Session Descriptions

Pre-Conference Sessions

Extremity and Spinal Manipulation for the Upper and Lower Quarter: Elevate your OMT Practice

Track: Precon

Presenter(s): Alec Kay, Brian Power

The session will be focused on using appropriate techniques of HVLAT in the spine and extremities with clinical examples. There will be approximately 1/3 lecture and 2/3 lab with emphasis on safety. This course would be appropriate for PT students with this interest.

Movement Analysis of the Extremities: Exploring Directional Preference

Track: Precon

Presenter(s): Ronald Schenk

This course presents an overview of the Mechanical Diagnosis and Therapy approach to examination and intervention of the extremity joints. Strategies for patients for patients with musculoskeletal disorders of the extremities will be presented in the context of OMPT clinical decision-making and critical thinking with consideration of evidence-based practice.Laboratories will promote development of skill in the application of examination and techniques for the extremities as discussed in a lecture format and attendees will have the opportunity to critically evaluate examination and intervention via cases from the published literature.

Differential diagnosis and treatment of sports-related concussion: Where orthopaedic and neurological therapy collide

Track: Precon

Presenter(s): Jennifer Reneker, Megan Donaldson

This pre-conference session will enable attendees to develop a holistic approach to effectively examine and treat concussion, utilizing concepts typically regarded as orthopaedic skills and integrating these with skills typically regarded as part of neurologic clinical practice.The complex relationships between the neurological and musculoskeletal system will be highlighted along with common patient presentations.The session will include presentation and practice of a compendium of clinical tests that should be included in a comprehensive assessment to identify underlying anatomic causes of dizziness after concussion.Following this, there will be presentation and practice of intervention techniques.Clinical cases and discussion will be used to help learners appreciate the timing and progression of these techniques and safety parameters that should be exercised when treating patients after a sports-related concussion.

Manipulating the Brain or Spine? Applying Modern Pain Neuroscience to Orthopaedic Manual Physical Therapy Practice

Track: Precon

Presenter(s): Jo Nijs

Traditional understanding of musculoskeletal pain from a biomedical perspective has been challenged in light of increasing evidence supporting a key role of central sensitization in some patients. This fact may erroneously lead orthopaedic manual physical therapists to conclude that hands-on interventions have no place in the management of chronic musculoskeletal pain, and that hands-off interventions must be applied exclusively. Therefore the aim of this course is to encourage orthopaedic manual physical therapists in finding an equilibrium between hands-on and hands-off interventions capable of desensitizing the central nervous system in patients with chronic musculoskeletal pain dominated by central sensitization. The theoretical rationale1 for simultaneous application2 of manual therapy and pain neuroscience education is presented together with skills training sessions. Practical problems orthopaedic manual physical therapists will have to deal with when combining these interventions are addressed.

On the Cutting Edge: Defining the Role of Physical Therapy for Osteoarthritis of the Knee

Track: Precon

Presenter(s): Chris Allen, Gail Deyle

Osteoarthritis of the lower extremity is an epidemic. Unfortunately most patients never receive physical therapy intervention prior to total joint replacement. This course is designed to bridge the gap between recent research developments and clinical application. We are offering an exciting one day interactive session filled with cutting edge research presentations and hands-on laboratory sessions lead by a team of clinician scientists who have spent the last two decades defining the effects of physical therapy interventions on osteoarthritis of the knee. Learn how to elevate your practice using best research evidence and market your services to the best referral and direct access sources. Research presentations will focus on the effects of orthopaedic manual physical therapy and exercise on the arthritic lower extremity including changes in end range rotational stiffness of the knee, stumble recovery following treadmill perturbations, WOMAC scores, and other functional outcome measures. Training for manual physical therapy examination and evaluation will include the use of an innovative training device (Novel Electronics Inc.) that will provide real time feedback to the learner to facilitate motor skill development. The inclusion of the objective feedback as well as the exceptional clinical and research experience of the faculty will help broaden and refine participant’s manual treatment skills. Learn clinically proven strategies to seamlessly integrate exercise with manual therapy techniques. Empower your patients to assume control of their chronic condition as you transition to a support and resource role while returning your patients to the activities they love.

Beyond the Slump Test: Lower Quarter Evaluation and Treatment of Peripheral Nerve Sensitization (The Angry Mother-in law) in Orthopedic and Sports Medicine Patients.

