Pain and dysfunction of the upper quarter is a common presentation in the outpatient setting. Conventional management often attempts to identify the painful structure and treat it directly. A more in-depth understanding of the drivers and mechanisms involved often reveals problems in other areas.

The course is designed to equip the therapist with the ability to differentially assess and treat the numerous causes of pain and dysfunction stemming from the cervical/thoracic spine, ribs, scapula-thoracic region, and upper extremity.  This involves looking for the ‘drivers’ not just the painful structure. 

Participants will learn to assess the influences of the thoracic spine, categorize the scapular into three syndromes to improve outcomes, assess and treat rib dysfunction and observe the effect these have on the function of the upper extremity, assess and treat the five shoulder syndromes, assess and treat dysfunctions in the elbow and hand 

The assessment and treatment system taught will allow the participant to apply sound clinical skills to be more effective in this region.  

The participant will be taught effective manual therapy approaches, including, Area of Greatest Restriction assessment (AGR), disc centralization rationale, mobilization, physiological overpressure mobilizations (POMs), muscle energy, and manual traction, along with strain and counter-strain and motor pattern retraining reinforced with exercise.

This is a practical course for a clinician in the outpatient setting.

Course Objectives:

By attending this course the participant will be able to:

·      Incorporate vindication and provocation tests to differentially assess problems of cervical spine, ribs, scapula-thoracic region, and upper extremity

·      Assess and treat with manual therapy and exercise the contribution of rib dysfunction to shoulder girdle problems      

·      Identify ‘drivers’ that are contributing to the problem

·      Identity and treat with manual therapy and exercise the three scapular positional faults

·      Understand how different manual therapy and exercise rationales are best used in the treatment of the upper quarter

·      Perform an effective objective assessment examination that is timely to assist in treatment selection

·      Assessment joint stability and mobility

·      Perform appropriate manual therapy and exercise treatment techniques for the ribs, scapulothoracic region, shoulder, elbow, wrist, and hand, taking irritability into account

Schedule:

DAY ONE

07:15   Sign In 

 08:00  Introduction to orthopedic manual therapy.   Lecture                                   

 08:45  Best practice and treatment rationale Lecture                                               

 09:30  AGR area of greater restriction   Lecture                                                     

 10:00  Break

 10:10  Cervical spine treatment rationale Lecture.                                                   

 11:00  Cervical spine objective screening                                                                                                                

 12:00  Lunch

01:00   Cervical core treatment Lab exercise treatment                                                   

01:45     Upper Limb Neural Tension testing/implications                                        

02:15    First Rib and SC assessment treatment Lab                                                                                                                                                         

3:00     Break

03:10     Cervical spine ‘Go to’ treatment techniques                                                           

 04:00     Static and dynamic scapula-thoracic assessment, Treatment.                    

05:00   End of day one. 7:40 mi

DAY TWO

08:00   Exercise Treatment of the three scapular syndromes. Lab                          

 09:00  Treatment of the shoulder girdle with strain and counter-strain. Lab           

10:00   Break

10:10   Shoulder girdle mobility assessment                                                             

10:30    Manual therapy and exercise treatment of the shoulder                               

12:00   Lunch

12:30    Shoulder Impingement treatment Lab Exercise                                           

01:00    Assessment and treatment of the elbow, Lab                                                           

02:00   Assessment and treatment of the wrist and hand Lab                                                                                                                                                                            

 03:00  End of course 6:20 total 14 hours

Educational Level:  Beginner to intermediate

Instructional Methods: PowerPoint Presentation, Video examples, Live demonstration, Supervised practicum