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Introduction to Functional Examination & Treatment of the Pelvis – Vernon, CT
June 15, 2018 @ 8:00am - 4:00pm
June 16, 2018 @ 8:00am - 4:00pm
Functional Examination & Treatment of the Pelvis
Over the last 25 years, Mark has developed a system of analysis and treatment based on MWM principles that greatly simplifies and clarifies examination and treatment of pelvic dysfunction.
This 2 day program was extensively updated in 2017 and has a new format designed to simplify and enhance the learning experience. By providing an electronic copy of the manual for pre-reading, it has been possible to further expand the “hands on” component of the course. You cannot learn the practical components of this material online!
Certificate of attendance is provided for 13 hours of Continuing Education (CE) credits
Each agenda item consists of Live Lecture and Lab Participation/Assessment. Typically, at least 50% of the agenda item is dedicated to Lab Participation/Assessment.
The examination component:
This course includes a new generation of functional load transfer tests that can be used to assess various elements of failed load transfer (pelvic dysfunction) across the pelvis. These tests are a critical element of pelvic examination as pelvic dysfunction has the capacity to result in pain being experienced in other parts of the body even when the pelvis is symptom free.
Some of these tests are validated, while others are currently being researched. They include observation based load transfer tests and tests for measuring inhibition, bracing and weakness.
In addition to identifying failed pelvic load transfer, these tests can be used to immediately assess the effectiveness of MWM (and other) interventions. However the true effectiveness of the MWM intervention can only be gauged by how it affects the patient’s presenting complaint. Consequently, the primary examination element taught in this program is how to use MWM to determine appropriate real time treatment. Rather than using pain provocation tests (PPTs) to provoke pain, MWM examination procedures are performed with the aim of eliminating pain on movement as the patient reproduces the previously symptomatic activity. In this way, the clinician is able to ascertain conditions that are required to render a pain provoking activity symptom free or eliminate the element of failed pelvic load transfer that has resulted in a symptomatic maladaptive movement pattern.
The treatment component:
The treatment elements of this course are primarily MWM based techniques directed primarily at the intra-pelvic joints (sacroiliac and pubic symphysis). However the pelvis MWM techniques integrate elements of manual therapy, functional exercise and cognitive therapy with the aim of affecting all components of the pelvic region. This is taught using a combination of practical instruction, real time demonstrations on individuals with PGP or pelvic dysfunction and video case example presentations.
Self-treatment techniques and integration of MWM techniques into what is termed a “no failure” functional exercise approach will be presented. When appropriate, additional treatment strategies and techniques are discussed and demonstrated including identification and management of causative factors.
Gentle, pain-free MWM techniques are ideal for treatment of pelvic dysfunction in women with pregnancy related pelvic girdle pain (PPGP) and these techniques are discussed and demonstrated in this workshop.
Why This Course?
Many clinicians find current examination and treatment options confusing, often contradictory and not particularly effective. The SIJ and PS may not in themselves be pain generators, but by altering relative flexibility and movement patterns may cause or contribute to many clinical problems including low back pain and hip pain, headaches and orofacial disorders.
Based on the Mulligan Concepts mobilization with movement (MWM), a system of movement analysis and treatment has been developed enabling clinicians to easily identify whether or not the SIJ and PS are contributing to functional or pain problems and to establish and execute an effective, clinically reasoned treatment plan.
The major component of the course is detailed supervised hands on practice of new MWM techniques and pelvic examination techniques that assess function and ease rather than provoke pain.
At the completion of this course (inclusive of pre-course reading), participants should:
- Have an understanding of applied anatomy of the pelvic osseous, ligamentous and neuromuscular systems as they relate to pelvic function
- Be aware of current literature related to examination and treatment of pelvic dysfunction and pelvic girdle pain
- Have an advanced level of understanding of the concept of MWM and the clinical reasoning process on which it is based
- Be able to confidently perform a functional evaluation of the pelvis using newly developed load transfer tests
- Be able to confidently construct and perform pelvis MWM examination and treatment techniques primarily directed at the intra-pelvic joints (sacroiliac and pubic symphysis)
- Be able to teach MWM self-treatment techniques
- Be able to integrate pelvis MWM techniques into an active functional evidence based approach for pelvic dysfunction and pelvic girdle pain
- When indicated be able to safely and effectively use MWM techniques to treat acute pregnancy related pelvic girdle pain
- Be able to further develop clinical skills and clinical reason related to examination and treatment of the pelvis by using the comprehensive descriptions in the course manual.
- Perform an examination of the pelvis using Mulligan Concept principles and use this to determine an appropriate Mobilization With Movement treatment strategy.
