The overall theme of this preconference session is to present clinical reasoning skills rooted in evidence-based practice when dealing with the high-level injured athlete. With the use of well-reasoned manual techniques and movement analysis, participants will augment their repertoire of clinical skills/tools in their OMPT toolbox. It is becoming more evident in the literature that using clinical reasoning to clarify how problems in the spinal region can influence the outcome of managing orthopaedic conditions of the extremity. Many of the individual assessment techniques and treatment approaches have been reported in isolation in the literature but these have not been presented as a combined manual and sports therapy approach to providing patient-centered care. It is a common pitfall for many students and clinicians that the interplay between spinal regions and related extremity symptom contribution is often missed leading to ineffective interventions. This course aims to provide the missing link in how to correctly identify contributions from these spinal regions and from manual and sports therapy examination approaches so that specific interventions are targeted to the cause and source of extremity problems thereby achieving desired outcomes. Case examples will provide participants with the clinical reasoning skills used by manual and sports clinical specialists in common patient scenarios. These examples will also demonstrate the use of functional testing to determine the readiness of athletic patients to return to sports activities.