AAOMPT Annual Conference Session Descriptions
Advanced Examination and Manual Intervention for the C0-C7 Segments Featuring Angular and Translatory Mobilization and Manipulation
Presenter: Doug Creighton
This session will demonstrate advanced upper cervical, lower cervical and cervicothoracic manual interventions designed for patients with complicated clinical presentations including lower cervical disc degeneration and associated segmental hypermobility and radiculitis. Session participants will learn to incorporate manual traction during the application of translatory or angular mobilization. These techniques are designed to protect painful segments while at the same time improve active and passive cervical motion.
Advanced Treatment of Valgus Extension Overload in the Throwing Athlete
Presenters: Toko Nguyen and Ben Renfrow
Effective evaluation and treatment of the throwing athlete is a challenging area in sports medicine and rehabilitation. The ability to identify compensatory movement strategies and the underlying mobility limitations that contribute pain and poor performance is critical in successfully returning the thrower back to high performance. This course will discuss in-depth clinical reasoning in identifying the true causes of medial elbow pain in the thrower and the proper implementation of manual therapy techniques and exercise prescription to maximize full recovery in the throwing athlete.
Big Data
Presenter: John Childs
We will generally cover what Big Data is, pros & cons, the value to PTs, etc. Specifically, my portion will cover the use of Big Data to look at questions on delivery of care. We will be looking in particular at 2 recent papers in which we utilized Big Data on questions immediately relevant to P.:
Big Data and risk stratification for improved care delivery
Presenter: Chad Cook
Session will discuss past risk stratification strategies and the new strategy using Big Data that is designed to identify the characteristics of outliers. The 'model' of the individuals who fit the outlier categories will be presented.
Cognitive functional therapy for managing disabling low back pain disorders
Presenter: Peter O'Sullivan
This course is based on the ongoing research into to contemporary management of disabling low back pain disorders. It provides a theoretical framework for understanding the mechanisms underlying non-specific low back pain and latest advances in their management.
Conservative treatment of knee osteoarthritis in a division I collegiate basketball player
Presenter: Michael Markee
This session includes the clinical presentation, subsequent treatment, and clinical outcomes of an athlete with knee osteoarthritis. The discussion will also include evidence relating knee osteoarthritis with surgical reconstruction of the anterior cruciate ligament, and the concepts of the envelope of function and of supraphysiologic overload.
Clinical pearls and quick tricks for OMPT - Creating patient buy in for spinal stabilization exercises and utilizing manipulation in the evaluation to accelerate clinical diagnosis
Presenter: Cameron MacDonald
This session will focus on clinical pearls and quick tricks/strategies to enable the OMPT to rapidly acquire patient buy in for a hands on treatment approach and the integration of spinal stabilization exercises into a home program and plan of care. Utilizing manipulation in the examination will be reviewed to demonstrate an advanced clinical diagnosis approach that informs both patient and provider of prognosis and creates an accelerated therapeutic alliance.
Creative Use of Conditioned Pain Modulation as a Novel Clinical Intervention
Presenter: Mary Beth Geiser
Finding new and novel ways to address pain are important to every clinician. When innovation precedes EBP a clinician needs to make a choice and find interventions that work. Come listen to a unique way to use conditioned pain modulation (CPM) in the clinical setting. Find out how a simple ice bath or a TENS unit can be used to facilitate descending inhibitory pathways and use these tools to your advantage. This session will start out with a brief review of the literature surrounding conditioned pain modulation and how the novel idea came to fruition. Next it will walk through 5 (retrospective) real-life clinical cases, with varied diagnoses, where CPM proved to be an effective intervention for treatment and was successfully integrated into use in a home exercise program.
Diagnosis and Prognosis through intervention
Presenter: Cameron MacDonald
This session is based upon the further refinement of the Regis Fellowship approach to OMPT initially developed as an evidence based test-re-test approach. In ten years of development an evidence informed dynamic clinical decision making model has evolved allowing OMPT practitioners from an ecclectic background to advance into highly skilled OMPT practitioners each unique in their treatment approach, yet holding to a core clinical decision making framework now title the Dynamic Wheel. This session will articulate this approach and how it enables the rapid development of the OMPT practitioners skill set in identifying optimal prognostic and diagnostic skills for the patient currently in front of them.
