Course Outline Hour 1 - Allied Health Education · Escamilla RF, Yamashiro K, Paulos L, Andrews JR. Shoulder muscle activity and function in common shoulder rehabilitation exercises

The Shoulder Complex and

Elbow Clinical Update in

Conventional and Integrative Rehabilitation

For Professional Yoga Therapist candidates

This CE corresponds to Module 10 Part 2

Course Outline ndash Hour 1

bull Shoulder Injury Causes Problems Risks

bull Biomechanics Update of Shoulder Complex Kinematics amp Injury Prevention

bull Scapular Dyskinesia Update and Testing

bull Pathophysiology of RTC Syndrome

bull Case Study

bull Integrated Rehab Methods

Objectives

1 Apply evidence-based methodology for incorporating a biopsychosocial model into current rehabilitation programs

2 Identify a minimum of 5 methods for use in shoulder rehabilitation or injury prevention

3 Describe safe application and appropriate use of yoga for the shoulder complex through understanding indications and contraindications

4 Identify movement therapy and specific patterns that allow for concurrent evaluation and therapeutic intervention in integrated shoulder rehabilitation

5 Analyze a case study format in evaluation and management of a common shoulder diagnosis

Our Loss Whorsquos Gain

Changing the Conversation

ldquoI dont want to survive I want to liverdquo

ldquoI donrsquot want to survive I want to liverdquo~wall-e

Mind Over Matter

in All Health Outcomes

The Biopsychosocial Model

Based on a biopsychosocial model of care the patient-

centered approach has been shown to be the most

effective and cost-effective way to address pain

~ Institute of Medicine 2011 report ldquoRelieving Pain in America A Blueprint for Transforming Prevention Care Education and

Researchrdquo

WHO (2001) and IOM support (2011)

WHO ICF Model

WHO ICF 2002 International Classification of Functioning Disease and Health Geneva Switzerland

Biopsychosocial Model(not just biomedical)

EastWest Model for

Systemic Health

1 Mindful Eating -

Adoption of a holistic bio-

psycho-socio-spiritual

model when dealing with

FGID patients (Chen et al 2010)

2 Mindful Movement ndashMedical therapeutic yoga

Systems-Based

Team Approach

Healthy Systemic Function including

bull Epigenetic regulation

bull Immunity amp Longevity via Telomere Preservation

bull HPA Axis Regulation and Allostasis

bull High bone mineral density and low pro-inflammatory activity

bull High parasympathetic input

Garner G Medical Therapeutic Yoga prospectus for publication Handspring Pub Ltd Scotland UK

Yogic MedicineMedical Therapeutic Yoga is

BPS Model

BPS Self-Management Strategies

Change Stress

Response

Experiential

learning amp

practice

Intuitive

Bio-energetic

methodsOR

Integrated Rehab

The MTY Model allows for ampor establishes

bull Inter-rater and intra-rater reliability through standardization of biomechanical alignment of posturesbreath

bull Rationale for documented approach

bull Improving patient outcomes and consumer safety

bull Culturally relevant context for postures

bull Educational competencies for yoga used as therapy or medicine

bull Lesson plans for wellness (prevention) programs and pathophysiology

bull Therapists to supervise and design medical therapeutic yoga programs for integrative medicine facilities

bull Stabilization (and safety) rather than mobilization (proximal to distal) ie Spine then extremities Shoulder then elbow

PYTI graduate international lecturer and Canadian physio Shelly Prosko PT PYT

Anterior and Posterior Shoulder

Anterior right shoulder Posterior right shoulder

Clinical Scenario

ProblemYou have to inform your patient that she cannot return to recreational activities and sports until she has reached certain levels of objective functioning in therapy due to her shoulder conditionhellip

Think about how you will answer her questions

Is this very common

In order to answer her question you must know

bull 36 of documented RT (resistance training)-related injuries and disorders occur at the shoulder complex (Kolber et al 2010)

bull 3rd most common MS complaint in general population (Croft 1993 Glocker 1995 Hudson 2010)

bull Peak incidence between ages 40-60 (Isabel et al 2011 Kolber et al 2010 Krogsgaard

et al 2009 Lamberts et al 1991)

bull Shoulder pain is second only to knee pain for referrals to orthopedic surgery or primary care sports medicine clinics(Lucado et al 2010 Lucas 2007)

Is this serious

bull In order to answer her question you must know

bull If left untreated shoulder pain could result in

bull RTC Tendonitis or bursitis

bull Impingement

bull Strain or sprain

bull AC joint separation

bull Anterior instability or capsular laxity

bull SLAP (superior labral ant-post) lesions

bull Posterior shoulder instability

How can you be sure what the

problem is with my shoulder

Patients with chronic or acute shoulder pain might experience the following symptoms

bull Audible pop or feeling of internal popping

bull Feeling of instability

bull Pain (during the day and at night)

bull Swellinghemarthrosis or bleeding in the joint

bull Limited ROM and restricted ability to complete ADLrsquos

bull Pain before during andor after activity

Pain Mapping

Bayam L Ahmad MA Naqui SZ Chouhan A Funk L Pain mapping for

common shoulder disorders Am J Orthop (Belle Mead NJ)

How did this happenThe Mayo Clinic cites that factors

contributing to shoulder pain might include

bull Age - gt40

bull Engaging in athletic activities that

involve repetitive arm use

bull Working in the construction or other

similar trades that involve repetitive arm use

bull Having poor posture

bull Having weak shoulder muscles

Despite identifiable high risk populations shoulder pain is considerably preventable Shoulder pain

causes fall into 3 movement categories

1 Repetitive Stress Syndrome

2 Poor ergonomic set up

3 Poor technique in sport

including yoga execution

The highest prevalence of shoulder

injuries is found in

bull 1st - Water hockey (swimming

+ overhead throwing)

baseball tennis swimming

bull 2nd ndash Volleyball (overuse)

bull 3rd ndash Ice hockey (acute)

