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From the Authors | William O’Grady: Thrust Joint Manipulation Skills for the Spine

William H. O’Grady, PT, DPT - March 21, 2018

In the first installment of our “From the Authors” series, Bill O’Grady tells us about his inspiration and intentions for writing Thrust Joint Manipulation Skills for the Spine, an exclusive new manual therapy textbook he co-authored with Emilio (Louie) Puentedura.

Louie and I had been teaching together for 10 years when we set out to write this book. Between the two of us, we brought almost 90 years of clinical experience and teaching to the table.

We both gravitated toward this field because we found that skillful application of these techniques provided such obvious successful outcomes. Its natural appeal was that we could witness immediate improvement in both the symptoms and quality of life for our patients.

We were fortunate to have great mentors and influences like Freddy Kaltenborn, Olaf Evjenth, James Cyriax, Stanley Paris, Geoff Maitland, Robin McKenzie, Dick Erhard, Peter Gibbons, Phil Tehan, David Lamb, Cliff Fowler, Erl Pettman and Laurie Hartman. Many of these renowned gentlemen authored their own textbooks on mobilization and thrust manipulation, and several of them were groundbreaking for our field. Needless to say, there are many books that provide descriptions of thrust techniques.

When Louie and I decided to write this book, we wanted to incorporate our education, clinical experience and teaching. Our goal was to publish a book that is simple to read and geared not only toward the entry-level and residency/fellowship student, but also the educator.  

The book includes a history of thrust joint manipulation (TJM) as well as research on the effectiveness, safety and clinical reasoning of using TJM. But we feel what makes our book most unique is the content in chapters five and seven.

Chapter five provides drills that both the student and educator can use to hone their thrust manipulation skills. There are drills in perfecting patient handling/palpation, stance, appreciating end feel as well as use of the core and larger muscle groups for control and speed development.

Chapter seven provides the “meat and potatoes” of the book. Each technique is briefly described, followed by the key recommendations of when to use it, which tests to perform after “red” and “yellow” flags are ruled out and the primary muscle groups that need to be activated to cue the operator and successfully perform the thrust. It is our belief that the larger muscle groups are responsible for speed and control while the hands are simply extensions of these muscles.  

Each technique is divided into five bulleted parts; “patient position,” “therapist position,” “points of contact,” “position for the thrust” and “application of the thrust.” Below each technique the reader will find tips for fine tuning and keys to success. These “clinical pearls” are provided to help the clinician/student perfect their TJM skills. The techniques and fine-tuning pearls are described in significant detail, providing the building blocks for effective and safe TJM to the spine.

Finally, the online videos provide both a “real time” thrust manipulation and a second step-by-step instruction of each technique. Easy online access allows the clinician to view techniques on their mobile phone or tablet from anywhere, at any time.


William H. O’Grady, PT, DPT, OCS, FAPTA, FAAOMPT, DAAPM
Dr. O’ Grady is a nationally recognized expert in the management of spinal disorders and has taught manipulative techniques for over 40 years. He has served as chair of the Board of Examiners for the American Academy of Orthopedic Manual Physical Therapists (AAOMPT), and as an instructor in advanced manipulation technique for the University of Southern California spine fellowship program as well as an adjunct professor at the University of Nevada, Las Vegas.


Discover how the clinical pearls from Bill and Louie’s book can enhance your practice and understanding of spine manipulation. Learn more about Thrust Joint Manipulation Skills for the Spine.



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William H. O’Grady, PT, DPT

Dr. O’Grady is a nationally recognized expert in the management of spinal disorders and has taught manipulative techniques for over 40 years. He is co-author of the new manual therapy textbook Thrust Joint Manipulation Skills for the Spine.

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