Learn a precise, repeatable clinical system that helps you make clearer decisions, deliver patient-specific corrections, and reduce the physical strain of adjusting.
You take your patients' care seriously. But difficult upper cervical cases can still leave you questioning the measurements, correction vector, or next clinical step.
You may be dealing with:
You should not have to rely on trial and error to move a case forward.
Advanced Orthogonal is a complete upper cervical clinical system built around detailed analysis, patient-specific correction vectors, instrument-based adjusting, and continued evaluation.
It gives you a clear process to follow—not only when a case is simple, but when the findings are more difficult.
Use patient-specific measurements and a defined clinical process to guide each correction.
Reduce variables that can make results depend too heavily on the individual doctor.
Follow a system designed to help you evaluate results and make informed changes.
Deliver the correction through a table-mounted instrument instead of relying on forceful manual adjusting.
Continue your training through seminars, certification, mentorship, and an active community of upper cervical doctors.
Get a two-hour overview of the principles, procedures, and clinical approach.
Start the Free CourseBuild your skills through seminars, Intensives, and Bootcamp.
Explore 2026 SeminarsShow your understanding and ability through the Institute's certification process.
The Certification PathThe Advanced Orthogonal Institute brings together practicing doctors, instructors, and students who believe upper cervical care should keep moving forward.
Through training, research, collaboration, and certification, the Institute helps doctors develop a more precise and dependable approach to care.
Advanced Orthogonal may be a strong fit when you are:
A focused, hands-on event for experienced doctors who want to improve precision and consistency while transitioning into the Advanced Orthogonal approach.
Five days of hands-on training, guest education, clinical updates, and connection with the Advanced Orthogonal community.
Advanced training, special topics, professional connection, and the Institute's annual community gathering.
Training is designed for chiropractors and chiropractic students who want to learn a precise, instrument-based upper cervical approach. It may also be useful for doctors trained in Atlas Orthogonal, EPIC, Orthospinology, or other upper cervical systems who want to cross-train.
No. The free Intro to AdvO course has no prerequisites and is a good starting point for doctors and students who are new to the technique.
After the introduction, you can continue into the Fundamentals Series, attend a hands-on Intensive or Bootcamp, and begin working toward certification.
The Intro to AdvO course is self-paced and takes about two hours.
Advanced Orthogonal uses a percussive sound-wave instrument to deliver a patient-specific correction.
You do not need to own equipment to begin. The free Intro course requires nothing but your time, and hands-on seminars provide the instruments and imaging you train on.
Clinical use of Advanced Orthogonal requires a percussive sound-wave instrument and access to the imaging the analysis depends on. Contact the Institute for current equipment details before you invest.
Advanced Orthogonal combines detailed digital measurements, patient-specific correction vectors, instrument-based adjusting, and a reproducible clinical process.
Yes. Chiropractic students are welcome at Institute training, and students are part of who this work is built for. Where a student rate is offered it is published on the event page — the 2026 Annual Conference student rate is $347. Bring proof of current enrollment.
The time needed depends on your previous training, seminar attendance, clinical experience, and completion of the Institute's requirements.
Membership is not required to begin with the free course.
Whether you are new to upper cervical care or ready to refine years of experience, your next step can be simple.
Start with the free two-hour Intro to Advanced Orthogonal course and see whether the approach fits your goals, your practice, and the patients you serve.
No prerequisites · Self-paced · Free
The training ground, the support system, and the professional community you need at every stage of your career.
The Advanced Orthogonal Institute exists for one reason: to help you become the best upper cervical doctor you can be.
Whether you're a student just discovering precision-based chiropractic, a practicing doctor looking to refine your skills, or an experienced clinician ready to master the most advanced applications of the technique—this is your home.
We are a nonprofit organization of doctors, educators, and leaders united by a shared commitment to precision upper cervical care. Our members practice across the country and around the world, but we share a common language: the Advanced Orthogonal technique.
What sets us apart isn't just the technique—it's the culture. AOI was founded on the belief that doctors grow best when they learn together, challenge one another, and share what works. We are clinicians first. We teach what we practice, and we practice what we teach. When you train with us, you're learning from doctors who are in the trenches every day, refining their skills and pushing the boundaries of what's possible in patient care.
We believe that precision matters—not for its own sake, but because your patients deserve care that is accurate, reproducible, and grounded in sound biomechanics and neurology.
