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SHOULDER, HIP AND KNEE
Functional Assessment & Treatment

COURSE DESCRIPTION
Normal movement is achieved through the integration of fundamental movement patterns with an adequate balance between mobility and stability to meet the demands of the task at hand. Altered mechanics in the upper and lower quarter are frequently being implicated as being contributory to various musculoskeletal conditions. An understanding of how abnormal limb function can contribute to the mechanisms of specific joint dysfunction is essential for the evaluation and treatment of common orthopedic disorders. The human body will migrate toward predictable patterns of movement in response to pain or in the presence of weakness, tightness, or structural abnormality. Over time, these pain attenuated movement patterns lead to protective movement and fear of movement, resulting in clinically observed impairments such as decreased ROM, muscle length changes, and declines in strength. An isolated or regional approach to either evaluation or treatment will not restore the whole of function. Functional restoration requires a map of dysfunctional patterns and a working knowledge of functional patterns to gain clinical perspective and design an effective treatment strategy.

This two-day in-depth evidenced-based course will take a look at the most recent and “state of the art” information in the evaluation and treatment of selected movement related shoulder and knee pathologies. New advances in assessment and treatment techniques, research on evidenced based practice, and outcome data makes it absolutely imperative that the clinician remain informed in order to produce successful cost effective care. The goal of this symposium is to provide clinicians with the most current information and tools available in order to develop, implement, document, and support evidenced based rehabilitation programs. Through lecture presentations and focused laboratory sessions, the participant will have an opportunity to outline a system to capture impaired patterns of posture and functional movement which will assist in the deductive process and determination of a functional diagnosis. In this workshop, the participants will identify key functional movement patterns through the Selective Functional Movement Assessment (SFMA) and describe the critical points of assessment needed for clinical application to identify dysfunctional movement. Traditional muscle and capsular length, strength, and special tests will be used to help the clinician identify the impairments which are associated with dysfunctional movement. This approach is designed to complement the existing exam and intervention with therapeutic exercise. It should serve as a model to efficiently integrate the concepts of posture, muscle balance and the functional patterns of the movement system into musculoskeletal practice. The main objective is for the course participant to understand the SFMA assessment system which provides an orderly and repeatable clinical process with respect to the functional movement assessment and the effects fundamental movement has on provocation of the patient’s main symptom as well as guide the development of focused intervention strategies.

Experienced clinicians and new graduates alike will leave this seminar with new information that can be used immediately in the clinic.

AUDIENCE

Physical Therapists, Physical Therapist Assistants, Certified Athletic Trainers, Occupational Therapists, COTA’s and other health care professionals involved in the management of knee and shoulder pathology. In addition, individuals working prevention and maintenance of a health lifestyle will find this course invaluable.

COURSE OBJECTIVES
After completing this workshop, the participant should be able to do the following.
Understand the importance of identifying dysfunctional movement patterns.
Describe pathological upper and lower quarter mechanics and segment interactions.
Describe the pathomechanics of common shoulder and knee disorders.
Interpret and evaluate the examination findings using clinical reasoning skills to develop successful therapeutic intervention programs for common upper and lower quarter pathologies.
Describe why it is important to assess movement patterns in both the loaded and unloaded positions and how this information can be used to guide intervention.
Use the information gained from the SFMA to select key impairments to assess and design appropriate interventions to normalize dysfunctional movement.
Link the assessment information to the initial therapeutic exercise strategy.
Develop evidenced based rehabilitation programs for specific pathologies that are based on current scientific research.
Monitor initial changes in dysfunction and impairment to guide the therapeutic exercise progression.
Utilize current evidence based upon clinical and scientific information to develop effective outcome evaluation measures.

TUITION
$485.00 - The registration fee includes a 300+ page comprehensive course and reference manual. A contitnental breakfast is provided both mornings with an afternoon snack.

ELIGIBILITY
Physical Therapists, Physical Therapist Assistants, Certified Athletic Trainers, Occupational Therapists, and Certified Occupational Therapist Assistants may attend applicable courses for continuing education credit.

CREDIT FOR COURSES
This course offers 17 contact hours, equivalent to 1.7 CEU's.
When offered in states requiring CEU's these courses will be approved by that state's licensing agency.
• NATA BOC approval #P551
• CSCS agency executive approval for CEU's

CANCELLATION OF COURSES
The Institute reserves the right to cancel courses with insufficient attendance two weeks prior to the start of the course. The Institute is not responsible for nonrefundable airline tickets and other commitments. Tuition may be transferred to another course or a full refund can be made if a cancellation does occur.