Track: Precon

Presenter(s): Jack Stagge

This one-day lab course will present concepts of differential diagnosis and treatment of patients with lower extremity radicular symptoms, pioneered by Bob Elvey PT, G.D.M.T. According to the International Pain Societies Research, these specific “Peripheral Neuropathic Syndromes”, also known as “Peripheral Nerve Sensitizations”,maybe responsible for the failure of rehabilitation in up to 17% of orthopedic patients.This diagnosis, often called “missing link” in evaluation and rehabilitation protocols, can directly cause tissue inflammation, fascial adhesion, and prevent patients from initiating proper patterning and functional restoration. Participants will learn and integrate into their normal evaluations six sensitive and specific tests to rule in or rule out these syndromes. In particular, this course will cover the differentiation of pain sources within the lumbar spine, the piriformis triangle, the hip joint, and the peripheral nerves themselves. Specific evaluation of the lumbar and sacral plexus will be demonstrated and skills acquired. This course will cover well-recognized but often misdiagnosed Orthopedic, Industrial, and Sports Medicine disorders of the lower quarter. These are including but not limited to piriformis syndromes, lumbar stenosis, "chronic hamstring tears," “failed back syndrome", nerve root adhesions, peroneal and tarsal tunnel syndromes, chronic plantar fasciitis etc. Treatment of pain syndromes of neural origin will be explained and demonstrated along the lines of well researched neural tissue bio-mechanics and physiological concepts. Real patient examinations, videos, case presentations and supervised labs will be used to further allow for application of the material into the participants daily practice.

Keynote Sessions

Balancing Hands-On and Hands-Off Interventions in the Treatment of Chronic Musculoskeletal Pain

Presenter(s): Jo Nijs

Traditional understanding of musculoskeletal pain from a biomedical perspective has recently been challenged in light of evidence supporting a key role of central sensitization in some patients with chronic musculoskeletal pain. This fact may erroneously lead manual physical therapists to conclude that hands-on interventions have no place in musculoskeletal pain management, and that hands-off interventions must be applied exclusively. Therefore the aim of this keynote is to encourage manual physical therapists in finding an equilibrium between hands-on and hands-off interventions capable of desensitizing the central nervous system in patients with musculoskeletal pain dominated by central sensitization. The theoretical rationale and evidence for simultaneous application of manual therapy and pain neuroscience education is presented together with skills training sessions. Practical problems orthopaedic manual physical therapists will have to deal with when combining these interventions are addressed.

Increasing evidence supports a cardinal role for conservative treatment of chronic pain. Orthopaedic manual physical therapists combine the unique skills for targeting the chronic pain patient’s mind, body and brain concomitantly. Yet orthopaedic manual physical therapists are often unaware of their ability to treat complex patients with chronic pain. Therefore, the lecture aims at increasing awareness among orthopaedic manual physical therapists to apply evidence-based guidelines for chronic pain management. The latter includes thinking beyond muscles and joints, thus providing additional interventions including exercise therapy, stress management and sleep management.

The Manual Therapy World Is No Longer Flat

Presenter(s): Paul Mintken

Things used to be so simple…A patient would come to you with pain, you would identify treatable impairments, and you would use manual therapy and exercise to improve their function and quality of life. People have always had pain. That has been a constant. Societal shifts led by the medico-industrial complex have changed perceptions and beliefs about pain. Chronic pain prevalence has more than doubled in the last 15 years. Our old tricks do not work on these new dogs. It is now estimated that over 100 million Americans suffer from chronic pain, at a cost to society of over $600 billion dollars a year. Due to marginal effect sizes in randomized controlled trials and systematic reviews, some physical therapists have abandoned manual therapy as an intervention. Blog posts such as “Why I am not a manual therapist” and “There is no skill in manual therapy…?” abound on the internet. New evidence has suggested that many manual therapy theories and paradigms are outdated and invalid, and we cling to them at our own peril. Is it time to throw the baby out with the bathwater, or is manual therapy still a viable treatment option for physical therapists treating individuals in pain?

Breakout Sessions

A movement impairment based approach to evaluation and treatment of common UE overuse injuries

Track: Clinical Decision Making

Presenter(s): Pieter Kroon, Brenda Boucher

Movement impairments in the cervical spine, shoulder, elbow and wrist will be discussed, and their influence on UE overuse injuries. More specifically, the principles of the extension/radial deviation syndrome will be explained. From a movement impairment syndrome perspective, this appearsthe driver of the most common elbow/forearm/wrist/hand overuse injuries. Rational treatment approaches to address deficits found will be discussed. This will include joint mobilizations/manipulations of the cervical spine, shoulder, elbow and wrist.

ALL IS NOT LOST: The Emerging Role of Manual Physical Therapists for Anterolateral Ligament Injuries and Rotatory Instabilities of the Knee

Track: Clinical

Presenter(s): Matthew Daugherty, Amanda Grant, David Kempfert

As a contemporary diagnosis, patients with ALL injury present a developing opportunity for OMPT to clinically manage these patients for optimal function. This course is designed to give a basic framework for clinical practice related to ALL pathology to prepare OMPTs with the necessary tools for effective clinical practice.This is a hands-on demonstration and practice lab session.