American football wrestling

Krogsgaard MR Safran MR Rheinlaedner P and Cheung E Ch 9 Preventing

Shoulder Injuries Bahr R and Engebretson ed Sports Injury Prevention

Blackwell Publishing International Olympic Committee 2009

What would happen if I continue

the same activitiesIn order to answer her question you must know that continued use of her shoulder could also result in

bull Articular cartilage damage

bull Labral lesion (SLAP tear)

bull Ligament damage

bull AC joint injury

bull Subluxation or joint instability

Scapular Dyskinesis

bull ldquoDysrdquo ndash alteration of

bull ldquoKinesisrdquo ndash motion

bull Changes in GH angulation

bull AC joint strain

bull Subacromial space

dimension

bull Shoulder muscle activation

bull Humeral position and motion

Conclusions

bull Dyskinesis OFTEN implicated in shoulder injuries

bull Impingement often implicated

bull Tx more effective by addressing dyskinesis

bull Reliable observational clinical method is needed

bull Restoration of scapular position and motion required

Kibler WB Ludewig PM McClure PW Michener LA Bak K Sciascia AD Clinical implications of scapular dyskinesis in shoulder injury The

2013 consensus statement from the scapular summit Br J Sports Med 201347(14)877-885 doi 101136bjsports-2013-092425 101136bjsports-2013-092425

SD Etiology amp Testing

1 GH Joint Angulation

2 GH Joint Integrity

3 Neurological Causes

4 Soft Tissue Mechanisms

bull GIRD ndash short post capsule

bull Short pec minor and biceps short head

5 Periscapular Muscle Activation and Force Coupling

bull Dynamic Scapular Dyskinesis Tests

bull SAT

bull SRT

bull Cadaver Models -

2013 consensus statement from the scapular summit Br J Sports Med 201347(14)877-885 doi 101136bjsports-2013-092425

101136bjsports-2013-092425

SD Classification

bull Upward rotation is primary

and posterior tilt secondary

during normal overhead UE

elevation with

internalexternal rotation

being minimal until 100deg (2009)

bull Kibler classification (2002)

bull Type I - inferior

bull Type II ndash medial

bull Type III - superior

Ludewig PM et al Motion of the shoulder complex during multiplaner humeral elevation J Bone Joint Surg

Am200991378-389

Kibler WB et alQualitative clinical evaluation of scapular dysfunction a reliability study J Shoulder Elbow

Surg200211550-556

bull httpswwwyoutubecomwatchv=XXiskkfNaHQ

bull Seitz et al 2012

bull 42 subjects (21 SAIS 21 control)

bull Effect of SAT on shoulder kinematics and subacromial

space measures in patients with SAIS

Seitz AL McClure PW Lynch SS Ketchum JM Michener LA Effects of scapular dyskinesis and scapular assistance test on subacromial space during

static arm elevation Journal of Shoulder and Elbow Surgery 201221(5)631-640 doi httpdxdoiorglibproxylibuncedu101016jjse201101008

bull Baseline AROM and pain is evaluated

bull ldquo+rdquo Test ndash pain reduction with therapist assist for active elevation by applying a posterior tilt and external rotation motion to the scapula

bull May be used in conjunction with other tests such as Neers Hawkins-Kennedy and Jobes relocation

bull Tate et al 2008

bull 142 college students

bull 98 ldquo+rdquo impingementbull 46 ndash reduced pain with SRT

bull All experienced increase in strength but only clinically sig in frac14 of athletes

Tate AR et al Effect of the scapular repositioning test on shoulder impingement symptoms and elevation

strength in overhead athletesJOSPT2008384-11

Glenohumeral Force Couple

Deltoid amp RTC

Escamilla RF Yamashiro K Paulos L Andrews JR Shoulder muscle activity and function in common shoulder rehabilitation exercises

Sports Med 200939(8)663-685

(graphic) Parsons IM Apreleva M Fu FH Woo SL The effect of rotator cuff tears on reaction forces at the glenohumeral joint J Orthop Res

2002 May20(3)439-46

bull 35-65 - MD

bull 30 - SSbull 25 - SSp

bull 10 - IS

bull 2 - AD

Teres Minor amp Infraspinatus

Posterior Cuff

Escamilla RF Yamashiro K Paulos L Andrews JR Shoulder muscle activity

and function in common shoulder rehabilitation exercises Sports Med 200939(8)663-685

Serratus Anterior amp Trapezii

bull SA + Pec Minor (protract)

scapula

bull SA + LTUT (upwardly rotate)

scapula

bull SA rules

bull Contributes to all 3-D

components of scapular

movement during humeral

elevation

bull Stabilizes medial border and

inferior angle of scapula

Kibler WB Ludewig PM McClure PW Michener LA Bak K Sciascia AD Clinical implications of scapular dyskinesis in shoulder

injury The 2013 consensus statement from the scapular summit Br J Sports Med 201347(14)877-885

Scapulothoracic Force Couples

W Ben Kibler and John McMullen Scapular Dyskinesis and Its Relation to Shoulder Pain J Am AcadOrthop Surg MarchApril 2003 11142-151

