane model of posteroanterior manipulation and mobilization 2002Clinical Biomechanics, Volume 17, Issue 3, Page 185

Lee, M et al, 1995, A model of spine, ribcage and pelvic responses to a specific lumbar manipulative force in relaxed subjects. Journal of Biomechanics, Volume 28, Issue 11, Pages 1403-1408

Leaver A 2010, Sydney University Alumni Magazine http://sydney.edu.au/alumni/sam/november2010/neck-click.shtml

Levin U et al. Variability of forces applied by experienced physiotherapists during provocation of the sacroiliac joint. Clin Biomech (Bristol, Avon). 2001 May;16(4):300-6.

Mann, TW; Refshauge K. (2001). Causes of complications from cervical spine manipulation. Australian Journal of Physiotherapy, 47, 255-266. http://ajp.physiotherapy.asn.au/AJP/vol_47/4/AustJPhysiotherv47i4Mann.pdf
Matyas T Bach Reliability in Clinical Arthrometrics AJP 1985 http://ajp.physiotherapy.asn.au/AJP/vol_31/5/AustJPhysiotherv31i5Matyas.pdf
Nykoliation J, Mierau D. Adverse effects potentially associated with the use of mechanical adjusting devices: a report three cases. JCCA.1999;43:161–167

Robinson R et al, Reliability and validity of a palpation technique for identifying the spinous processes of C7 and L5, Manual Therapy August 2009 (Vol. 14, Issue 4, Pages 409-414)

Shearar, K., Colloca, C., White, H. (2005) A randomized clinical trial of manual versus mechanical force manipulation in the treatment of sacroiliac joint syndrome. Journal of Manipulative and Physiological Therapeutics, 28 (7), 493-501.

Snodgrass, Suzanne; Rivett, Darren Thumb Pain in Physiotherapists: Potential Risk Factors and Proposed Prevention Strategies Journal of Manual & Manipulative Therapy, Volume 10, Number 4, 2002 , pp. 206-217(12) http://ajp.physiotherapy.asn.au/AJP/49-4/AustJPhysiotherv49i4Snodgrass.pdf

Stochkendahl M J et al 2006 Manual examination of the spine: a systematic critical literature review of reproducibility Journal of manipulative and physiological therapeutics. 29(6):475-85

Taylor S H; A review of the literature pertaining to the efficacy, safety, educational requirements, uses and usage of mechanical adjusting devices J Can Chiropr Assoc. 2004 March; 48(1): 74–108.

Wajon A, Ada L., Refshauge K. Work-related thumb pain in physiotherapists is associated with thumb alignment during performance of PA pressures, 2007, Manual Therapy, Volume 12, Issue 1, Pages 12-16

Wood TG, Colloca CJ et al. A pilot randomised clinical trial on the relative effect of instrumental vs manual thrust manipulation in the treatment of cervical spine dysfunction. JMPT 2001 24(4): 260-271