An Australian Osteopathic approach to mobilization and manipulation of the Lower Extremity

Track: Clinical

Presenter(s): Matthew Wood

The session will comprise a technique course/demonstration with opportunity for practice, based around Australian Osteopathic manual medicine and the clinical reasoning underlying application of these techniques. A short (10min) introductory lecture/presentation will describe basic osteopathic clinical reasoning/decision-making factors and how these may apply in PT practice in the US. Demonstrations of osteopathic manipulation/mobilization techniques typically referenced in osteopathic literature for the lower extremity will follow with audience participation encouraged in both demonstrations and practice.

Burden of Proof - Part 1: Circumstantial Evidence and Paradigm Shifts in Musculoskeletal Rehabilitation

Track: Scholarship

Presenter(s): Roy Film

We are a profession in transition. Although our profession has increasingly embraced EBP, the culture of PT clings to many disproven treatment approaches. Our next step down the road of our continuing journey must involve shedding these outdated interventions to allow space for approaches with scientific support. Part 1 focuses on the Sociology of Knowledge, cognitive bias, and how we know what we think we know. This sessions is designed for clinicians of all levels, from student to seasoned practitioner.

Burden of Proof - Part 2: Navigating Sea Changes as an Evidence-Informed Practitioner

Track: Scholarship

Presenter(s): Roy Film

The growth of scientific literature continues at a breakneck pace while the discovery of unproven rehab interventions outpaces the speed at which we shed ineffective interventions. Despite strategies that exist to help filter the literature, the sheer amount of information makes it increasingly difficult for clinicians to track useful clinical advancements. At the same time, this inundation of information confounds the majority of clinicians, fostering the rise of non-peer-reviewed resources such as healthcare blogs and podcasts. How can we navigate these rough seas? We will explore the level of “proof” each of us requires before adopting/eliminating a treatment approach and discuss strategies for dealing with the noise in the system resulting from the increased influence of easily-available, non-peer-reviewed content. This session, along with Part 1, is designed for clinicians of all levels, from student to seasoned practitioner. Attendance at Part 1 is recommended, but not essential.

Constructing a Differential Diagnosis: Methods to consider for physical therapists as first contact healthcare providers.

Track: Clinical Decision Making

Presenter(s): Carleen Jogodka

As more physical therapists become first-contact providers, the need for an efficient and systematic method of differential diagnosis increases. Based on methods currently used by some emergency care physical therapists, this course will introduce systems adapted from a commonly used medical models but applied for use by the physical therapist. Session attendees will be invited to practice the use of the model within the education session in order to promote greater understanding and encourage implementation into clinical environments. Research on clinical decision making and methods of reducing cognitive error will also be discussed.

Decisions, Decisions, Decisions: Clinical Decision Making in the Assessment and Treatment of the Lumbopelvic- hip region

Track: Clinical Decision Making

Presenter(s): Michael O'Donnell, Andrew Hawkins

The session will be a combination discussion/ demonstration using three case vignettes to discuss presentations of three distinct origins of low back pain complaints. Current evidence along with the utilization of the Norwegian (Kaltenborn/ Evjenth) approach of provocation / alleviation will be utilized to enable the clinician to distinguish various origins of low back pain

Differential Diagnosis of the Lumbar Spine and Lower Extremity Nerve Entrapment

Track: Clinical Decision Making

Presenter(s): Cody Mansfield

This presentation will benefit AAOMPT conference attendees seeking board certification in orthopedics.In order to pass the orthopedic certified specialty (OCS) examination, physical therapist need to have an expert level knowledge of the lumbosacral plexus and lower extremity nerves.The presentation will help physical therapists differentiate between pathologies of the lumbar spine referring symptoms to the lower extremities and lower extremity neuropathies.Not only is this knowledge pertinent to pass the OCS exam, but also it is important to deliver exemplarily care to our patients.The presentation will focus on case based learning with audience interaction, review of neuroanatomy, nerve distributions, and how to apply the information clinically.

Dynamic Spinal Control – Blending Of Dominant Paradigms

Track: Clinical Decision Making

Presenter(s): Rusty Smith, Gary Austin

This seminar will explore the two dominant paradigms in physical therapy management of patients with impaired dynamic spinal control: Inner/Local/Micro/Deep/Intrinsic versus Outer/Global/Macro/Superficial/Extrinsic. The focus will be on a unique integration of the dominant paradigms, based on evidence that suggests a false dichotomy into two sub-systems. General principles of clinical reasoning, examination, intervention, and evidence- based practice will be applied in case scenarios of patients with decreased spinal stability. Application and integration of current evidence will be presented in the context of patient-centered care.