Pathophysiology of RTC Syndrome

Impingement

To Be or Not To Be

ldquoonly states that you have ruled out cervical referred pain

adhesive capsulitis GH instability for examplehelliprdquo Kibler et al 2013

Empty Can or Full Can

Empty Can

1 Reduced subacromial width

2 Abd + extreme IR = abduction moment at SSp at 0 to 90 deg Abd

3 Increased tensile force of SSp

4 Delayed healing of SSp tendon

5 Nonoptimal scapular mechanics

1 Posteroinferior capsule tension

2 Diminished IR and ER strength by 13-34 and 20 repsectively

Full Can

1 Enhanced SSp force

production - better scapular

kinematics

2 Equally accurate to empty

can in identifying SSp tears

3 Less pain provocation

4 Most optimal SSp isolation

Integrated Injury Prevention

Matrix

The science of yoga in a holistic biopsychosocial model

bull Identify postural anomalies

bull Consider Regional Interdependence

Krogsgaard MR Safran MR Rheinlaedner P and Cheung E Ch 9 Preventing Shoulder Injuries Bahr R and Engebretson

ed Sports Injury Prevention Blackwell Publishing International Olympic Committee 2009 Garner 2015

WHO ICF Model

Case Study Application

Post-partum routine was walking and pt

was familiar with yoga already from prenatal required ADLrsquos ie lifting infant

32 yo femaleL shldImpression Stage III RTC tearexternal

impingement

Left shoulder pain night pain unable to care for

infant or complete ADLrsquos

Some history of prenatal

yoga participation BMI 19 motivated proactive no

good family support system

no other children in home flexible work situation but self-employed and injury

prevents working

ldquo+rdquo Impingement (Hawkins Neer) empty can MMT 2+-

3+5 and painful ROM NT 2nd pain Mild scapular dyskinesis global UE weakness

BPS Model in Action

Physical

bull Posture Prescription

bull Prevention of (re)injury

Energetic

bull Breathing for awareness and healing

as well as posture maintenance and

self correction

bull ADL Completion using good postural

alignment and core initiation

bull Pain management and healing

Psycho-emotional

bull Healing Meditation with breath practice

bull Comfort measures (sleep positioning)

Intellectual

bull Patient education

bull Movement modification

bull Social support for stress management

bull Identification of root causes of injury

Plan Program designed as adjunct to patientrsquos regular post-partum fitness routine

Duration 6 weeks x 15-30 minutes daily HEP Fu at 3 months

Contraindications

If a patient is unable to perform pre-asanapostures with safety and self-correction because of the following

bull Lack of motor control and awareness

bull Performing asana quickly and without proper biomechanical alignment

bull Not introducing low level force loads for dynamic stability in the shoulder joint during asana

bull Returning to activity before adequate healing and strengthening

AVOID Yoga postures that include but are not limited to

bull Cow arms

bull Eagle arms

bull Inversions such as

bull 4 point weight bearing such as in handsknees posture or downward facing dog without specific biomechanical modification

bull Dolphin dive

bull WB headstand

bull Shoulder stand

Activation Sequencing Treating Scapular Dyskinesis amp Impingement

ldquoSyndromerdquo bull Downtrain UT (watch for lsquoshruggingrsquo during

shoulder elevation)

bull Balance UT and LT force couple ndash correct latent

firing of LT

bull Correct decreased SA activation

bull Shortened pectoralis minor (creates excessive

posterior protraction at rest and limits scapular posterior tilt or external rotation with arm motion)

Kibler WB Ludewig PM McClure PW Michener LA Bak K Sciascia AD Clinical implications of scapular dyskinesis in shoulder injury The 2013 consensus statement from the scapular summit Br J Sports Med

201347(14)877-885

Regional Interdependence

bull Cervical spine core work and related synergists (Isabel de-la-Llave-

Rincoacuten et al 2011)

bull Thoracic mobility (Sueki et al 2011)

bull Elbow and wrist function (Lucado et al 2010)

bull Latent trigger points in scapular positioning and muscle activation patterns

(Lucas 2007)

bull Impaired balance scores (SLBT) and core stability (DLL) in athletes with

shoulder pain (Radwan et al 2014)

Lucado Ann1 Kolber Morey2 Cheng M Samuel2Echternach John3 Subacromial impingement syndrome and lateral epicondylalgia in tennis players Physical Therapy Reviews

Volume 15 Number 2 April 2010 pp 55-61(7) Lucas K 2007 Effects of latent myofascial trigger points on muscle activation patterns during scapular plane elevation PhD Thesis School of Health Sciences RMIT UniversitySueki Derrick G Chaconas Eric J The effect of thoracic manipulation on shoulder pain a regional interdependence model Physical Therapy Reviews Volume 16 Number 5 October 2011 pp 399-408(10)Isabel de-la-Llave-Rincoacuten Ana Puentedura Emilio J Fernaacutendez-de-las-Pentildeas Ceacutesar Clinical presentation and manual therapy for upper quadrant musculoskeletal conditions Journal of Manual amp Manipulative Therapy Volume 19 Number 4 2011 pp 201-211(11)Radwan A Francis J Green A et al Is there a relation between shoulder dysfunction and core instability Int J Sports Phys Ther 20149(1)8-13

Acute Program A graduated approach for Deep Abdominal Breathing Shoulder Lock TATD Breath (0-6 weeks)

Yoga Couch (Three tier Approach)

bull Flexibility of pectoralischest

bull Restorative for joint mobility and positioning for jt Mobs

bull Arthrokinematics Grade I-II jt Jobs for pain relief and gentle capsular mobility PRN (after acute phase)

