Maine Orthopaedic-Manual SIG

Maine Orthopaedic-Manual SIG

Purpose of the Orthopaedic Manual /Physical Therapy SIG:

To provide opportunities for networking and education amongst PTs and PTAs with a common interest in Orthopaedic Manual Physical Therapy, along with providing community resources and promoting the advancement of evidence-informed physical therapy practice in the state of Maine.

Current Topic and Zoom Meeting:

►Spinal Manipulative Therapy Education and Thrust Joint Manipulation

1.  Presenting initial data collected and analyzed as part of a mixed methods study.  Chad Howland is conducting on the topic of HVLAT manipulation in entry-level DPT education.

2.  How can Maine PTs foster skill development in spinal manipulative techniques, addressing perceived barriers, and promoting competencies in the area of assessment and intervention.

3.  Get perspectives from different parties (PTs in clinical practice, faculty, and current students). 

Do you have questions?  Ask Chad!

When:  Tuesday, February 27th at 7:30pm EST
Where:  Zoom
Zoom Invitation:

Meeting ID: 922 1444 1089
Passcode: 869806

Previous Topics:

►Chronic Mortise Instability - Part 1
Functional Anatomy of the Ankle Mortise


An underlooked cause of chronic ankle instability (CAI) is an unstable mortise. An unstable ankle mortise arises from ankle sprains of moderate-to-severe trauma. This type of lower limb instability alters the rear foot and midfoot biomechanics, resulting in premature loading of the medial foot (i.e., sudden foot flattening), and impaired absorption and propulsion during gait. The sequela of an unstable mortise produces concomitant clinical conditions ranging from an acquired flat foot, posterior tibialis tendon dysfunction, hallux valgus, and metatarsalgia1 . Extrinsic to the foot and ankle, the unstable mortise can produce altered motor control, evidenced by muscle inhibition and facilitation patterns of the lower limb, pelvic girdle, and spine. Altered activation within specific neuromuscular sets can produce hip internal rotation mal-tracking (credit to Gail Molloy ( , SI-joint dysfunctions (innominate rotations and sacral torsions), and lumbar spine disorders (disc injury and functional instability)1,2 .

The purpose of this initial commentary is to describe the functional anatomy of the ankle mortise. Subsequent posts aim to answer the following questions.

1. How does ankle mortise instability occur?
2. How do we identify ankle mortise instability?
3. How do we restore ankle mortise stability?

Written by Dr. Chad Howland, PT, DSc, DPT, SMT, CMPT

To read the full article, click HERE.

Do you have questions?  Ask Chad!

Cuboid Syndrome

What is cuboid syndrome and its clinical presentation?

"Cuboid syndrome is a debilitating foot condition caused by a disruption or subluxation of the cuboid bone due to a change in the structural integrity of the calcaneocuboid joint (Jennings and Davis, 2005). This syndrome is often associated with sinus tarsi, lateral foot, and mid foot pain. Given the lack of reliable tests, this syndrome can be challenging to identify. A physical therapist must link the subjective history, injury mechanism, physical exam, and their own clinical experience to establish a probable hypothesis. Therefore, recognizing the cluster of signs and symptoms becomes essential." 
Written by Dr. Chad Howland, PT, DSc, DPT, SMT, CMPT

To read the full article, click HERE.


Leaders Needed!

We are in need of volunteers to assist in managing and growing the SIG.  If you have a desire to have community and have ideas to help other Ortho-Manual Physical Therapists and Physical Therapists Assistance.  Please contact Chad Howland or Christie Krueger to have a conversation.  Email contacts are below.  The positions listed need to be filled.  If you are interested in any of the positions, please submit a nomination form.  We need people like you!

  • Chair
  • Vice Chair
  • Secretary
  • Nominating Committee
  • Student Liaison

Click HERE to find a nomination form.

You are always welcomed to talk with Chad Howland at or Christie Krueger at