Elevate Your Manual Therapy Practice by Incorporating State-of-the-Art External Focus Exercise and Training

Track: Clinical Decision Making

Presenter(s): Jan Dommerholt, Marc Sickel

The workshops combine brief didactic lectures with experiential training / exercise methods using a variety of high-tech and low-tech equipment, such as Fit-Lights, the Trazer, and other exer-gaming equipment and approaches.

Elevate Your Profession: Engagement Approaches to Facilitate Critical Thinking in Teaching Orthopaedics and Manual Therapy.

Track: Educator

Presenter(s): John Heick, Michael Lebec

This session is intended to enhance engagement, understanding, and critical thinking of orthopaedic and manual therapy principles. The session is geared towards enhancing educational approaches for entry-level physical therapists, residents, or fellows.

Elevating Our Profession Through Mentoring: From Master Clinicians to Millennials

Track: Educator

Presenter(s): Lauren Clark

The session will highlight the evidence based benefits of mentoring in professional practice and offer immediately applicable solutions for adjusting mentoring to personality type, generation, and setting.This session will also include an interactive discussion on personal approaches, available resources, and relationships between mentors and mentees as a network.

Evaluation and Treatment of Tarsal Tunnel Syndrome Using Manual Therapy and Specific Adverse Neural Tissue Tension Testing

Track: Clincial

Presenter(s): Mark Gutierrez, Matthew Walker

A short lecture on relevant anatomy, literature, and underlying biomechanics, followed by a live demonstration of evaluation of ankle and foot joint mobility, adverse neural tissue tension testing, and specific corrective exercises.

Evaluation, Treatment and Differential Diagnosis of Plantar Heel Pain

Track: Clinical Decision Making

Presenter(s): Pieter Kroon, Katherine Gwyn

Biomechanics offoot/ankle will be discussed,and how biomechanical impairments affect tissue breakdown in the hindfootMovement impairment syndromes of the LE will be discussed, and their influence as a causal factor of plantar heelpain. Rational treatment approaches to address deficits found will be discussed. Demonstrated examination and intervention techniques include joint mobilizations/manipulations, soft tissue mobilizations, treatment of Adverse Neural Tension and specific therapeutic exercises to address movement impairments identified in the evaluation.

Extremity and Spinal Manipulation for the Lower Quarter: Elevate your OMT Practice

Track:

Presenter(s): Alec Kay, Brian Power

Extremity and Spinal Manipulation for the Upper Quarter: Elevate your OMT Practice

Track:

Presenter(s): Alec Kay, Brian Power

From Learner to Leader: Lessons learned along the mentorship continuum.

Track: Educator

Presenter(s): Dana Tew, Jennifer Frerich, James Heafner

New professionals frequently identify mentorship and leadership opportunities as the single most important aspect when looking for a job or trying to advance their careers. Unfortunately, only a small percentage receive the mentorship experience they were desiring. As these new clinicians develop in their careers, they naturally become the next generation of mentors. Success or failure as a mentee will often dictate their future outcome as a mentor. In this session, the speakers will share evidence-based frameworks and strategies for integrating leadership development and purposeful mentoring for new professionals. They will discuss the phases of a mentoring relationship and identify unique experiences and lessons learned along the continuum of mentorship. Each speaker will address the expectations and barriers observed at their respective stage of professional development. Attendees will be invited to actively participate throughout the program.

Hey Students, Get With The Flow! (Lumbar Intervertebral Fluid Flow and Impacts of Spinal Loading)

Track: Clinical Decision Making

Presenter(s): Mary Beth Geiser, Ulrike Mitchell

This interactive session will explore both older and newer research related to lumbar spine physiology, within-disc fluid flow and the concept that spinal movements performed today can help with disc health in the future. We will review the anatomy and physiology (nutrition and fluid flow) of the intervertebral disc, briefly discuss diffusion-weighted MRI and address clinical questions, such as: what does imaging tell us and when should it be used? What PT techniques have shown to improve fluid flow within the disc and can a change in fluid flow alter pain? We will take a look at disc degeneration and discuss if we can delay its onset, and thus the pain related to it. Lastly, we will perform simple exercises that will enhance lumbar disc fluid flow. This combination of interactive lecture and lab will elevate your baseline knowledge and bring literature reviews, imaging concepts, therapeutic intervention and clinical reasoning to the forefront.