Easy Seated Pose

bull Dynamic Neuromuscular Re-education Spinal Neutral

bull Seated Meditation Centering Stress management Pain management

Sleep PositioningEducation

Pectoralis FlexibilityJt MobilityPostural Re-educationStress amp Pain Management

Energetic + Physical Stability TATD Breath

There are distinct biomechanical and physiological benefits to using the

TATD breath including increase of safety in using yoga as medicine

1 Anatomical Principle

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

(Renovato et al 2010 Hides et al 2011 Fraca et al 2012 Willson et al 2005 Richardson et al 1999 Hides et al 2006 Hodgest and Richardson

1997 Cholewicki amp McGill 1996 Cholewicki amp Panjabi 1997 Cresswell and Thostensson 1994 Lee 2001 Hodgest and Gandevia 2000 Hodges et

al 2003 McCandless 1975 Morris et al 1961 Critchley 2002 Lee 2005 Sapsford 2001)

NM Re-edScapular Kinematics

bull Arm Floats Progression from AAROM with bamboo cane to AROM

bull Core and trunk Control

bull Neuromuscular re-ed Proprioception

bull Regional Interdependence model

bull TATD breath

bull SH and LP awareness

bull Rib controlobliques amp serratusanterior

bull Started with 45-60 degrees flexion and progressed to 180 deg Flexion by end of 6 weeks

Childrsquos Pose to Upstretched Mountain

Subtle Body

bull Restorative Biofeedback Proprioceptive and neuromuscular

re-education Myofascial release

Gross Body

bull LT isolation UT inhibition

Postural alignment

Positioning for posterior jt mobs PRN

Sun Salutes with AAROM assist with right hand Performed at wall andor with wall assist PRN

Postural EducationAdditional Biofeedback

Above 90 MVIC EMG amplitude UT MT and LT

Above 80 Supraspinatus Posterior Deltoid Middle Deltoid (Above 40 IS Tminor)

Correct form - Childrsquos Pose Reach Roll and

RiseIncorrect form

Extrapolated from Kibler et al 2013

RTC Periscapular Synergy

Acute to subacute progression(s)

1 Arm Spiral ndash TATD Breath myofascial release of upper quarter and chest

median n mob downtrain UT engage LT SA

2 Plank with push up plus ndash TATD breath postural alignment spinal neutral

under loading plus upper and lower subscapularis SSp IS pectoralis major

teres major LD

3 Press upScales ndash UT MT LT LS Rhomboids SA Pminor P major (84 +-

42) LD (55 +-27)

Kibler 2013 Kibler 2003 Garner 2015Modified arm spiral

Activating the Posterior Cuff

IS and TMinorIn order of activation

1 Weight Shift in Four-Point Position (GRF on hand = 32 BW)

2 Plank with Chatarangawithout (34BW) with feet elevated (39BW)

3 Side Plank (1-armed push up) (60BW)

Questions

bull DDP (right)

bull Yogic mindful activation for neural patterning

Escamilla RF Yamashiro K Paulos L Andrews JR Shoulder muscle activity and function in common shoulder rehabilitation exercises Sports Med 200939(8)663-685

Garner 2015

Downward Dog Preparation

UE Synergy + Core Biofeedback

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kibler 2013 Garner 2015

PMinor (flx) UT LT SA

Activation Sub-Acute Modifications

Top left to right Upward facing bow Cow Arms (scaption in full can and subscap Strength IR flexibility UT LT SA activation)

Bottom left to right Fish over bolster (pminor flx) Boat (LP control)

Seated Twist (myofascial release)

Sub-Acute Progression - Top left to right Downward Facing Dog with strap

Strap-Assisted Plank Bottom left to right Dolphin Dive

Advanced Sub-Acute Progression

for UE Synergy amp Scapular

Kinematics

Advanced Final Progression

Left top to bottom Strap assisted dolphin NWB headstand prepMiddle Wall assisted NWB Headstand

Right left to right NWB Headstand Forearm balance

Review

Neuromuscular Retraining amp Strength

bull Control and position during sport exercise and ADL function

bull Pre-position the body and upper extremity prior to initial ground contact

bull Stability amp integrity

bull Glenohumeral Lumbopelvic

bull RTC Scapular dyskinesis andor loss of coracoacromial arch space

Proprioceptive and Biofeedback Activities

bull Proprioceptive activities combined with decision-making

bull Balance agonistantagonist

bull Train joint mechanoreceptors

bull Upper extremity kinetic chain work employing joint stabilization requisites (in Modules 1-7PYT Volume 1 text)

Flexibility - Posterior capsule Latissimus dorsi Pectoralis major amp minor Myofascial amp neurovascular mobility and response (Lucas 2007)

Program Impact

Pre-Test Results

bull Pre-test AROM ndash abduction to 45 deg without pain

bull PAS 710 with attempted activity

bull Special Tests

bull Positive Hawkinrsquos impingement

bull Positive Empty Can

bull MMT ndash 2+5 (flexion abd

Post-Test Results

bull Post-test AROM ndash full pain-free abduction

bull PAS 010 with full activity

bull Special Tests ndash negative

painfree

bull MMT ndash 55 painfree

bull Able to return to full ADLrsquos and activity without pain

Resources

bull Quick Dash Outcome Measure httpdashiwhoncasystemfilesquickdash_questionnaire_2010pdf

bull Nutrition amp Orthopaedicscourse httpswwwalliedhealthedcomblogcourse2100

bull Yoga Couch TATD Breath Abdominal Breath Sleeping Positions ndashwwwmedicaltherapeuticyogacom

bull Beth Israel Deaconess Medical Center ScapaularDyskinesis Guidelines httpwwwbidmcorgCentersandDepartmentsDepartmentsOrthopaedicSurgeryServicesandProgramsSportsMedicineForPatients~mediaFilesCentersandDepartmentsOrthopaedicSports20MedicineRehab20ProtocolsScapular20Dyskinesisashx