COURSE DATES / LOCATIONS
Birmingham, Alabama August 15 - 16, 2008
Orlando, Florida August 15 - 16, 2008
Charlotte, North Carolina August 22 - 23, 2008
Springfield, Illinois September 12 - 13, 2008
Salt Lake City, Utah September 19 - 20, 2008
Baltimore, Maryland September 26 - 27, 2008
Williamsburg, Virginia October 10 - 11, 2008
Columbus, Ohio October 24 - 25, 2008
Kansas City, Missouri November 14 - 15, 2008
Manchester, New Hampshire Nov 21 - 22, 2008

COURSE OUTLINE

FRIDAY - DAY ONE:

AM Session 8:00 am
Welcome & Introduction
Selective Functional Movement Assessment – The SFMA
  1. Introduction to the pathomechanical examination process: Screen-test-assess
  2. Categorizing pathologies into anatomical and mechanical dysfunctions
    • Stability vs. Mobility problems.
  3. The evaluation & treatment algorithm: A new paradigm for success
    • Demonstration of SFMA – Lab Practice

Treatment of Mechanical Shoudler Dysfunctions
  1. The Scapulothoracic articulation – starting at the base
    • Evaluation of the Scapulothoracic articulation (Demonstration / Lab)
  2. What is the best way to strengthen the rotator cuff musculature
  3. SFMA Upper Body Extension Break-out – Isolating Movement Dysfunction (Demonstration/Lab)
    • Integration of functional exercise to correct movement dysfunction
    • Introduction to the chop and lift tubing progressions

Rotator Cuff Pathology: Diagnosis and Decision making
  1. Evaluation of Impingement and Rotator Cuff Function (Demonstration/Lab)
    • SFMA Provocation Maneuvers
    • Non-operative options
    • Post-operative rehab following rotator cuff surgery

12:30 – 01:30 LUNCH

PM Session (1:30 pm - 5:30pm)
Problems with Shoulder Mobility
  1. Stiffness vs. Adhesive Capsulitis: Is it really frozen?
    • What does the evidence say? A current update.
  2. What is the best approach to restore motion?
  3. Manual therapy options: What does the science say?
    • Mobilization Lab: Glenohumeral, Scapular, and Thoracic extension-MWM’s

Problems with Shoulder Stability
  1. Anterior Shoulder Instability: Diagnosis and decision making
    • Understanding the pathology causing impairment
  2. Classifying the instability: Unidirectional vs. Multidirectional
    • TUBS vs. AMBRI
    • Evaluation of Shoulder Instability (Demonstration / Lab)
  3. Glenoid labrum pathology: Bankart vs SLAP Lesions
    • Evaluation of the Labrum (Demonstration / Lab)
  4. Non-operative treatment strategies
  5. Rehabilitation following operative shoulder stabilization surgery.

Problems with Smoothness
  1. Articular Cartilage Disorders – Where are we today?
    • Basic science through aggressive management
    • Total Shoulder Arthroplasty

DAY TWO

AM Session (7:30am - 12:30pm)
Dynamic Lower Quarter Stability: Current theory & clinical guidelines
  1. A paradigm shift towards neuromuscular control.
  2. SFMA Single Leg Stance Breakout
  3. Reactive Neuromuscular Training
    • Integration of functional exercise to correct movement dysfunction (Demonstration / Lab)

HIP INJURY: The Evidence behind pathology and rehab
  1. Screening for dysfunction before pathology presents
    • Demonstration / Lab
  2. Understanding the pathomechanics to conceptualize a solution
    • SFMA Lower Body Extension Breakout
      • Demonstration / Lab
    • SFMA Lower Body Rotation Breakout:
      • Demonstration / Lab
    • Integration of functional exercise to correct movement dysfunction
  3. Arthroscopic interventions & post-operative management considerations

ACL-Current concepts in the management of ACL injuries
  1. Mechanisms of various knee injuries
    • Biomechanics of non-contact injuries
  2. Long term consequences of ACL injury – repair
    • Conservative management – who can cope?
  3. Unique considerations for the female patient
    • Why are women more susceptible to injury?
  4. Screening techniques for neuromuscular control – functional assessment
    • Baseline testing of function (demonstration / lab)
  5. Preventions programs to help prevent injury – do they really work?
    • Training to prevent ACL injuries – targeting neuromuscular imbalances
      • Common effective components of prevention programs
      • Program Design – Putting it all together

12:30 - 01:30 LUNCH

PM Session (1:30pm - 5:00pm)
Patellofemoral Dysfunction
  1. Understanding the pathomechanics to conceptualize a solution
  2. Influence of abnormal lower extremity mechanics on the PF joint
  3. PF joint examination
    • SFMA Deep Squat Breakout (Demonstration / Lab)
    • Integration of functional exercise to correct movement dysfunction
  4. Treatment guidelines for patellofemoral pain: a new perspective on an old problem
    • Proximal stability training: beginning at the top
    • Preventing medial collapse at the knee
      • Bracing & exercise: Functional exercise training to achieve success

The Osteoarthritic Knee - Total Knee Arthroplasty
  • Articular Cartilage Disorders
  • What are the complications and how do we manage them?

 

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