We believe that growth is a lifelong pursuit. No matter how experienced you are, there's always more to learn, and we've designed our training pathways to meet you wherever you are and take you further.
We believe that collaboration accelerates progress. The most important breakthroughs in this work have come not from individuals working alone, but from doctors sharing insights, questioning assumptions, and building on one another's discoveries.
And we believe that you belong here. Whether you trained in Atlas Orthogonal, Orthospinology, EPIC, or are brand new to upper cervical care—if you're committed to precision and excellence, there's a place for you at AOI.
The Advanced Orthogonal Institute is founded on the advancements of the chiropractic profession dating back to the original upper cervical philosophy presented by B.J. Palmer, and the extensive research by John F. Grostic, D.C., the developer of Orthogonal chiropractic. In the same nature as the Institute was founded on advancement to upper cervical chiropractic care, the Institute will continue to grow, expand, and refine the technique and procedure.
The Advanced Orthogonal Institute and its affiliated doctors are constantly striving to incorporate the latest research in chiropractic, developments in upper cervical care, and breaking discoveries in neurology. Furthermore, the Institute is dedicated to participating in and initiating research to further validate the functional and neurological changes of specific upper cervical procedures.
To preserve, advance, and expand the life-changing potential of precision upper cervical care by equipping doctors with the training, tools, and collaborative ecosystem needed to deliver reproducible, neurologically focused correction.
We exist to cultivate a higher standard of clinical mastery—one that demands precision, objective application, and continual innovation grounded in reproducible results. Our aim is to unify and empower a growing community of upper cervical chiropractors who pursue clinical excellence for the sake of their patients.
From our free Intro to AdvO online course to the immersive week-long Bootcamp, we offer a full spectrum of training options. Our Fundamentals Series builds your foundation. Our AdvO Intensive sharpens your hands-on skills. And our Annual Conference brings the community together for advanced education and connection.
See All TrainingOur certification process is rigorous, transparent, and designed to ensure that every Certified Advanced Orthogonist meets the highest standards of proficiency and clinical excellence. We'll guide you through every step—from your first seminar to your final exam.
The Certification PathWhen you join AOI, you gain access to a network of doctors who want to see you succeed. You'll find mentorship, collaboration, and camaraderie—whether you're troubleshooting a complex case, preparing for certification, or looking for your next opportunity.
Meet the CommunityCertified members are listed in our doctor directory. Members receive continuing education opportunities, marketing support tools, and discounts on all AOI training events. We're continually developing new resources to help you grow your skills and your practice.
Member ResourcesExplore our training. Connect with our community. And when you're ready, step into ownership of your future.
A precision approach to correcting craniocervical junction misalignments using percussive sound wave adjusting technology.
Just as the pioneers of upper cervical chiropractic took a radical look at the ways we can correct the spine more accurately and reproducibly, Advanced Orthogonal continues the upward trajectory of the advancements that are shaping the future of upper cervical chiropractic care.
Advanced Orthogonal care is constantly evolving to new developments, discoveries, and technology in chiropractic and beyond. There is no boundary to how far we will look to find the next advancement to better help those we serve. If we cannot find a technology we need to grow, we will make it. It is our nature to go beyond the fringe.
The focus of Advanced Orthogonal care is to restore the function of the human body from the inside out. This is done by removing interference on the brainstem by realigning the upper cervical spine to its orthogonal nature based on each person's genetically unique anatomy.
The Advanced Orthogonal procedure is more than just an adjusting procedure. It is an entire protocol for accurately evaluating nerve interference in the body, analyzing the upper cervical spine accurately, correcting the craniocervical misalignment with a precise approach, and monitoring the progress of the individual for maximum healing.
Today, Advanced Orthogonal chiropractic stands alone as the most evolved offspring of the upper cervical procedures. It is the only procedure within the profession that includes:
The outcomes of these refinements have eliminated as much human-error from the misalignment puzzle as possible. Through dedicated study and strict adherence to the fundamentals, these enhancements give the Advanced Orthogonal doctor a consistent clinical procedure for accurate evaluation and reduction of the atlas subluxation complex.
Accurate correction of the upper cervical spine normalizes postural reflex loops, which allow the body to permanently stabilize spinal structures — often without the need for specific exercises or physical therapy modalities.