Selected Sources (1)

bull Kolber MJ Beekhuizen KS Cheng MS Hellman MA Shoulder injuries attributed to resistance training a brief review J Strength Cond Res2010 Jun24(6)1696-704

bull Croft P Soft-tissue rheumatism In Sillman AJ Hochberg MC Eds Epidemiology of the Rheumatic Disease Oxford England Oxford University Press 1993375ndash421

bull Glockner SM Shoulder pain a diagnostic dilemma Am FamPhysician 1995511677-87ndash1690-2

bull Hudson VJ PhD DPT MBA ATC Evaluation Diagnosis and Treatment of Shoulder Injuries in Athletes Clinics in Sports Medicine Volume 29 Issue 1 Pages 19-32 January 2010

bull Isabel de-la-Llave-Rincoacuten Ana Puentedura Emilio J Fernaacutendez-de-las-Pentildeas Ceacutesar Clinical presentation and manual therapy for upper quadrant musculoskeletal conditions Journal of Manual amp Manipulative Therapy Volume 19 Number 4 2011 pp 201-211(11)

Sources (2)

bull Kolber MJ Beekhuizen KS Cheng MS Hellman MA Shoulder injuries attributed

to resistance training a brief review J Strength Cond Res 2010 Jun24(6)1696-

bull Krogsgaard MR Safran MR Rheinlaedner P and Cheung E Ch 9 Preventing

bull Lamberts H Brouwer HJ Mohrs J Reason for Encounter- Episode-and Process-

Oriented Standard Output From Transition Project Part I Amsterdam Department of

General PracticeFamily Medicine University of Amsterdam 1991

bull Lucado Ann1 Kolber Morey2 Cheng M Samuel2 Echternach John3 Subacromial

impingement syndrome and lateral epicondylalgia in tennis players Physical Therapy

Reviews Volume 15 Number 2 April 2010 pp 55-61(7)

bull Lucas K 2007 Effects of latent myofascial trigger points on muscle activation

patterns during scapular plane elevation PhD Thesis School of Health Sciences

RMIT University

Sources (3)

bull Bayam L Ahmad MA Naqui SZ Chouhan A Funk L Pain mapping for common shoulder disorders Am J Orthop (Belle Mead NJ) 201140(7)353-358

bull Krogsgaard MR Safran MR Rheinlaedner P and Cheung E Ch 9 Preventing Shoulder Injuries Bahr R and Engebretson ed Sports Injury Prevention Blackwell Publishing International Olympic Committee 2009

bull Kibler WB Ludewig PM McClure PW Michener LA Bak K Sciascia AD Clinical implications of scapular dyskinesis in shoulder injury The 2013 consensus statement from the scapular summit Br J Sports Med 201347(14)877-885 doi 101136bjsports-2013-092425 101136bjsports-2013-092425

bull WHO ICF 2002 International Classification of Functioning Disease and Health Geneva Switzerland

Sources (4)

bull Garner G Medical Therapeutic Yoga prospectus for publication Handspring Pub Ltd Scotland UK 2015

bull Escamilla RF Yamashiro K Paulos L Andrews JR Shoulder muscle activity and function in common shoulder rehabilitation exercises Sports Med 200939(8)663-685

bull Parsons IM Apreleva M Fu FH Woo SL The effect of rotator cuff tears on reaction forces at the glenohumeraljoint J Orthop Res 2002 May20(3)439-46

bull Tate AR et al Effect of the scapular repositioning test on shoulder impingement symptoms and elevation strength in overhead athletesJOSPT2008384-11

Sources (5)

bull Seitz AL McClure PW Lynch SS Ketchum JM Michener LA Effects of scapular dyskinesis and scapular assistance test on subacromial space during static arm elevation Journal of Shoulder and Elbow Surgery 201221(5)631-640

bull Ludewig PM et al Motion of the shoulder complex during multiplaner humeral elevation J Bone Joint Surg Am200991378-389

bull Kibler WB et alQualitative clinical evaluation of scapular dysfunction a reliability study J Shoulder Elbow Surg200211550-556

bull W Ben Kibler and John McMullen Scapular Dyskinesis and Its Relation to Shoulder PainJ Am Acad Orthop Surg MarchApril 2003 11142-151

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

bull Spinal Kinematics

bull Integrated PT Application via

bull Guidelines Indications

Contraindications

Objectives

bull Describe how the simultaneous application of yoga Ayurveda and spinal kinematics can influence and improve overall systemic health and wellbeing

bull Identify the ways spinal osteokinematics and arthrokinematics can operationalize the biopsychosocial model of assessment

bull Analyze 12 yogic postures and their symbiotic effect on spinal functional mobility GI motility and overall health

ProblemAn individual with back pain comes

to you after having been to a

physician to rule out structural and

systemic issues and to a physical

therapist for conventional low back

pain rehabilitation Her pain persists and she wants to know if alternative

methods of rehabilitation (ie yoga)

may work

bull Think about how you will answer her questions

bull 80 of Americans experience back pain

bull Back pain is the most common

bull neurological ailment after headache in the US

bull cause of job-related disability and lost days from work

bull in the third decade of life

After ruling out systemic and structural GI issues one must also consider GI triggers

bull Gastrointestinal dysfunction is one of the most common hospital admissions in the United States today (AHRQ 2006)

bull The Cleveland Clinic cites lack of exercise as a shared risk factor in both functional GI disorders (constipation IBS) and back pain

