Email – ariel@physioactif.com
Course Description
Cervical spine and temporomandibular joint (TMJ) symptoms can arise from trauma such as whiplash, but frequently it is an insidious, recurrent and an ongoing problem for many people. This is often related to suboptimal loading on the tissues around the cervical, orofacial and scapula-thoracic regions.
The mechanism driving the sub-optimal loading on the tissues may be the:
- Movement Pattern (too much and too little)
- Translation Control of the joint
- Biomechanical Exposures to Loading
There is considerable individual variation in how these present. These loading mechanisms may present in combinations or alone. As well, how the central nervous system tries to control the loading could be too much or too little.
Motor control and sensory motor deficits can be identified in association with neck and TMJ pain. Following an episode of cervical pain changes occur in the central nervous system including: a loss of proprioceptive awareness, reduced tactility, deficits in oculomotor function, altered postural stability, and changes in movement patterns. As well, the deep stabilising muscles have been shown to exhibit motor control deficits and the superficial muscles become more active at low threshold compared with non-neck pain subjects. The changes are more pronounced following whiplash. Tissues can be overloaded from uncontrolled segmental translation or compression due to the increased activity of the superficial muscles.
Alteration of muscle activation of the scapula-thoracic muscles can result in the scapula adopting a downwardly rotated resting position and / or a loss of dynamic control of the scapula in functional arm movements. This can cause tissue loading in the shoulder and cervical regions provoking the patient’s pathology.
This course will provide participants with strategies to sub-classify a movement pattern control deficit in the cervical spine, TMJ and whether this is influenced by the scapular function.
Motor control retraining strategies will be introduced using a comprehensive and evidence based clinical reasoning process. This involves; specific activation of the appropriate stability muscles to control segmental translation of the anterior and posterior cervical spine; and superior and horizonal control of the TMJ; the retraining of movement patterns of the cervical spine and the TMJ. This can create an environment for normal healing by reducing tissue provocation.
The integration of other physiotherapy skills such as manual therapy, myofascial trigger point release and progressive loading exercise will also be discussed. Some beneficial taping techniques will also be used.
The exercise progressions are described and strategies for the integration into function are discussed with participant examples and case studies to link it real life difficulties.
Course Objectives:
- Make an accurate movement pattern control sub-classification and relate this to the client’s presentation
- Understand the relationship of scapular motor behavior to cervical and TMJ
- Use movement patterns as a clinical reasoning tool to help guide manual therapy and other techniques
- Integrate the treatment of movement patterns and translation control into clinical practice
WHAT WILL YOU GET FROM THIS COURSE THAT YOU MAY NOT ALREADY HAVE?
Cervical Segmental Stability – Posterior
Translation control is more than the deep neck flexors. The posterior muscles of the neck experience segmental atrophy and need to be specifically retrained. We’ll give you strategies. Learn alternative strategies to activate the anterior translation control muscles (deep neck flexors).
TMJ Translation control
We have researched and developed strategies for translation control of the TMJ.
Heavy Head Syndrome
We’ve all heard patients complain of a heavy head. Learn a simple way to rehab this
Upper Trapezius is a Good Guy Muscle
Upper trapezius does not elevate the scapula – it has a local and global stability role for the neck and shoulder girdle. It has a major stability influence on the neck, shoulder and thoracic spine. It has an anticipatory timing pattern and is delayed with pain – similar to Transversus. It also experiences sudden atrophy – similar to Multifidus. It rarely loses extensibility so assessment and retaining needs to be specific. Lower trapezius does not pull the inferior angle of the scapula down and in. There are better ways to train lower trapezius for scapular stability!
Primitive Reflexes
Over 90% of people with musculoskeletal pain have primitive reflexes. They contribute to altered motor control and tone. Learn how they will influence cervical and TMJ movement.
Myofascial Trigger Point (MTP) Release
MTP release is a useful way in many people to improve aspects of motor behavior (e.g., range of movement). In some people it can be a source of pain. Motor Behavior Therapy can be used to help desensitize MTP’s.
Neurodynamics
Neurodynamic reactivity can significantly affect the way people move. We’ll show how movement can be used to treat neurodynamic reactivity.
Taping
There are some great taping techniques for the shoulder girdle, forearm and neurodynamics!