Differentiating anterior shoulder pain in the overhead throwing athlete
Presenter: Angela Gordon
Presentation in lecture and demonstration format on differentiating the causes of anterior shoulder pain and addressing the kinetic chain involved in throwing. Understanding the regional interdependence of the upper kinetic chain on the shoulder is essential to identify the true underlying cause of pain. Scapular dyskinesis, postural adaptations, trigger points, and cervical dysfunction are a few topics that will be covered in detail to facilitate a better understanding of how to evaluate and treat an overhead athlete. Sample case studies from major league baseball players with anterior shoulder pain will be presented pulling all the information together at the end of each session.
Do you Treat Ribs? The Relationship Between the Axial and Appendicular Skeleton
Presenters: Eric Furto and Larry Yack
The session will consist of a mixture of lecture and hands on lab sessions discussing the importance of proper evaluation and treatment of the thoracic spine and ribs, and their role in general function throughout the body. The participant will learn a thorough examination process of this region, followed by treatment applications that include thrust and non-thrust spinal manipulation, neuromuscular reeducation, and upper extremity integration. The presenters will support the presentation with current evidence and discuss the biological, neurophysiological, and psychological benefits of manipulation in the thoracic spine. This course will meet the demand of the AAOMPT consumer with an 80-20 lab-lecture ratio and will provide ample techniques and clinical pearls to be applied in the clinic on Monday morning.
Evaluation and treatment of lateral elbow pain, a movement impairment based approach
Presenters: Pieter Kroon and Brenda Boucher
The principles of the extension/radial deviation syndrome will be explained. From a movement impairment syndrome perspective, this is the driver of most lateral elbow pain complaints. Movement impairments in the cervical spine, shoulder, elbow and wrist will be discussed, and their influence on lateral elbow pain. Rational treatment approaches to address deficits found will be discussed. This will include joint mobilizations/manipulations of the cervical spine, shoulder, elbow and wrist.
From First Semester to Last: Integrating Modern Pain Science into Your Student's Educational Experience
Presenter: Mary Beth Geiser
As research related to pain science and education begins to proliferate and new university curriculums are beginning to emerge, it is important to find ways to integrate pain science into the students learning experience. While several universities are already supporting individual pain management classes in their DPT curriculums and finding success, why not also consider other alternatives which explore how pain science and education can be filtered into classes across the entire curriculum. Come listen to suggestions on how to engage your students in pain related topics from their first day on campus through their last day before graduation. The purpose of this session is to help educators recognize key 'stepping stones' that students need to know about pain throughout their PT journey. Simple and complex subject matter all needs to be addressed — but where does it fit best? Which core classes offer the best opportunity for learning? What are some sample algorithms to consider when revamping your curriculum? This session will discuss personal experiences in the educational field and offer insight on how to prepare all levels of students (from DPTs to Fellows) for treating painful conditions the workforce. Another purpose of the presentation will be to encourage open dialog on this topic to discuss pitfalls, barriers and success stories that others have experienced.
How integrating dry needling can decrease pain and improve movement and function
Presenters: Michelle Layton and Rob Stanborough
This workshop will cover how dry needling has an influence on the musculoskeletal and nervous systems by reducing/eliminating pain, improving range of motion, strength, and movement patterns to help maximize the overall function of the patient. Patient cases will highlight how dry needling can be utilized in isolation or in conjunction with other manual therapy techniques to maximize gains. Current evidence relevant to the patient cases will also be covered.
Identifying and Treating Crossover Syndrome in Runners
Presenters: Marc Riley and Adam Walsh
We will discuss the typical mechanics seen in runners; how to identify crossover syndrome; the potential results of the pathological mechanics seen with crossover syndrome; a method for using high speed camera technology to identify; and a method for determining the optimal location to start treatment of the crossover syndrome.
Improving Your Junctions' Function: utilizing clinical decision making with refining techniques of HVLAT for comfort and effectiveness
Presenters: Alec Kay and Brian Power
Clinical decision making concepts regarding the application of HVLAT will be presented in the lecture and sprinkled throughout the lab as well. There will be limited lecture on safety and contraindications of using thrust techniques and the latest evidence related to that topic. Brief lecture will also review relevant biomechanics and anatomy of the regions addressed. The majority of the time will spent with hands on instruction and practice for refining the manipulation techniques presented for the junction zones of the spine.