NIH 2003 Hoy et al 2010 Rahman et al 2010 Hoy et al 2010 (3)

Is this very common

Is this serious

bullIn order to answer her questions you must consider

bull Musculoskeletal systembull Degenerative Disease

bull RheumatologicalDisease States

bull Skeletal anomalies

bull Organicsystemicbull Metabolic Bone Disease

bull Gastrointestinal

bull Reproductive

bull Vascular (aortic aneurysm)

bull Oncological

2008 Consumer Guidelines for Low Back Pain published by The American Chronic Pain Association

How did this happen

The Mayo Clinic cites

the following risk factors for low back

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

How can you be sure the two

problems are related In order to answer her question you must know The most common GI functional disorders carry similar risk factors

bull Poor nutrition

bull Being overweight or obese

bull Being sedentary

Patients with persistent back and abdominal pain that have been differentially diagnosed may feel

bull Patterns of pain related to eating and digestion or specific movements or exercise

bull Concurrent lower abdominalback pain

bull Stiffness or loss of ROM amp flexibility

bull Inability to complete ADLrsquos

Anatomy amp Physiology

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Figure 511 amp 12 Axial Skeleton

Spinal Biomechanics

Arthrokinematics amp Osteokinematics

Arthrokinematics determine osteokinematics

ldquoThree joint complexrdquobull Smooth cartilage

surfaces

bull Flexible ligament capsule

bull Synovial jointfluid

Clinical Biomechanics

bull Facet joint orientation

bull Torsional stiffness

ldquoKnowledge of 3 dimensional spine coupling characteristics is important for treating patients with

spinal painrdquo ~Sizer et al 2007

Kapandji 2008 Sizer et al 2007 White amp Panjabi 1990 Image Donatelli and Thurner 2014

Coupled vs Uncoupled Movement amp Definition of ldquoNeutral Spinerdquo

bullAn uncoupled movement is defined as a motion that occurs in absence of another osteokinematicrange of motion and can occur independently (Norkin and Levangie 1992)

bullRotation and side bending however occur in conjunction as coupled movements For example if side bending occurs to the right the spinousprocesses will rotate to the left

bull There are ligamentous and bony checks to flexion side bending and rotation while extension is limited mostly by the spinousprocesses themselves

bull It is important to note that osteokinematic and arthrokinematic motion can be functionally limited by musculoskeletal dysfunction or poor postural habits Coupled motions can also widely vary dependent on age and posture (Edmonston et al 2005)

Fryettersquos ldquoLawsrdquo of Physiologic Motion

bull Lovett ndash 1905

bull Fryette ndash 1957

bull Basic principles (at left)

bull Evolving principles (slides

which follow)

bull Yogic context

Somatic Dysfunction

Accordionpranayama fold

Recalibrating

Fryettersquos ldquoLawsrdquo ndash Type I

Table 52 Lateral variation of wide angle forward seated bend or upavista konasana (Left to righttop to bottom progression)

Recalibrating

Fryettersquos ldquoLawsrdquo ndash Type II

Table 53 Revolved

head to knee or parivritta janusirsasana

Cranium amp Cervical Spine Kinematics

CraniumC1

bull Plane joint 10 deg flexion 20 deg extension 15 deg SB

C1C2 ndash Atlasaxis

bull Pivot joint No disc 30-45 deg or 50 rot Combined skullC1 and C1C2 motion closer to 36 deg

C2-C7 - Remaining 15-30 degrees of rotation

bull Type II movement

Cook et al 2006

CraniumC-spine Application

Cranium-C1 Movement

bull Mild chin lock or Mild jalandharabandha

bull Slippage of head on atlas

C2-C7 Rotation

bull Cam action of first 30-45 degrees of rotation at C1-C2

bull Rotation becomes more limited with increasing head rotation which further supports cervical rotation as a nonlinear motion

Thoracic Spine Kinematics

Thoracic Spine Movements

bull Flexion and Extension

bull T1-T6 ndash limited flexionextension

bull T9-T12 ndash most available

bull Rotation and Side Bending

bull 75 sidebending

bull Upper T spine - rotation easiest

bull Lower T spine ndash less available

bull Rotation limited by rib cage age pliability

bull Force couples conflict in literature

Sizer et al

Yoga example ndash Threading the needle

(unloaded)

Thoracic Spine Coupling

SB as primary motion = SB + Rot

bull T1-T4 - 21 ratio

bull T4-T8 11

bull T8-T12 ndash 31bull Ipsilateral SB + Rot (Type II motion)

bull 47 of subjects at T1-T4

bull 83 of subjects at segments T4-T8

bull Remaining subjects experienced Type I motion (contralateral rotation) with SB

Rot as primary motion = SB + Rot

bull T1-T4 ndash 18

bull T4-T8 ndash 99

bull T8-T12 ndash 93

bull Ipsilateral SB + Rot (Type II motion)

bull Remaining subjects experienced Type I motionSizer et al 2007 Willems et al 1996 Theodoridis and Ruson 2002

Revolved Triangle Entry

Theodoridis amp Ruston

bull Initiation of thoracic coupling via UE

elevation in 25 female subjects

bull 92 ipsilateral thoracic SB + rot in

UE flexion

bull 8 contralateral

bull 76 ipsilateral coupling in scaption

bull 24 contralateral coupling

D Theodoridis S Ruston The effect of shoulder movements on thoracic spine 3D motion Clin Biomech(Bristol Avon) 17 (2002) pp 418ndash421

