Many clinicians have moved away from providing hands on treatment secondary to substantial amounts of evidence-based medicine advocating exercise-based care for spine related injuries. Practical application will incorporate using manual therapy in conjunction with active interventions to diversify treatment approach and improve patient outcomes. An emphasis will be placed on the neurophysiologic component of manual therapy and exercise. The lasting benefits outside of the manual therapy treatment window will be presented. This course will be provided as a component of the Eastern District Meeting for the Nebraska Chapter of the APTA held on September 15, 2020 virtually.