Integrating Behavioral and Psychologically-Based Interventions into OMPT Practice: A Necessity in the Management of Patients with Chronic Pain
Presenters: John Leschitz and Tasha Mouton-Shanklin
The purpose of this presentation is to describe the concept of therapeutic alliance (TA), leveraging patient expectations, and implementing psychologically-informed principles in addition to manual therapy and exercise to improve patient outcomes in chronic pain. It will include specific strategies for optimizing TA and expectation, overview cognitive-behavioral principles in current and future OMPT practice, and discuss indications for outside referral.
Integrating Manual Therapy and Somatics: Enhancing Our Repertoire for Improved Pain Outcomes
Presenters: Mark Erickson, Gil Haight and Stephanie Mikoliczak
The course material is presented in a developmental fashion progressing from more established content to that which is less familiar. After an introduction designed to pique curiosity, the instructors present, in an integrated manner, the first section of the course. Here we introduce participants to the field of Somatics, provide an overview of current pain system science and expand the Biopsychosocial Model to explain the four-quadrant approach as described by Ken Wilber, PhD. Misperceptions about past and present orthopedic manual therapy treatment models and their ramifications on education and practice are discussed in relation to advancing our treatment paradigm for challenging patients. The Psychosocial aspects of care are investigated with an emphasis on intentional and specific communication assessment and intervention strategies designed to augment our manual communication skills.
Integration of pain sciences and dry needling to enhance movement and function for upper quarter dysfunctions
Presenters: Derek Clewley, Elizabeth Lane, Daniel Maddox and Mark Milligan
This session will provide background information on dry needling specifically related to upper quarter dysfunction. Evidence review will highlight some of the emerging data suggesting that dry needling might have an additive effect on improving function and movement by reducing pain symptoms. Pain science will be explored to provide plausible reasoning for some of the potential effectiveness of dry needling.
MDT and the Relevant Lateral Component: Strategies for the Challenging Cervical Spine Patient
Presenters: Ron Schenk, Amy Fletcher and Brian McClenahan
PowerPoint presentation with lecture and demonstration and practice of lateral procedures and manual therapy techniques that commonly are performed with the management of cervical spine conditions. The presenters will outline the classification of mechanical neck disorders utilizing an MDT assessment and selected OMPT tests and measures. Several cases will be presented to demonstrate the clinical reasoning that determines the appropriate patient centric intervention. The cases will describe the use of appropriate screening and progression of forces when thrust and non-thrust manipulation are required. Patient specific procedures of thrust and non-thrust manipulation within a system of force progressions will be demonstrated to improve function within the framework of the existing evidence.
MDT and the Relevant Lateral Component: Strategies for the Lumbar Spine
Presenters: Ron Schenk, Christopher Chase and Robert Robinson
PowerPoint and video presentation with lecture, discussion of cases, and demonstration of lateral procedures and manual physical therapy techniques that may be performed in the management of challenging lumbar spine patients with asymmetrical symptomatic and mechanical baselines. Several cases will be presented to demonstrate the clinical reasoning that determines the appropriate patient centric intervention. The cases will describe the use of appropriate screening and progression of forces when thrust and non-thrust manipulation are required. Patient specific procedures of directional thrust and non-thrust manipulation within a system of force progressions will be demonstrated to improve function based on the available evidence.
Managing Uncommon Sources of Wrist Pain to Maximize Function: Utilizing Manual Therapy Approaches
Presenter: Amanda Grant and Matt Daugherty
This session will take the clinician through some uncommon impairments that can be a sources of wrist pain. This will be divided into two categories: ulnar and radial sided wrist pain. Under the radial pain category we will briefly discuss impairments including but not limited to:DeQuervain's Tenosynovitis, superficial radial nerve pathology, scaphoid pathology, and radiocarpal joint pathology with implications at the radiohumeral joint. On the ulnar side we will discuss: distal radioulnar joint, TFCC pathology and ulnar tunnel syndrome. This will include some biomechanical discussion and physical therapist management of these conditions including clinical pearls for effective and efficient patient management to maximize function including technique demonstration.