Revolved Triangle Final (parivritta trkonasana)

Lumbar Spine Movements

bull Vertebrae large facets suggest stability over mobility

bull Rotation - 13 contribution

bull Side bending L1-S2 about 27 degrees

bull Flexion or reversal or lordosisExtension ndash L4-S1

bull Importance of normative values of L spine motion in question

bull AMA hierarchy

bull Anthropology of lumbar motion differs between races

bull ldquoDifferent criteria should be usedhelliplumbar spine mobility forhellipgroupsrdquo (2010)

Modified sage pose or maricyasana A

Lumbar Spine Kinematics

Hands to big toe or padangusthasana

Trudelle-Jackson et al 2010 Intolo et al 2009 Chung and Wang 2009 Van Herp

et al 2001 McGregor et al 1995 Dvorak et al 1995 Sullivan et al 1994

bull Lumbosacral Junction

bull Reciprocal movement ndash L5 flexes and S1 extends L5 rotates right and S1 rotates left L5 side

bends right and S1 will side bend

bull Sacroiliac joint 3 planar motion Type II movement which can occur unilaterally or bilaterally

bull Flexion and extension of sacrum

bull Right or left rotation of sacrum

bull Right or left sidebending of sacrum

bull Torsion a combination of the three Bow and arrow pose or akarnadhanurasana

Kinematics ndash Sacroiliac Joint

Extended side angle or uttitaparsvokonasana

Fryettersquos Laws ndash Type III

Table 54 Revolved forward seated bend or

parivritta paschimottanasana

Intervention amp PrescriptionEvolving Yoga

Three Pronged Theory based on currentbiomechanical ldquoabsolutesrdquo and theory recognized in medicine

1 Yoga postures for mobilization of the spine are not universally applicable

2 Yoga posture prescription for spinal mobility must consider not just medical condition and age but race and gender

3 Yoga postures for the spine especially those using the higher risk movements of flexion and rotation should be prescribed and not taught as a general modality for all populations

bullNote that yoga postures are the primary physical context of yoga but do not represent a complete MTYPYT prescription based on the conceptual model

Modified Noose

(Pasasana)

Fig 2 The six subsystems of movement

Hoffman J Gabel P Expanding Panjabirsquos stability model to express movement A theoretical model Medical Hypotheses Volume 80 Issue 6

2013 692 - 697

httpdxdoiorg101016jmehy201302006

Prior to Medical Therapeutic

Yoga Posture Prescription 1 Identify bony landmark idiosyncrasies

(static or dynamic) in spine2 Teach TATD breath first3 Consider myofascial or neurovascular

involvement

Safe Prescription of Postures

depends on bull Employing TATD breath during all non-

restorative postures especially during transitions

bull Application of spinal mechanical theory bull Introducing planar movements one

degree of freedom at a timebull Follow the primary FMA bull Emphasize slow performance speed

General Indications

Indications Compression amp

Torque Consider compression amp torque in posture prescription

Compression

bull Hemodynamic perfusion of abdominal organs via manual massage and mobilization

bull Gravity dependent postures and spinal flexion

bull Abdominal massage action increases GI motility reduces GI related pain amp decreases overall GI related symptoms (Sinclair 2010 Lamas et al 2009 Ernst 1999)

Torque

bull Applied force and a distance between the applied force and its axis of rotation

bull Spinal rotation

bull Caution when combining with axial compression flexion and rotation (Shirazi1989)

Modified noose pose or pasasana

Safety can be provided through the PYT precepts (Module 1)

bull Breath before pose (3)

bull Abdominal breath before TATD breath

bull Then TATD breath for all poses except restorative (2)

bull Stability before mobility (4)

bull Lumbopelvic stability provides foundation for all other stability (7)

bull Spine receives priority over extremities (7)

bull No weight bearing inversions are taught or used in PYT (12)

bull No chin lock (jalandhara bandha) for populations with C1 or C2 instability or cervical fusion

bull No flexion + rotation for osteoporosis population

bull Flexion postures can be performed with rotation for compression but should be avoided in populations where flexion is contraindicated

bullPostures are practiced and applied for program planning in the shoulder and cervical spine lumbopelvic course and Module 14 on-site course

Cautions amp Contraindications

Selected Sources

bull Cook C Coupling behavior of the cervical spine A systematic review of the literature J Manipulative Physiol Ther 200629(7)570

bull Donatelli RA Thurner MS The young Athletersquos spinal mechanics In Spinal injuries and conditions in young athletes Springer 201417-25

bull Sizer PS Coupling behavior of the thoracic spine A systematic review of the literature J Manipulative Physiol Ther 200730(5)390 390-399 399

bull JM Willems G Jull J Ng An in-vivo study of the primary and coupled rotations of the thoracic spine Clin Biomech 11 (1996) pp 311ndash316

bull Hoffman J Gabel P Expanding Panjabirsquos stability model to express movement A theoretical model Medical Hypotheses Volume 80 Issue 6 2013 692 ndash 697

bull Garner G Medical Therapeutic Yoga 2015 (tent)Handspring Pub Ltd Scotland UK (PYT Volumes III 2001-2014)