It has become accepted in the chiropractic profession that the adjustment itself only produces a transient correction. Advanced Orthogonal chiropractic teaches the concept of sustainable corrections. Many Advanced Orthogonal patients have shown marked reduction in thoracolumbar scoliosis curves, and mid and low back pain conditions consistently respond favorably as a byproduct of this upper cervical correction.
Advanced Orthogonal practitioners determine misalignment of the upper cervical spine using specific three-dimensional x-rays, and using digital software, are able to measure the position of the upper cervical structures with a high degree of precision. A 1998 study published in the Journal of Manipulative and Physiological Therapeutics showed that interclass correlation coefficients (ICC) for locating pathology on x-ray was only 0.4–0.75, while line drawings for x-ray displacement had ICC's in the 0.8–0.9 range. Trained Advanced Orthogonal doctors utilize clinical procedures that promote the highest degree of intra and inter examiner reliability.
The typical manual chiropractic adjustment requires moving joints to near end-ranges of motion to cause joint distraction and cavitation. This is not an option and would be contraindicated for many patient populations, including those with low bone mineral densities, certain types of disc injuries, surgical fusions, some pediatric patients and those with a variety of other conditions.
The Advanced Orthogonal procedure uses a percussive sound wave to correct the upper cervical misalignment complex. The low force of this technique allows wider patient populations to be candidates for this treatment, and the correction takes place within the patient's normal range of motion, which eliminates the potential risk of ligamentous trauma to the patient.
"A mechanical impulse is imparted to the metal stylus by means of a spring loaded plunger… At the patient-stylus interface, dependent on the impedance match, a portion of this wave energy is transmitted into the patient and a portion is reflected back to the plunger."
Many of the 'hands on' upper cervical techniques can be very challenging to learn, with experienced clinicians stating it can take 10–20 years to become a skilled adjuster. The percussion sound-wave adjusting instrument delivers a consistent force and can be accurately pre-set to deliver a patient-specific correction vector, eliminating as much doctor error as possible. This procedure dramatically reduces the learning curve, and allows doctors to deliver high quality and repeatable corrections very early in their clinical career.
Physical adjusting can take an extreme toll on the clinician's body, with many chiropractors acquiring chronic injuries from their choice of adjusting procedure. The Advanced Orthogonal technique minimizes strain on the doctor's body by delivering the adjusting force through a sound wave instrument — allowing the Advanced Orthogonal doctor to continue to practice for many years without sustaining chronic injuries.
Start with the free two-hour Intro to AdvO course — no prerequisites.
Nine seats. Three open every year. Guided by the members, for the members.
The Institute is governed by a nine-member board elected by the membership, with three seats opening every year — ensuring new voices and forward-thinking leaders always have opportunities to influence the direction of the Institute and the profession.
Three of nine seats open every year. Your voice, your vote, your Institute.
A federally registered research organization building the evidence base for precision upper cervical care.
Advanced Orthogonal has always been a measurement-first discipline — misalignment quantified from digital x-ray analysis, corrections delivered by instrument rather than by hand, outcomes monitored over time. That same rigor is what the Institute now brings to formal research. Our aim is straightforward: produce data of a quality that stands up outside our own profession.
Registration in SAM.gov is the federal government's entity registry — the prerequisite for receiving any federal grant, contract, or award. Our active registration establishes the Institute as a recognized entity eligible to submit proposals, hold awards, and receive federal research funding.
EBRAP is the submission portal for the Department of Defense's Congressionally Directed Medical Research Programs. Our registration gives the Institute a direct path to submit pre-applications and full proposals to DoD biomedical research funding opportunities — including those addressing traumatic brain injury, chronic pain, and neurological conditions.
Together these registrations mean the Institute is positioned to pursue funded, peer-reviewed investigation — not merely to publish case reports, but to compete for the kind of support that produces trials the wider medical community reads.
Every Advanced Orthogonal correction begins with a precise digital x-ray analysis and an instrument setting derived from those numbers. This produces something most manual-technique research cannot: a quantified pre- and post-intervention variable that does not depend on the examiner's hands. Study design starts there.
Because the adjusting instrument delivers a consistent, pre-set force based entirely on patient-specific variables, the intervention itself is reproducible from doctor to doctor and clinic to clinic. Multi-site data collection is therefore viable in a way it rarely is for hands-on techniques — and reproducibility is the foundation of any credible trial.