Meet the Committees
Presenters: AAOMPT Committee Representatives
Are you thinking of serving on a committee, but not sure what it is all about? Are you interested to hear what these committees are working on and how your skill set could perhaps benefit the Academy? If yes, then this session is just for you! A representative from each Committee will be in attendance and will give a brief synopsis of their committees and their expectations of potential committee members. Be sure to attend to learn more about the happenings in the AAOMPT Committees.
Methods for Manual and Self-stretching of the Posterior Shoulder Region
Presenter: Cody Manton
Recently, much has been written about glenohumeral internal rotation deficit and its association with shoulder conditions. The purpose of this session is to describe the various stretching techniques for the posterior shoulder region. The session will include demonstration and practice of stretching techniques for the posterior shoulder region with emphasis on manual stretching of the posterior shoulder. Mobility exercises for the posterior shoulder region will also be discussed. In addition, current evidence for stretching of the posterior shoulder region and the dosing of therapeutic exercise will be reviewed.
Modulating pain with thrust manipulation: the big, the small, how to tackle them all
Presenters: Stacy Soappman and Ann Porter-Hoke
What do you do when your patient is bigger than you' How do you save your own body from fatigue and injury when treating your case load' How can your improve your speed and body mechanics to make manipulation more effective' Do you cringe when you see a patient larger than you who needs a lumbar manipulation or do you shy away from thoracic manipulation because it hurts your hands' If you have thought these questions then this is the course for you! The session will focus on teaching the best psychomotor learning tools, to educate and practice thrust manipulation strategies to achieve success and minimize pain and strain to both parties. The use of core and key muscle groups for speed, while minimizing strain on the practitioner's spine, shoulders and hands. Techniques: thoracic, low lumbar, cervico-thoracic junction, and peripheral joints. Clinical reasoning of alternative techniques for patient body types or pathologies that include: large or heavy patients, shoulder instability, regional sensitivity, hypermobility syndrome, potential bone fragility, concern of close body contact, etc.
Organize and exercise: A Practical Framework for Managing Chronic/Persistent Pain
Presenters: Andrew Bennett, Alyson Ellis and Matthew Stevenson
This is a breakout session that will explore a proposed framework for management of patients with chronic/persistent pain. This session will incorporate a bio-psychosocial model to include exploration of stages of change, patient belief, and physical therapy's impact on behavior change. We will examine the role of the patient and physical therapist in discovering 'what is' in an attempt to avoid the hero, victim, or villain role. An emphasis on sustainable health will guide long-term management of patients with pain. We aim to provide an overview of the persistent pain cycle and how we, as physical therapists, can affect that cycle. We will discuss current literature supporting the facilitation of input and expand upon those ideas with resources to help further organize pain pattern to progress to a sustainable lifestyle through communication, manual therapy, and exercise. Specific case examples will help further illustrate the information presented.
Orthopedic Manual Therapy for the Pediatric Patient
Presenter: Mitchell Selhorst
This session will explain how orthopedic manual physical therapy can be an effective tool to treat the pediatric orthopedic population. Pediatric patients are not tiny adults, they have conditions and injuries that are specific to their population and without proper understanding the orthopedic manual therapist risks injuring these patients. Evidence supporting the use of manual therapy in pediatric patients will be presented. Specific precautions and relative risk of injury from manual therapy in the pediatric population will be presented. Using examples of common pediatric conditions, this session will highlight the differences and similarities between pediatric and adult patients and show how manual therapy can be an effective tool to treat the less familiar pediatric orthopedic patient.
Paradigm Shift to Treating Extension-Based Back Pain in Young Athletes
Presenter: John Winslow
This session will review current guidelines for managing extension-based back pain, demonstrate the pathoanatomic relationship between the pars interacularis and the facet joint, and present original research on the correlation between multifidi atrophy and return to play as well as the efficacy of thoracic manipulation and facet joint injections in this population. A new treatment algorithm for managing extension-based back pain will be presented and discussed.
Parietal-Frontal Circuits & Chronic Pain: Intention & Motor Planning in Manual Therapy
Presenter: Francois Prizinski
This course reviews the motor cognitive literature and what is involved when we discuss motor planning in the athletic or chronic pain populations. Motor learning in the context of a biopsychosocial approach is discussed in terms of a physical therapist providing treatment or a referral to maximize patient outcomes.