- Perform basic mobilization with movement techniques for the SIJ
- Perform basic mobilization with movement (MWM) techniques for the pubic symphysis
- Enable participants to treat derangements of the pubic symphysis during pregnancy using mobilization with movement techniques
- Perform and interpret the findings of the research validated active straight leg raise test (ASLR) and use it to determine the effectiveness of MWM interventions
- Perform a detailed assessment of the passive accessory movements of the pubic symphysis
- Identify basic maladaptive movement patterns, bracing responses and inhibitory patterns originating from the pelvis by using functional movement testing
- Develop a treatment plan for a female long distance runner experiencing pelvic pain incorporating three MWM techniques.
- Perform MWM techniques appropriate for age and degeneration related stiffness of the SIJ
- Describe a proposed pelvis MWM procedure to a patient with pelvic dysfunction to obtain informed consent to apply the technique
- Evaluate the potential presence of failed load transfer in a patient with a pelvic joint dysfunction.
- Communicate three key guidelines that are to be expected of an MWM prior to performing a technique on a patient with a joint dysfunction.
- Apply one pubic symphysis MWM technique with correct hand placement in a patient with multi-directional hip motion loss.
- Demonstrate a SIJ MWM technique for loss of hip extension for a patient with pain and loss of motion.
- Recognize three symptoms/conditions warranting a differential diagnosis in a person with pelvic girdle pain.
- Demonstrate a MWM on a patient with knee pain originating from the pelvis.
- Instruct a patient in a pelvis self-MWM technique to address pain in the lumbar spine involving the pelvis.
- Demonstrate one SNAG technique for the lumbar spine for a patient with pelvic girdle pain.
- Demonstrate the use of a belt in one MWM technique for the pelvis in a patient with low back pain and loss of ROM.
- Instruct a patient with loss of trunk flexion in a pelvis self-MWM technique to add to their HEP.
- Incorporate one taping strategy to eliminate pain in a patient with pelvic girdle pain.
|800am||Overview of MWM related to the pelvis
Functional anatomy, biomechanics and neurophysiology of the pelvis Pelvic dysfunction – lecture
|900am||The PS, pregnancy and pubic symphysis MWMs – lecture
PS MWM techniques – demonstration and practical
Case study – pregnancy related pubic symphysis pain
|1000am||Determination of SIJ plane – demonstration and practical
Functional examination procedures for the pelvis – demonstration and practical
|1100am||PS MWM techniques – practical
SIJ MWM techniques – practical
|1230pm||Overview of pubic symphysis (PS) anatomy – lecture
Functional examination of the pelvis – demonstration and practical
|SIJ MWM techniques – practical
Case study pelvis MWMs –
integration of functional exercise, and other treatment options –demonstration and practical
|SIJ MWM treatment techniques – demonstration and practical
Short case studies
|Advanced lumbar and hip techniques – demonstration and practical
Addressing causative factors – demonstration
Case study – MWM related to MRI visualized lumbar IVD protrusion
Discussion, questions & summary
This course is 50% hands-on so come dressed to learn. You will need to bring:
- Wear loose, comfortable lab clothing (with long hair pulled back)
- Bring your copy of the text, a small hand towel and a Mulligan NAGS & SNAGS Mobilization belt
- Foam mobilization pads are recommended.
- Required Text: Manual Therapy, “NAGS”, “SNAGS”, “MWM’S”, ETC., 6th ed., Brian R. Mulligan, F.N.Z.S.P.,Dip. M.T.
Course Evaluation: Yes
Certificate of Completion: Yes
- Certificate of attendance is provided for Continuing Education (CE) credits
- Connecticut CEUs applied for
Mark Oliver MAppSc(Curtin), GradDipMT(Curtin), DipMT(NZMPA), DipPhysio(NZ), CMP, MCTA
Mark Oliver is a New Zealand and Australian qualified Manipulative Physiotherapist with a private practice in Western Australia. He is a Clinical Educator with more than 30 years clinical experience and Australia’s most experienced accredited Mulligan Concept teacher. Mark has completed a research Masters examining lumbar spine biomechanics, has published in international journals, written textbook chapters and was a lecturer on the Graduate Diploma in Manipulative Therapy and Sports Physiotherapy courses at Curtin University teaching clinical practice, anatomy, pathology and diagnosis. He has developed new methods of evaluation and treatment for sacroiliac joint (SIJ), pubic symphysis (PS) and temporomandibular joint (TMJ) disorders utilizing the Mulligan Concept and has conducted more than 100 lectures and clinical workshops on these subjects in Australia and Internationally.
In 2009, Mark was presented an Australian Physiotherapy Association (WA) award for contribution to physiotherapy education “An award presented to an APA member who has made an outstanding contribution to physiotherapy education”. He has written five textbook chapters and published in peer reviewed journals. Together with Jill McDowell, a fellow Mulligan Concept teacher, he is currently writing two textbooks and completing two papers on the Mulligan Concept in relation to pelvic and orofascial disorders. He is a member of the Australian Physiotherapy Association, a titled Musculoskeletal Physiotherapist (Musculoskeletal Physiotherapy Australia) and a member of the Mulligan Concept Teachers Association.