Saturday General Session & Breakout Session Details
Saturday General Session
Title: Trouble with Reaching? What Impairments are Driving the Problem?
Presenters: Joe Godges, DPT, MA, OCS; Paula Ludewig, PhD, PT, FAPTA
Description: In this session we will review integrated upper quarter kinesia and dyskinesia (movement deviations) as related to development or outcome of common clinical tissue pathologies such as rotator cuff pathology, nerve injuries, and pain syndromes. The session will incorporate current evidence regarding relationships between impairments, movement deviations, and tissue pathologies. Emphasis will be on integrating head, neck, and shoulder clinical practice guideline recommendations into effective reasoning processes for the client and the clinician to address the client’s movement related concerns.
Key Topics Addressed:
- Integrating assessment across isolated joint function and dysfunction
- Integrating understanding of movement system impairments and associated tissue pathologies
- Common cervical, thoracic, and rib referred pain patterns of the upper quarter related to problems with reaching
- Common upper limb nerve tension patterns related to problems with reaching
- Physical examination procedures to rule in or rule out referred pain or radiating pain and the related mobility of the neural elements as relevant impairments
- Physical examination procedures to rule in or rule out glenohumeral mobility, movement coordination, and muscle power as relevant impairments
- Mutual determination of interregional intervention strategies, in the most efficient sequence and using the most effective dosage
Breakout Session #3
Title: Trouble with Reaching? Movement Analysis and Reeducation Strategies
Presenter: Paula Ludewig, PhD, PT, FAPTA
Breakout Description: In this session we will overview and perform movement screening with an emphasis on scapular dyskinesias in each of the frontal (upward/downward rotation), sagittal (tilting) and transverse (internal rotation) planes. Participants will be given the opportunity to perform an upper quarter movement screening and use case vignettes to identify appropriate follow-up tests and consider diagnostically driven physical therapy interventions. Appropriate stretching, strengthening and movement coordination interventions will be discussed, including use of electromyographic biofeedback.
- Perform upper quarter movement screening to direct key follow-up tests and measures.
- Identify appropriate follow-up tests and measures dependent on movement screening results.
- Describe appropriate treatment sequencing following from examination findings.
- Recognize clinical presentation of spinal accessory versus long thoracic nerve palsies
Breakout Session #4
Title: Trouble with Reaching? Manual Examination and Intervention Strategies: Addressing Relevant Pain and Mobility Impairments
Presenter: Joe Godges, DPT, MA, OCS
Description: In this session, participants will be invited to participate in hands-on practice with co-participants with feedback from the instructor and lab assistants – so come in lab clothes and be ready to expose your neck, upper back, shoulders, and arms. There will demonstrations and practice with ongoing clinical reasoning “pearls” using live case examples. The labs practice sessions will cover examination, manual interventions, and reassessment of:
- cervical, thoracic spine, and rib segmental mobility,
- upper limb nerve mobility and symptomatic entrapment sites,
- glenohumeral joint and soft tissue restrictions.
Objectives: Through live case examples, demonstration, and discussion, gain a greater understanding of:
- identifying the physical impairments that are most related, at a particular point in the episode of care, related to the patient’s reported pain and/or activity limitations (e.g., overhead reaching)
- Sequencing of treatments to optimally address the patient’s reported pain and limitations
- Reassessment of intervention strategies and techniques to achieve the identified outcomes
- Provision of therapy in a patient-centered and patient-therapist collaboration, which facilitates self-efficacy (confidence), hope, and shared responsibility
- Through demonstration, practice, and feedback, gain improved skill at:
- Selection of spinal mobilization/manipulation, soft tissue mobilization, manual stretching, and mobilization with movement procedures to address relevant tissue mobility deficits
- Motor skills with application of manual procedures, utilizing efficient body mechanics to create a therapeutic effect and desired treatment outcomes
- Dosing of the intensity of the procedural application consistent with the patient’s tissue tolerance to applied stress (irritability), stage of tissue healing, personal sensitivity and preferences
- Sequencing of treatments in the optimal therapeutic order, given the presenting clinical findings and physical impairments hypothesized to be most relevant to address, at a specific point in the patient’s episode of care