Peripheral Nerve Sensitization: The 'Angry Mother in Law' in Upper Quarter Orthopedic and Sports Rehabilitation
Presenter: Jack Stagge
This one day course will present concepts of differential diagnosis and treatment of patients with upper quadrant pain and loss of function pioneered by Bob Elvey P. T., GDMT. Participants will learn to integrate the six sensitive and specific evaluation techniques into their standard evaluations and specific treatment protocols will be demonstrated and practiced. Often misdiagnosed maladies of the upper quadrant including shoulder impingements, "chronic tendonitis", adhesive capsulitis, failed whiplash syndromes etc. will be discussed and well documented neurogenic causation will be presented. Case presentation, and lab practical's will allow for application into the participant's daily practice.
Selective Activation of the Deep Cervical Muscles with Exercise Design and Dosage
Presenters: Jim Rivard and Cindy Unsleber
The session will involve presentation of original research on EMG assessment for cervical muscle recruitment using different types of force moments. Cervical exercises, on pulleys as well as hanging free weights, are modified to recruit specific muscles and emphasize different depths of cervical muscles. Minor lab sessions performed during the lecture, with subject sitting or laying down if room, will be presented to assess cervical motor performance. Instruction on exercise design based on these findings, as well as application of the research presented. The content is a progression of training concepts from the curriculum's of MET (Medical Exercise Therapy concept - Norway) / STEP (Scientific Therapeutic Exercise Progressions - USA).
Self-Mobilization of the Hip with Belting Techniques
Presenter: Everett Nicolai
Demonstrations of hip self-mobilization in multiple planes using belting techniques. Self-mobilizations are brilliant ways to prepare the patient for discharge. The hip is of central importance for regional interdependencies for the lumbar spine, SIJ, knee and ankle.
sSIG Presents: TMJ/headache, Antepartum Lumbar/Pelvic Girdle Pain, and Maigne's Syndrome'OMT Considerations for New and Experienced Clinicians Alike
This AAOMPT sSIG sponsored Breakout Session will feature three mini presentations focusing on the areas of TMD/headache, Lumbar/Pelvic Girdle pain in the antepartum patient, and Maigne's Syndrome. The first presentation, given by Michael Bourassa, PT, DPT, OCS, FAAOMPT, will discuss the current literature on the association between upper cervical spine and Headaches/TMD, as well as delve into the selection and utilization of manual based interventions for the management of HA/TMD. The second presentation, given by Susan Clinton, PT, DScPT, OCS, WCS, COMT, FAAOMPT, will discuss the current evidence supporting examination clusters relevant to the antepartum population with lumbar/pelvic girdle pain and include demonstration on how to modify examination/intervention techniques for the pregnant client with pelvic girdle pain. The final presentation, given by Vicki Luebbe, MS, PT, FAAOMPT, will guide attendees through a differential assessment of primary Maigne's syndrome by contrasting it to other orthopedic conditions that can produce pseudo like symptoms of low back and SI pain, as well as discuss possible entrapment sites, both at the segmental vertebra and the ilium, of the posterior cutaneous branch of the dorsal rami. Insight and recommendations regarding a manual therapy approach to the treatment of Maigne's Syndrome will be included. The three presentations will be followed by a 15 minute Q & A session with the audience facilitated by an AAOMPT sSIG member.
The BIO of a bio-psycho-social approach: Manual Therapy
Presenters: Adriaan Louw, Tim Flynn and John Childs
In recent years, pain neuroscience research has increasingly focused on the brain, brain plasticity, central sensitization, immune responses and more. The clinical outflow of this pain science shift has culminated in ever-increasing popular treatments such as pain science education, graded motor imagery and sensor motor retraining. These ?advanced? treatments has put into question traditional treatments such as manual therapy. A deeper understanding of pain neuroscience and brain plasticity, however, implies that skillful and deliberate application of hands-on treatment is a fundamental part of physical therapy in treating conditions such as spinal pain. It can be well argued that skillful delivery of manual therapy aids in brain remapping, enhancement of endogenous mechanisms, graded exposure, cognitive restructuring of threat and more, all of which are very important in a human pain experience. In the pursuit of a bio-psycho-social approach to treat people with spinal pain, the ?bio? emphasizing the biological issues of movement, tactile stimulation, blood flow, tissue health and more has seemingly been forgotten. This session will feature three deliberate parts aiming to help attendees realize the importance of not neglecting, but rather embracing manual therapy in a pain science approach for spinal pain. In the first part, Tim Flynn will discuss the pendulum shift over the past decade leaving behind the ?bio? of the bio-psycho-social approach. In the second part, John Childs will analyze and present the evidence implicating the efficacy of manual manipulative therapy for treating spinal pain. In the final part, Adriaan Louw will aim to provide a neuroscience rationale as to the mechanisms behind the efficacy of manual manipulative treatments aimed at treating spinal conditions, thus emphasizing the need to not neglect the ?bio? of the bio-psycho-social approach.