If Goldilocks was a PT...The Principles of Tissue Loading: Getting it "Just Right"

Track: Clinical Decision Making

Presenter(s): Dana Tew, Brian Duncan

The underpinning of rehabilitation is the biologic principle of mechanotransduction, or how load may be used therapeutically to stimulate tissue repair and remodeling.Purposeful, individualized, and properly dosed activity & exercise is essential to optimize outcomes. Using a response-dependent approach to loading that accounts for structural state, psychological state, and physiologic patient response is necessary to combat the deleterious effects of injury and illness.Recent literature suggests that PTs often under-dose loading in the clinic which leads to elevate injury risk, particularly early on the in return to sport or activity phase.In this session, the speakers will link exercise principles such as periodization, volume, intensity, and recovery to successful patient outcomes.

Impairment-Based Approaches – Wrong End of the Stick?

Track: Clinical

Presenter(s): Rusty Smith, Kevin Helgeson

The use of impairment-based approaches has gained popularity in the physical therapy management of patients with musculoskeletal disorders. The goal of improving the effectiveness of intervention has lead to the development of classification systems emphasizing impairments. In many ways, these impairment-based approaches have philosophical roots in the biomedical model. With healthcare moving forward in the adoption of biopsychosocial models, consideration of the implications of this new model on the classification systems utilized by physical therapists is needed. This session will compare and contrast current impairment-based approaches with approaches emphasizing biopsychosocial considerations. The discussions will focus on the physical therapy management of patients with spinal pain within a biopsychosocial approach. Application will focus on the physical therapy management of patients with spinal pain within a biopsychosocial approach. Implications for the clinician and researcher will be explored.

Implementation Science for the orthopedic and manual physical therapist: Part 1

Track: Educator

Presenter(s): Jake Magel

The principles highlighted in this breakout session are designed to provide an introduction to the skills needed to participate in quality improvement work within a learning health system including private practice environments. The core principles of quality improvement are grounded in the scientific discipline of implementation science and include documenting and evaluating clinical care processes, identifying and measuring key process indicators, measuring both process and patient-centered outcomes, and providing feedback to clinicians to continuously improve care. We will present a practical example of building a quality improvement infrastructure within an outpatient physical therapy environment.

Implementation Science for the orthopedic and manual physical therapist: Part 2

Track: Educator

Presenter(s): Jake Magel

This is the second of a 2-part breakout session. We highlight the challenges and lessons learned surrounding real-world implementation of a project aimed at improving patient centered outcomes. This session will highlight a partnership between physical therapists and physical medicine & rehabilitation physicians to improve the quality of care for patients with low back pain. The partnership emphasizes initial management in Physical Therapy with subsequent management in Physical Medicine & Rehabilitation. The challenges and opportunities will be discussed from the perspective of both services.

Management of patients with chronic pain: does manual therapy harm or help?

Track: Clinical

Presenter(s): Jason Sharpe, Elizabeth Lane, Joshua Johnson

Patients with chronic pain present multiple practice challenges including high levels of symptoms, decreased strength, poor endurance, and fear of movement. Physical therapists often use manual therapy to address patient symptoms but determining the appropriateness of manual therapy with a patient suffering from chronic pain can be difficult. Current evidence suggests that multidisciplinary patient centric treatment including fostering a sense of self efficacy, self management, goal development, and pain science education are among the most effective treatment strategies for the treatment of chronic pain. We will focus on the considerations and application of manual therapy in this group of patients, including matching the treatment to the patient’s mechanisms of pain (degree of central sensitization). We will also review the costs and benefits of using manual therapy, and the suggested patient education to avoid dependence and address self-efficacy in patients with chronic pain.

Manual Physical Therapy for Upper Extremity Neuropathy – a clinically reasoned approach

Track: Clinical Decision Making

Presenter(s): Rachel Condon, Chris Allen, Elizabeth Painter

Interactive lecture focusing on background evidence, current literature for treatment and clinical pearls regarding the evaluation and manual physical therapy treatment for patients with upper extremity neuropathies. This session will enhance the attendee’s ability to identify impairments in this patient population and address them while critically reasoning the relationship between joint, soft tissue and nerve mobility, and exercise dosage. Attendees will be able to confidently examine and manage patients presenting with a variety of upper extremity neuropathies.

