THE UPPER QUARTER
Evidence-Based Evaluation and Treatment Utilizing Classification Systems, Manual Therapy and Exercise
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 reveal problems in other areas.
The course is designed to equip the clinician with the ability to differentially evaluate 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 evaluate the influences of the thoracic spine, categorize the scapular into three syndromes to improve outcomes, assess and treat rib dysfunction and observe the affect these have on the function of the upper extremity, evaluate and treat the 5 shoulder syndromes, evaluate and treat dysfunctions in the elbow and hand
The evaluation 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.
Audience:ATs, PTs, PTAs
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
- Evaluate the contribution rib dysfunction to shoulder girdle problems
- Identify ‘drivers’ that are contributing to the problem
- Identity the three scapular positional faults
- Describe how different manual therapy rationales are best used in the treatment of the upper quarter
- Implement an effective objective examination that is timely to assist in treatment selection
- Evaluate joint stability and mobility
- Implement appropriate manual therapy treatment techniques for the ribs, scapulo-thoracic region, shoulder, elbow, wrist and hand, taking irritability into account
COURSE SCHEDULE – 1.75 days
7:15 Sign In
8:00 Introduction to orthopedic manual therapy
8:45 Best practice and treatment rationale
09:30 AGR area of greater restriction
10:10 Cervical spine treatment rationale
11:00 Cervical spine objective screening
01:00 Cervical core assessment and testing
01:45 Upper Limb Neural Tension testing/implications
02:15 First Rib and SC evaluation and treatment
03:10 Cervical spine ‘Go to’ treatment techniques
04:15 Static and dynamic scapula-thoracic evaluation
5:00 End of day one
08:00 Treatment of the three scapular syndromes
09:00 Treatment of the shoulder girdle with strain and counter-strain
10:10 Shoulder girdle mobility evaluation
10:45 Manual therapy treatment of the shoulder
12:30 Shoulder Impingement treatment
01:00 Evaluation and treatment of the elbow, including epicondylalgia
02:00 Evaluation and treatment of the wrist and hand
03:00 End of course