The spinal accessory and median nerves as contributing factors to cervical and occipital pain in a patient
Presenter: Michelle Layton
This session will highlight a patient case with right-sided cervical pain and occipital headaches that did not respond to manual therapy directed at the soft tissue and joint structures as expected. Upon further clinical examination, altered neurodynamics of the spinal accessory and median nerves were found and treated, with a notable reduction in the soft tissue and joint restrictions that were present during physical examination.
Thoracic mobilization and manipulation for the treatment of shoulder pain
Presenters: Brent Perdizet and Patrick Cook
Brief discussion of the evidence around the use of cervical and thoracic manipulation for the treatment of should pain:
- Evidence appearing in references supports the use of cervical and thoracic manipulation and mobilization techniques in the management of shoulder conditions.
- Indications for the use of these and other techniques can be determined using a dynamic treatment model including insight gained from additional assessment, evaluation, treatment, and reflection.
Cervical and Thoracic manipulation and mobilization techniques will be briefly introduced and demonstrated by two presenters. Time permitting, techniques may include;
- Seated Cerviothoracic Manipulation and Mobilization
- Seated Cervicothoracic Manipulation
- Seated Thoracic Manipulation
- Supine Thoracic Manipulation
- Supine Cervical Manipulation
- Prone Cerviothoracic Manipulation
- Prone Thoracic Manipulation
- Variations on these techniques that can be useful for patients after shoulder arthroscopic surgery, or other conditions requiring protection of soft tissues of the shoulder will be included where appropriate.
If time permits, the audience will be allowed to practice these techniques with guidance of the presenters. Printed written and illustrated notes for this presentation and techniques will be provided by the presenters.
Treating phantom limb with dry needling
Presenter: Todd Hooks
This breakout session describes the evaluation and treatment of a patient presenting with upper extremity phantom limb pain. The patient was noted to have trigger points within the proximal arm with resultant familiar pain upon examination. This session will describe the clinical examination and treatment of referred symptoms (phantom limb pain) using both cervical manipulation and dry needling to mediate peripheral stimulus and eliminate symptoms.
Using BIG data for SMALLer projects
Presenter: Dan Rhon
Traditionally 'big data' is seen for use in large population-health studies and retrospective cohort studies. This would lead most researchers and clinicians to leave this up to the epidemiologists to work out. However, this same data can also help augment outcomes for smaller case series, cohorts, and trials. Many clinicians may already have access to this type of data and simply not know what to do with it.
Use of Big Data to assess patient benefits from physical therapy care by providers with different levels of education and training
Presenter: Jason Rodeghero
This session will include an introduction to the concept of Big Data and its importance to the field of physical therapy. There will be a specific focus on the influence of various levels of education, including fellowship training, on the clinical outcomes of patients treated by physical therapists.
Using OMT and Sports skills to Maximize Outcome for Cervico-Thoracic and Shoulder Painful Conditions- from the Clinic to the Athletic Field
Presenters: Marie Potter, Michael Wong and Emmanual Yung
Emerging evidence suggests that multimodal (manual therapy and exercise) therapy is effective while high utilization of care may actually produce poorer results for neck pain. This implies efficient utilization of a multimodal intervention may maximize outcome. Most OMT and sports movement exam and treatment approaches have been published in isolation, but these were not widely presented in combination to optimize clinical and sports rehabilitation results. This session aims to fast track the real-time differentiation and verification of OMT modifiable movement impairments from cervico-thoracic and shoulder regions, thereby achieving desired outcomes from the clinic to the athletic field.