Neuromechanics and the Recent Advances in Understanding the Role of Connective Tissue in Movement Disorders

Track: Clinical Decision Making

Presenter(s): Lawrence Steinbeck, Brent Harper, Carl Heldman

Through lecture and demonstration we will present a fresh look at how the role of the physical therapist is becoming more defined and focused in addressing movement limitations. Advances in human anatomy dissection have provided a framework for the role of deep fascia. Looking at the anatomy, histology and innervation of the fascial system exposes a framework to assist the central nervous system (CNS) in proprioception and coordination of motor control. Additionally, fascia’s interaction with muscles has been shown to be associated with somatic dysfunction.In the opening paragraph from, Neural Origins of Muscle Synergies, the authors state, “When the central nervous system (CNS) generates voluntary movement, many muscles, each comprising thousands of motor units, are simultaneously activated and coordinated. Computationally, this is a daunting task, and investigators since Bernstein (1967) have strived to understand whether and how the CNS’s burden is reduced to a much smaller set of variables.” Researchers are identifying evidence of simplifying strategies by exploring whether the motor system makes use of lower level discrete elements.The field of Neuromechanics describes these constructs as motor modules. Experimentally these motor modules have been associated with specific biomechanical functions and movement synergies. This presentation will present the most recent models of the human fascial system and its role in these synergies. The clinician will learn a new paradigm of the relationship and role that connective tissue has in motor control and in pain syndromes. Understanding this model will enable the physical therapist to provide a comprehensive rehabilitation process. Furthermore, this paradigm provides a more reasonable explanation of the regional interdependence construct and how physical therapy intervention may prevent impairments in other body segments.

Novel taping techniques for the foot and ankle in high level ballet dancers: Techniques across the rehabilitation continuum from acute injury through return to performance

Track: Clinical

Presenter(s): Emma Faulkner, Margaret Gebhardt

Due to high levels of impact, unique footwear, and required extreme ranges of motion, the foot and ankle are at very high risk for injury among dancers. The foot and ankle are common injury sites in dancers of all ages, genres, and professional levels and account for the majority of missed rehearsal and performance hours. Taping techniques can be utilized at the foot and ankle to protect or limit motion following injury, support weakened structures during the healing process, assist mobility during rehabilitation, and address minor mechanical faults to prevent further or new injury.Typical injuries that respond well to taping are lateral ankle sprains, syndesmotic sprains, posterior impingement, FHL tendonitis, and hypermobile/unstable talocurual joints. In dancers, taping is often preferred over bracing due to the aesthetic requirements of dance. Manual physical therapists are often the providers with access to taping equipment and the necessary skill set to utilize taping techniques.During this session, attendees will be presented with multiple taping techniques and progressions from most supportive to least supportive tapings that could be utilized for dancers during all phases of rehabilitation from a foot or ankle injury. Attendees will be exposed to the techniques and educated in modifications that can be made for specific dancers, foot types, or performance demands. In addition to manual physical therapy interventions, taping can be an effective adjunct treatment modality for dancers as they progress through the rehabilitation continuum.

Opportunities in Clinical Reasoning - Considering the Whole Person: A Blueprint for an Integrated Biomedical and Biopsychosocial Clinical Reasoning Model for the Orthopaedic Manual Physical Therapist

Track: Clinical Decision Making

Presenter(s): Michael Leal, Bryan Dennison, Janice Lwin

Historically manual therapy has been grounded in a clinical decision making process related to impairment level findings and structurally based diagnosis. Teachings based on a particular school of thought, geographical location, or paradigms of practice based on an expert’s name have been the primary cornerstone of many manual therapy approaches to date. Consideration of biomedical and biopsychosocial contributions to a patient’s presenting problem is a key element in our decisions on how to proceed with OMPT patient care. Having a reasoning process which includes the patient as an active participant is key to having a holistic understanding of not only their unique health and disability issues, but also the integration of physical, environmental, and psychosocial factors. This session will highlight the importance of a well-structured clinical reasoning process that incorporates the biomedical and biopsychosocial components of the patient’s presentation, ultimately allowing the OMPT to direct care at the whole person. It will provide clinicians with a framework that will include an introduction to the Mature Organism Model, key hypothesis categories needed for every patient examination, a thorough assessment of potential psychosocial variables as well as a mechanistic assessment of pain pathobiology. Although clinical reasoning appreciating the whole person may appear to be “common sense”, effective clinical reasoning in practice can be quite difficult. The Presenter(s) hope to demystify some of the complexities of OMPT patient management through a whole person, patient-centered assessment, incorporating biomedical and biopsychosocial knowledge.

Poster, Presentation, Paranoia! How to start and, finish, and present research. A Primer.

Track: Scholarship

Presenter(s): Karen Dubrow, Steve Karas, Jodi Young

Three Presenters will provide clinicians an interactive session on "how to" create and present an experimental research study. We'll take you from the start of selecting a topic, literature search, designing the methodology, study implementation, how to find and choose a statistician, through completion to presentation. The participant will walk away with pearls for poster presentation, live presentation skills, a topic to study, and knowhow to move forward with research in his/her own clinical setting.

Specificty Matters in Treating Peripheral Nerve Sensitivity (The Angry Mother in Law) Patient specific treatment is guided by their sensory profiles and provocation patterns.

