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Latest Testimonial

Dear Ross and Ian, I would like to thank you both for presenting your Level 1 Neural Tissue course for the Central Essex Community Services MSK Physiotherapy team. I cannot recommend it highly enough! Being a delegate myself, I thought that the training was delivered in such a way that everyone was engaged throughout… Read more

Gerdalize du Toit

Clinical Manager Central Essex Community Services

I have known Ian since 2007 in his capacity as consultant physiotherapist for West Ham United, Charlton and now Portsmouth FC. Ian has always provided a teaching input to my staff and I would definitely recommend… Read more

Steve Allen Portsmouth FC Head Physiotherapist

Lumbar spine management in Football

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Clinical Solutions

'Clinical Solutions' is a teaching organisation dedicated to specialist post-graduate education in manual therapy and was established in 2008 by the co-directors Ian Cowell and Ross Poyton. The course tutors have combined their knowledge as expert clinicians, with extensive and differing clinical experiences, to develop a programme of courses for physiotherapists.

Ian Cowell MSc MCSP HPC MACP PgC Msk Ultrasound

Ian is the principal physiotherapist and director of Brook Physio and has over 20 years of clinical experience. He qualified as a Chartered Physiotherapist in 1989 and in 1993 he travelled to Curtin University, in Perth Western Australia, where he completed a Graduate Diploma in Manipulative Therapy and was awarded the 'Brian Edwards' prize for clinical excellence. Curtin University is an internationally recognised centre of excellence for musculoskeletal and manual therapy and Ian elected to complete his Masters in Manipulative Therapy there in 2000; researching the effectiveness of physiotherapy in the treatment of cervical spine related arm pain.

He is a current member of the MACP the Manipulative Association of Chartered Physiotherapists; a group of Chartered Physiotherapists recognised for their enhanced skills in neuromuscular physiotherapy.

Ian specialises in the management of therapy resistant chronic disorders and has a particular interest in persistent spinal disorders and the treatment of non-specific low back pain. A large component of his clinical case load involves consultancy physiotherapy for a number of professional football and rugby clubs, where his client group includes premier league and elite internationals.

He is one of the few chartered physiotherapists in the UK to have qualified as a musculoskeletal ultrasonographer and is a member of BMUS the British Medical Ultrasound Society. Using ultrasound in conjunction with clinical assessment, Ian is able to pinpoint more accurately the diagnosis, thus facilitating the most appropriate treatment pathway for his patients. This combined approach is invaluable in the management of chronic tendon and muscle injuries. Ian has also extended his scope of practice to include injection therapy and uses ultrasound to carry out guided joint and soft tissue injections for pain relief and to facilitate manual therapy and exercise approaches.

Ian is also actively involved in post-graduate physiotherapy teaching and has published several research articles on spinal manual therapy and presented at many conferences on the management of low back pain in football. He is also an invited lecturer on the Musculoskeletal Ultrasound Course at Canterbury University.

Ross Poyton MSc MCSP HPC MACP 

Is the principal physiotherapist and director of The Physio Team. He qualified as a Chartered Physiotherapist in 2001 and in January 2007 travelled to Perth, Western Australia and completed the Masters in Manipulative Therapy Curtin University. Here Ross gained a Masters in Manipulation with High Distinction for which he was awarded 2 academic prizes.  Firstly the “Brian Edwards Prize” for clinical excellence and secondly the archive merchants book prize for the highest academic performance.

Since returning to the UK, Ross has gained membership to the specialist physiotherapy group the MACP the Musculoskeletal Association of Chartered Physiotherapists a group of Chartered Physiotherapists recognized for their excellence in neuromuscular physiotherapy. 

Ross also went onto to complete further postgraduate training at various Universities. These additional studies have included MSc modules in extended scope physiotherapy, injection therapy and in supplementary prescribing. Ross has combined his role in private practice with working as an Extended Scope Orthopaedic Physiotherapist within the NHS whilst providing some consultancy to professional football clubs.  This unique working environment allows him to see varied chronic spinal disorders in a variety of client groups for which he specialises in the sub grouping and classification to allow appropriate onward management.  His client group includes professional footballers, Olympic tri-athletes and various elite level sportspersons and talent squads.

Ross has supervised many postgraduate students mainly those looking to complete MSc’s or to gain MACP membership via various universities.

Ross has taught and lectured at various NHS trusts and private hospitals mainly on spinal disorders and the treatment and sub classification of neural disorders.



  • Manual Therapy Approaches to the Physical Evaluation and Treatment of Disorders Involving Neural Tissues in the Upper Quadrant. Level 1
  • Manual Therapy Approaches to the Physical Evaluation and Treatment of Disorders Involving Neural Tissues in the Lower Quadrant. Level 2

Course Description: These unique two day courses bring together manual therapy techniques, motor control concepts and an appreciation of the neural system in the examination and treatment of neuropathic pain in the upper and lower quarter.  The course presents a clinically validated classification system for neuropathic pain underpinned with a comprehensive physical examination protocol including neurological examination, neural tissue provocation testing, neural palpation and specific motion segment palpation. Patho-anatomical changes related to cervical and lumbar spine disorders are considered and mechanism based targeted interventions are covered in detail. Central nervous system manifestations of a pain disorder will be discussed in order to determine the suitability of a condition for physical treatment.

  • The Management of Lumbar Spine disorders in Fooball

Course Description: This two day course integrates manual therapy techniques, motor control concepts and an appreciation of the neural system in the examination and treatment of lumbar spine disorders in professional footballers.  The course includes detailed lectures on the patho-anatomical changes related to lumbar spine disorders, biomechanical considerations and motor control system dysfunctions related to development of lumbar spine pain in this specific patient group. The course covers examination of the lumbar spine from an articular, neural and functional motor control perspective.

Adolescent back pain within football will be covered adressing specific patho-anatomical abnormalities that relate to this group; such as spondylosis and spondylolisthesis. Common maladaptive postural and movement control patterns in this group will be presented and their relationship to symptoms.

The aim of this course is to develop participants’ clinical reasoning when formulating a treatment plan for this group. Based on a model of mechanism based targeted intervention the course includes practical treatment techniques and rehabilitation strategies, ranging from from manual therapy techniques to progressing functional motor control programmes from early stage to high level sports specific rehabilitation. The two course tutors Ian Cowell and Ross Poyton have combined their knowledge and experience as expert spinal clinicians, with years of experience in the management of back pain in football, to develop this course.