[Purpose] The purpose of this study was to report a case of lower back pain with symptoms in both lower limbs, and the improvement of the chief complaint by joint mobilization of the thoracic vertebra. [Case Description] The patient was a man with a diagnosis of lumbar disc herniation with a history of 2 months. The chief complaint was low back pain, numbness in the front of the left thigh, and muscle pain in both lower limbs. [Clinical Reasoning] The evaluation of thoracic vertebrae and symptoms of both lower limbs and night pain suggested dysfunction of the 10th thoracic vertebra. Therefore, as a first treatment, manual physical therapy was performed on the 10th thoracic vertebra. [Outcomes] After 27 treatment session over 34 days, back pain remained, but it was possible for the patient to return to work. [Conclusion] Suspecting thoracic spine dysfunction in cases of bilateral leg symptoms is important when implementing physical therapy.

Physiotherapists in Australia are “first contact” practitioners, which means they are able to diagnose a patient’s injury without a referral from a doctor. Physiotherapists can also refer patients for many types of medical investigations including X-rays, CT, and MRI scans. They require evidenced-based practice to counter medical litigation; they have to consider the sensitivity and specificity of diagnostic examinations used to diagnose patients, and assess the effects to prioritize treatment. The Australian Physiotherapy Association requires physiotherapists to complete post-graduate studies of at least 20 hours every year to maintain their professional quality. They also create career pathways to support the evolving and diverse professional development needs of physiotherapists. Such pathways are achieved via gaining clinical competence certificates at either entry level, titling or specialist level. Titling is available to graduate physiotherapists by completion of either an academic or experiential pathway. The academic pathway is to complete a recognised Australian Master's degree by coursework. With the experiential pathway you must gain five years full-time equivalent (FTE) of relevant clinical experience with three years FTE in the selected discipline. The specialist level is only available to previously titled physiotherapists who are prepared to undergo at least two additional years of training with the Australian College of Physiotherapists. Once specialisation has been achieved, you are known as a Fellow of the Australian College of Physiotherapists, the pre-eminent professional body representing specialist physiotherapists in Australia. The Australian Physiotherapy Association requires physiotherapists to update knowledge every year through high evidenced papers or courses, as the best treatment for diseases change as research progresses.

A comprehensive understanding of the current state of physiotherapy education in foreign countries can assist in developing and shaping physiotherapy in Japan. This article summarises the postgraduate physiotherapy educational system in Australia. The author’s personal account of experiences of university studies and workplaces provides further context. In particular, the continuing professional development is outlined based on clinical career pathways available for Australian clinicians.

The number of specialties of physical therapy in the United States has grown over the years. Recently, the performing arts, which includes dance, has been added to the area of specialties in Fellowship for U.S. Physical Therapists. To specialize in dance injuries, physical therapists must continue with specialized education, and orthopedic manual therapy is one of the relevant topics of continuing education courses for them. This article describes physical therapists’ clinical activities and continuing education in manual therapy and dance. The author’s experience as a New York state-licensed physical therapist with a specialty in dance is also introduced.

In recent years, the number of Japanese physiotherapists working overseas has been increasing. However, there are not so many reports about clinical experience and post graduate education in the Netherlands. The author is a physiotherapy graduate of a Japanese university who has been working in the Netherlands for 8 years. This report describes the author's roles as a physiotherapist at a Dutch professional soccer club and private orthopedic clinic, and post-graduate education in the Netherlands.