Track: Clinical Decision Making

Presenter(s): Jack Stagge

This breakout session will allow for attendees to recognize the need to use specific evaluation techniques to guide them to more effective treatment protocols for Peripheral Nerve Sensitization.New evidence into patient’s individualized sensory profiles and provocation patterns, current pathophysiological research citing level specific afferent hypersensitivity, and real patient examples will be presented to illustrate the point. This new evidence and patient examples will illustrate the need for treatment specificity.Demonstration of eval driven treatment technique will allow for the participant to interrelate and assimilate the presentation into their daily practice.

Subgroup Classification and Directional Preference: are they only useful in the spine?

Track: Clinical Decision Making

Presenter(s): Joshua Kidd

To date there is limited evidence in identifying prognostic indicators for shoulder pathology. Our traditional model includes using pathoanatomical diagnostic labels which include tendonitis, bursitis, adhesive capsulitis, subacrominal impingement, and rotator cuff sprain/strain, among others.Despite the numerous diagnoses, the pathophysiology of shoulder disorders is not well understood. Additionally, when diagnosing patients with shoulder pain, clinicians will traditionally use both a thorough history and physical examination process which includes orthopedic special tests. While a large number of orthopedic tests have been used to diagnose pain of pathoanatomical origin the reliability of these tests has generally been shown to be limited and the diagnostic validity of most tests is moderate at best.A proposed alternative to traditional pathoanatomical diagnosis is utilizing a subgroup classification system to treat shoulder pain. Multiple models will be discussed which include, the Movement System Impairment Syndrome (MSI) which was proposed by Shirley Sahrmann, the Shoulder Symptom Modification Procedure (SSMP) developed by Jeremy Lewis, and Mechanical Diagnosis and Therapy (MDT) proposed by Robin McKenzie.The lecture with then focus on MDT as it has been demonstrated to be successful and reliable when treating shoulder pathology. The discussion will include a multifactorial approach to shoulder pathology that includes the biopsychosocial and self-empowerment strategies associated with MDT. Directional Preference (DP) will also be discussed in length as it describes the clinical phenomenon where a specific direction of repeated movements and/or sustained positions result in clinically relevant improvements in either symptoms and/or mechanics. DP has been shown to be a reliable and prognostic indicator in the treatment of spinal pain, but until recently has not been studied in the extremities. New emerging research will be presented regarding the prognostic indicator and clinical utility of Directional Preference in the management of musculoskeletal disorders of the shoulder.This lecture will include strategies and concepts which the participants will be able to implement immediately in the clinic.

Symmetry is Overrated: Advancing the Thrower from Rehab to High Performance

Track: Clinical

Presenter(s): Toko Nguyen, Ben Renfrow, Adeeb Khalfe

Evaluation and treatment of the throwing athlete is a challenging area of practice in sports medicine and rehabilitation. Due to their movement demands, throwers create distinctly different movement impairments and mobility deficits compared to non-throwing athletes. This course will discuss how to return the thrower back to a high level of performance with intentional progressions of manual therapy and exercise prescription specific to the movement demands of the thrower. This course will include a strong lab component to demonstrate advanced manual therapy techniques and purposeful exercise prescription.

Temporomandibular Joint Dysfunction: An Area of Untapped Potential for Physical Therapists

Track: Clinical

Presenter(s): Paul Tadak, Jeffrey Chelette

The first part of the session will focus on the need for physical therapists to fill the void of TMD along with the evidence supporting our primary role in treating patients with TMD. The 2nd part of the session will focus on instruction of manual techniques for the TMJ, including both intraoral and extraoral techniques.

The role of coccyx dysfunction in lumbopelvic pain, an integrated approach to evaluation and treatment

Track: Clinical

Presenter(s): Michelle Nesin, Julie Sarton, Janine Nesin

Coccydynia and lumbopelvic pain are common presentations experienced by patients in both the orthopedic and pelvic health settings and results in restriction of the most basic of all functional activities – sitting. Often missed as a contributing factor of both lumbosacral pain and pelvic floor dysfunction, coccyx restriction can play a role not only in low back pain, SI joint dysfunction, and sacral pain but also in pelvic and sexual pain, painful voiding, painful defecation and difficulty with bowel and bladder emptying. Due to the attachment of the pelvic floor onto the coccyx and its relationship to the sacrum, it is essential that pelvic floor and orthopedic PTs manifest a solid understanding of the evaluation and treatment of the sacrococcygeal region and be able to treat it effectively. This educational session will provide an up-to-date solid foundation for the PT to understand the anatomy of the coccyx and associated structures as well as analyze the role of the coccyx relating to the sacrum, innominate, lumbar spine and pelvic floor stability/mobility. You will learn key manual therapy techniques as well as appropriate home program exercises for your patient’s condition. You will feel confident in formulating an understanding of the coccyx’s role in sitting, standing and pelvic floor function as well as identify normal and abnormal coccyx positioning. With the information presented you can create a basic care plan relating to patient’s symptoms and exam. Lectures will be delivered with an integration of video demonstration, case studies and live demonstration of external evaluation and treatment techniques (if class size permits). Large group discussion will be available with a question and answer session at the end.