Clinical outcomes are captured using established, published instruments rather than internally invented scales, so results can be compared against the wider literature. Where physiological measures are appropriate, we pair patient-reported outcomes with objective data.
Human-subjects research is conducted under appropriate institutional review, with informed consent, pre-specified endpoints, and de-identified data handling. Our practitioner network's data is protected under the same security standards that govern the Institute's member platform.
Findings are prepared for peer-reviewed publication regardless of whether they confirm our expectations. Research that only reports favorable results is advocacy, not science.
A technique built on precise measurement should be held to an equally exacting standard of evidence.
Upper cervical chiropractic has a long clinical record and a thin research record. Closing that gap is how the discipline earns a seat at the table with neurology, physical medicine, and military health — and how patients with complex, poorly served conditions eventually get referred to us rather than found by accident.
Certified Advanced Orthogonal doctors are the Institute's research network. Participation can mean contributing de-identified outcome data from your practice, serving as a data-collection site for a funded study, or submitting a case for publication support. If you would like to be included as opportunities open, contact the Institute and we will add you to the research roster.
Tell us about your practice and we'll add you to the research roster.
From your first free course to full mastery — every training pathway through the Institute.
And members save $600 on the AdvO Bootcamp.
TAP ANY INSTRUCTOR PILL FOR THEIR BIO
Anyone can practice this work — the Institute officially recognizes those who prove their proficiency.
Certification in the Advanced Orthogonal Technique ensures that there is a minimum standard being kept by all doctors and students that practice the procedure. Anyone can practice this work, but the Institute will only officially recognize the proficiency of those individuals who have gone through the certification process.
Level 1 Certification proves your proficiency to safely and effectively correct the upper cervical spine with the Percussive Sound Wave Instrument. Completing Level 1 also earns you one free year of AOI membership.
Level 1 RequirementsLevel 2 Certification is proof of mastery of the Advanced Orthogonal technique and opens you up to become an instructor within the Institute.
Level 2 RequirementsEnsure that you have met the requirements (other than testing) for the level of certification that you are applying.
Submit your application, fees, documents, and X-rays to the Certification Committee.
You will be assigned Reviewers who will administer your testing and review your documentation, X-rays, reports, and application until all requirements are met.
Once all requirements are approved, you will be officially issued your certification.
Application fees for certification will be paid to the Advanced Orthogonal Institute. These fees cover the costs for the review, testing, processing of the application, and printing and shipping the Certificate.
All doctors and students who have trained with Advanced Orthogonal Techniques and Procedures, or the Institute's predecessor organizations, and have completed their training according to the standards that were present at the time they were trained have been grandfathered into appropriate certification levels based on experience. Grandfathering is determined on a case by case basis by the Certification Committee based on attendance to prior seminars and active practice experience in the Advanced Orthogonal technique.
Any doctor that has not been "grandfathered" into certification and believes that the standard for certification has been met may send a request for review by the Certification Committee.
Contact the Certification Committee→Full conference registration, directory listing, and every member benefit — our investment back into you.
Certified Advanced Orthogonist — the Institute’s recognition that you can deliver Advanced Orthogonal care to standard.
Level 1 Certification confirms that a doctor meets the minimum standards required to deliver Advanced Orthogonal care. To earn it you demonstrate a solid understanding of the fundamentals, show that you can manage moderately difficult cases, and show that you can guide a patient through basic care.
Two reviewers from separate clinics evaluate your application, your examination, and your x-ray analysis reports. Once every requirement is met, the Certification Committee issues your certification.
There is more than one route into Level 1. Pick the one that fits how you learn and how your schedule works — the standard at the end is the same.
Complete the full Fundamentals Series, then attend one Advanced Seminar.
Complete the Advanced Orthogonal Bootcamp, then attend one Advanced Seminar.
Complete the full Fundamentals Series and the Bootcamp.
Complete an Advanced Orthogonal Internship, then attend one Advanced Seminar.
Complete the Technique Transition Seminar, then attend one Advanced Seminar.
Complete the Advanced Orthogonal elective at a chiropractic college, then attend one Advanced Seminar.
The Level 1 application fee is $1,200. It covers review, testing, processing, and the printing and shipping of your certificate — and it includes one year of free AOI membership, which carries full registration for the Annual Conference.
Attend one Advanced Seminar each year to keep your certification active.
You may retake the examination no sooner than one month and no later than twelve months from the date of the failure. A second failure means restarting the application process.
