Utilizing Clinical Reasoning and Manual Therapy in the Management of Upper Quadrant Conditions

Course Description: 

Patients with a primary report of upper extremity pain provide clinicians with several challenges in attempting to identify the nature of the patient’s symptoms and determine an appropriate course of treatment. This hands-on course will integrate current evidence of the physical therapy clinical examination and interventions for the shoulder complex while also touching on treatment for the elbow wrist and hand. It will provide extensive laboratory sessions intended to develop the clinician’s skills in performing clinical tests, manual therapy skills, and prescription of appropriate therapeutic exercise. Patient education tools will be presented to facilitate symptom management and enhance treatment outcomes in a physical therapy clinical environment. 

Course Objectives: 

• Critically evaluate the science of the examination of the cervico-thoracic and shoulder region in order to identify impairments that may be addressed through conservative care.

• Develop appropriate intervention strategies for patients with upper extremity complex pain including a multimodal approach of both manual therapy and therapeutic exercise.

• Demonstrate psychomotor competency of performing different clinical tests and manual therapy techniques of the upper extremity region to enhance outcomes.

• Formulate an opinion of the value of several different interventions of the upper extremity complex according to the most recent literature.

• Integrate effective therapeutic exercises in the intervention of individuals with shoulder dysfunction. 

Schedule: 

Day One 

8:00a.m. Introductory principles and clinical reasoning for examination and a multi-model treatment plan for the Upper Quarter. 

9:30a.m. Break 

9:45a.m. Evidence review of evaluation and treatment of the cervicothoracic region and integration of therapeutic interventions 

10:45p.m. Manual therapy and therapeutic exercise for the cervicothoracic region (Lab Practice) 

12:00p.m. Lunch 

1:00p.m. Evidence review for evaluation and treatment of the shoulder girdle and glenohumeral joints 

1:45p.m. Specific evaluation techniques for the glenohumeral and acromioclavicular Joints (Lab Practice) 

2:30p.m. Manual therapy techniques of the scapular girdle, glenohumeral and acromioclavicular joints and (Lab Practice) 

4:00p.m. Review integration of therapeutic exercise and neuromuscular re-education (Lab Practice) 

4:30p.m. Round Robin Practice 

Day Two 

8:00a.m. Evidence review of evaluation and treatment of the elbow 

9:00a.m. Round Robin Practice previous days techniques 

10:00a.m. Break 

10:15a.m. Manual Therapy Techniques of the elbow and integration of therapeutic exercises (Lab Practice) 

11:30a.m. Round Robin Practice and Review 

12:00p.m. Lunch 

1:00 p.m. Evidence review of evaluation and treatment of the wrist and hand with integration of therapeutic interventions 

1:45p.m Manual therapy techniques for the wrist and hand and integration of therapeutic exercise (Lab Practice) 

2:45p.m. Break 

3:00p.m. Evidence review of evaluation and treatment of common upper extremity neuropathies and the complicated shoulder 

3:45p.m. Manual therapy techniques and the integration of therapeutic exercises of the nervous system (Lab Practice) 

4:30p.m. Discussion and Questions 

5:00p.m. Course Adjourns

Course Instructor Background: 

Dr. Josh Bruner, PT, DPT, OCS, CSCS is currently a board certified Orthopedic Clinical Specialist and holds a certification as a Strength and Conditioning Specialist (CSCS). He graduated from the University of Wisconsin – La Crosse’s Doctor of Physical Therapy program in 2014 and completed an orthopedic residency with Specialized Physical Therapy Education (SPTE) in 2017. Since completing the residency training, Dr. Bruner has been a clinical mentor for the program as well as a guest lecturer for multiple Physical Therapy and Physical Therapy Assistant programs. He’s also been an instructor for several continuing education courses varying from dry needling to the management of various physical therapy disorders. Outside of the residency program, he has received additional training in analyzing and treating movement impairments as a certified performance specialist and implementing sports performance programs for high school and collegiate athletes. Prior to the physical therapy profession, Dr. Bruner spent time working as a strength and conditioning coach for Auburn University’s football program.