The Triaxial function of the Radio-Ulnar joints and its relationship to Osteoarthritis of the first CMC

Track: Clinical

Presenter(s): Gail Molloy, Renee Johnson

One of the leading culprits in the development of osteoarthritis is mechanical overloading. This session describes the loading effect of normal and abnormal radio-ulnar and carpal mechanics that lead to destructive forces at the first CMC joint of the thumb.

Thoracic Outlet Syndrome- An Evidence Based Investigation: It is more common than we originally thought.

Track: Clinical

Presenter(s): Ulysses Juntilla

Pain experienced in the shoulder, upper and lower arm can originate from a countless of medical conditions including mechanical pain from nearby musculoskeletal structures such as the shoulder, neck or from regional structures such as the thorax and brachial plexus. Patients are frequently referred to physical therapy with the diagnosis of shoulder and arm pain. During examination and evaluation of the patient, the therapist must consider all potential causes of the patient's symptoms. Clinicians should be aware of ways to recognize this disorder and can differentiate it from other conditions that present with neck and arm pain and can provide a specific intervention to address the associated impairments. This lecture will describe the new proposed criteria in identifying neurogenic thoracic outlet syndrome developed by the Consortium for Outcomes Research and Education on Thoracic Outlet Syndrome (CORE-TOS) versus cervical radiculopathy and describe the indications and utilizations of neurogenic thoracic outlet - specific rehabilitation program.

Thrust joint manipulation of the transitional areas of the spine

Track: Clinical

Presenter(s): William O'Grady, Louie Puentedura

This breakout session will provide a lecture demonstration on the skillful and effective application of thrust joint manipulation to transitional areas of the spine. This area is particularly challenging to treat due to the shape, accessibility, and location in controlled and safe manner. Safety of application of the techniques are emphasized.

Upper Cervical Anatomy/Biomechanics: Applying Anomalies and Imaging to Management of Headaches & Neck Pain

Track: Clinical

Presenter(s): Rusty Smith, Jason Grandeo, Kevin Helgeson

Neck pain is one of the most common reasons patients seek the care of a physical therapist and has a lifetime incidence of 70%. Often, the upper cervical, craniovertebral junction, is the dysfunctional region. The anatomy and mechanics are vastly unique at the occiput–C1 and C1–C2 articulations with the presence of frequent various anomalies. In order to effectively treat patients with headaches and neck pain, clinicians must appreciate the biomechanical and anatomical uniqueness of the upper cervical region. Physical therapists’ understanding of the functional anatomy of the upper cervical region is often limited. This two-hour presentation will review the basic anatomy, including anomalies, and biomechanics/ kinesiology of the upper cervical region with discussion of implications for physical therapist management of patients with neck pain and headaches including imaging using an evidence-based approach. Anatomical and biomechanical understanding will be applied to basic imaging of the upper cervical spine.

Upper Ribs: Uncommon link to shoulder/Thoracic and Cervical regions

Track: Clinical

Presenter(s): Catherine Patla, Libby Bergman, Amanda Grant

The upper ribs have been identified as a link to both shoulder, cervical and thoracic functioning.The interrelationship of these regions is presented in a lab format. The lab sessions will identify varied examination methods to detect primary and secondary rib impairments.Intervention strategies and tactics are performed. Management of rib impairments are discussed and analyzed. Patient case scenarios are presented for discussion.

Other Sessions

sSIG Meeting - Loan Education Session

Student loan education session led by Joseph Reinke, CFA who will discuss the state of student loans for physical therapy as well as loan repayment options. Joe's wife, Cindy Hon, is a Fellow of the Academy and he is intimately aware of the effect of student loans on physical therapists. Joe will open up the floor in the second half of this session to general Q&A regarding financial planning, budgeting, and student loans. Joe is a Chartered Financial Analyst (CFA) and a Registered Investment Advisor (RIA). He is the CEO of FitBux, a company created exclusively to help physical therapists with their student loan debt. FitBux currently helps over 2,000 PTs manage $200 million in student loan debt.

sSIG Meeting - Manual Therapy Hands On

Meet Fellows, learn or refine manual therapy skills including thrust manipulation techniques and get introduced to the AAOMPT student special interest group (sSIG).