Students may apply, sit the examination, and submit their reports before graduating. Certification is held in pending status until a Doctor of Chiropractic diploma is submitted to the Institute.
Full conference registration, directory listing, and every member benefit — our investment back into you.
Proof of mastery — and the doorway to teaching this work inside the Institute.
Level 2 Certification means the doctor has demonstrated a level of proficiency that is reproducible and consistent with the standards of Advanced Orthogonal care. It affirms strong application of the technique, competence in complex clinical scenarios, and high proficiency both orally and practically.
Three assigned reviewers evaluate your examination, your training requirements, your clinical application, and your case reports. The same reviewers conduct the Oral Interview and the Practical Exam. On completion you are recognized as a Level 2 Certified Advanced Orthogonist and receive a certificate from the Certification Committee.
The application process, including every requirement, must be fulfilled within one year of the date the application is submitted.
The Oral Interview is a discussion of your understanding of the upper cervical subluxation complex and the Advanced Orthogonal procedures used to correct the misalignment. All three reviewers take part. You answer questions and work through scenarios, demonstrating proficient understanding of the technique out loud.
The Practical Exam is a hands-on test of your proficiency in table placement and instrument alignment. The three reviewers conduct it, with one of them acting as the patient. You demonstrate your understanding of the five Advanced Orthogonal subluxation complex patterns and show adequate logic and reasoning throughout.
Each report covers at least the first three months of the patient’s care and the outcomes over that period. The patient must be under your direct treatment.
At least one of the submitted cases must demonstrate a minimum of one analysis factor that did not reduce, or that increased.
A complex case is a patient presentation of a disorder other than musculoskeletal pain, radiculopathy, or basic headache — or one involving complicating anatomical or aberrant structures. Your reviewers determine whether a case qualifies.
The application fee for Level 2 Certification is $1,800.
You may retake the examination no sooner than one month and no later than twelve months from the date of the failure. If a reviewer becomes unavailable, an alternate reviewer may substitute for that exam only. Retakes are permitted once; a second failure means restarting the entire application process.
Mastery of the technique is where teaching it begins — the Institute’s faculty comes from its Level 2 doctors.
The members of the Advanced Orthogonal Institute are the keystone of our Institute's strength and progress.
As a member, you not only guide the future of the organization through your voice and your vote, but you also gain access to essential resources designed to propel your career as an Advanced Orthogonal doctor and strengthen your expertise in the upper cervical specialty.
The culture of our Institute—built on trust, collaboration, and shared purpose—is the fuel that drives innovation and growth. Together, our members pool resources, advance research, and pursue key goals that shape the future of Advanced Orthogonal care.
Membership in the Advanced Orthogonal Institute is intentionally broad and inclusive. Membership is open to:
This is not a closed membership requiring prior certification. Instead, it serves as the gateway to growth—an open access point designed to accelerate your learning, strengthen your expertise, and expand your professional opportunities.
Your membership comes with full registration for the AOI Annual Conference, a value of $797. This event is more than a meeting; it is the ultimate homecoming for AdvO doctors, students, and colleagues from across the upper cervical field. Members may also add continuing education credits for just $50.
About the ConferenceMembership gives you the right to vote in board elections, and certified members are eligible to run for board positions themselves. With three of the nine seats opening every year, new voices and forward-thinking leaders always have opportunities to influence the direction of the Institute and the profession.
Meet the BoardMembers receive $600 off the AdvO Bootcamp, $200 off every seminar, and exclusive partner discounts through UC Strategic Solutions, Synapse Continuing Education, and other collaborations that will expand as the Institute grows. These savings quickly add up, often covering the cost of membership itself.
Browse SeminarsCertified members — Level 1 or above — are listed in the Doctor Directory, an actively promoted resource that helps patients find qualified doctors they can trust. This visibility not only builds your credibility but also expands your practice reach.
Doctor DirectoryComplete your Level 1 Certification and receive one free year of membership — full conference registration and every standard benefit included.
Certification marks the beginning of your professional journey, and your complimentary membership ensures that you stay plugged into the Institute at the very moment you are ready to grow the most.
The Certification Path→With conference registration included and deep seminar discounts, membership often pays for itself in the first year.
Clinical insights, research updates, and news from the Advanced Orthogonal Institute community.
The Institute is dedicated to participating in and initiating research that validates upper cervical care.
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