Sources (2)

bull Hoy D Brooks P Blyth F Buchbinder R The Epidemiology of low back pain Best Pract Res Clin Rheumatol 2010 Dec24(6)769-81 Review PubMed PMID 21665125

bull Rahman Shiri Jaro Karppinen Paumlivi Leino-Arjas Svetlana Solovieva and Eira Viikari-Juntura The Association Between Obesity and Low Back Pain A Meta-Analysis Am J Epidemiol (2010) 171(2) 135-154 first published online December 11 2009 doi101093ajekwp356

bull Hoy DG Protani M De R Buchbinder R The epidemiology of neck pain Best Pract Res Clin Rheumatol 2010 Dec24(6)783-92

bull Adam Goode Eric J Hegedus Philip Sizer Jr Jean-Michel Brismee Alison Linberg and Chad E Cook Three-Dimensional Movements of the Sacroiliac Joint A Systematic Review of the Literature and Assessment of Clinical Utility J Man Manip Ther 2008 16(1) 25ndash38 PMCID PMC2565072 2008

Clinical Update on

Integrated Care

of the Elbow

Part 3

bull Lateral Epicondylitisndash Epidemiology amp Case Study Integrated Care

bull Yoga in America Trends and Cultures

bull Evaluating Existing Yoga Programs

bull PYTS Paradigm ndashShifting the Learning Experience

Objectives

bull Review the current evidence base and epidemiology concerning the most common elbow injuries

bull Identify elbow rehabilitation or injury prevention methods in integrated treatment of lateral epicondylitis

bull Describe safe application and appropriate use of integrated care for the elbow through understanding indications and contraindications

bull Analyze a case study format in evaluation and management of a common elbow diagnosis

bull Evaluate yoga programs for safety and efficacy

bull Describe how medical yoga can improve health care and its delivery in the US

Case Scenario

ProblemYou have to inform your patient a

construction worker that he will miss

a minimum of 2 weeks of work

because he has developedhelliphellip

Think about how you will answer his

questions

Is this very common

In order to answer his question you must know

bull Epicondylitis is a disorder of the arm that commonly affects working-age individuals in the general population

bull Occurrence not influenced by gender

bull Lateral epicondylitis is more prevalent than medial epicondylitis (ME)

Reported 5-10 times more common than ME

Annual incidence 1-3 of the population

Shiri et al 2006 Walz DM et al 2010 Calfee et al 2008 Mellor 2003 Bisset et al 2005 Johnson et al (AAFP presentation)

What is epicondylitis

epicondylitis is defined as Inflammation and subsequent

degeneration of the muscles on the medial or lateral condyle

of the humerus caused from repeated

bull Pronation

bull Supination

bull Gripping flexion medially or laterally in the forearm

How can you be sure the problem is in my elbow

bullPatients with epicondylitis might experience pain with the following actions

Wrist extension

Gripping

Gripping with supination (lateral)

Wrist flexion

Gripping and pronation (medial)

bullJohnson et al 2007 Walz et al 2010 Calfee et al 2008 Levin et al 2005 Jobe et al 1994

bullPatients with epicondylitis can present with the following signs and symptoms

Ho pain at elbow with recreationaloccupational activities that require repetitive action

Insidious onset

Pain reproduced with resisted supination andor wrist extension

Point tenderness over origin of common extensor tendons (LE)

How did this happen

In order to answer his question you must know risk factors for epicondylitis include

bull Smoking

bull Working age

bull Repetitive movements

bull Obesity

bull Forceful activities or heavy physical load

bull Fault mechanics or ergonomics

bull Other comorbiditiesShiri et al 2006 Hudak et al 1996

Despite identifiable high risk populations At issues

are considerably preventable Epicondylitis can fall into two broad categories

bull Intrinsic Risk Factors

bull Extrinsic Risk Factors

Activities related to injury include Construction

Autoworkers

Chefscooks

TeachingEducation Childcare

What would happen if I kept playing

that continued use of her elbowforearm could result in

bull Microtears leading to chronic epicondylitis

bull Tendinopathy from collagen degeneration

bull Angiofibroplastic proliferation

bull Full thickness tear requiring surgery

bullJohnson et al 2007 Hudak et al 1996

Anatomy Review

Injury Prevention

In order to prevent epicondylitis it is critical that you identify

Intrinsic Factorsbull Weakness in forearms

bull Musculoskeletal imbalance

bull Repetitive stress source

bull Lack of flexibility and ROM in forearm and related joints

bull Poor postural habits

bull Obesity

bull Smoking

bull Diabetes

Extrinsic Factorsbull Training or activity execution

errors ie overgripping

bull Environmental factors in sport and activity bull Ergonomic setup

bull Stressful work environment

bull Poor trainingbull Lack of cross training

bull Lack of rest

bull Faulty equipment

Medical Management

Johnson et al 2007 Burke 2010 httpwwwpri-medcomPMODigitalAssetsShared20FilesSyllabus20Files_Fall

202010AccessAtlantaSession205-Extremities-Access20Atlanta-ONLINEpdf

WHO ICF Model

45 yo active male right lateral epicondylitis no remarkable PMH

Does house projects such as building walls

hanging sheetrock and painting who co of forearm pain amp inability to complete ADLrsquos after a weekend of caring for

his 24 pound 7 month old

Insidious onset of lateral elbow pain that now prevents patient from

completing ADLrsquos

Reports almost constant discomfort

in right (dominant) elbow pain increases on holding and caring for infant especially

while multi-tasking ie holding infant and cooking dinner Patient is very active loves to hike

climb surf and rappel Conscious about diet eats mostly organic

Right lateral epicondyle tender to

palpation at insertion point of extensor muscle mass positive lateral epicondyle test

MMT 45 and painful reduced grip strength

Good support system low stress

able to commit to PT motivated and educated with high health literacy

Acute Management

bull Physical therapy supported to offer mid-to-long range

relief

bull Supervised programs superior to HEP

bull Medical management with corticosteroid injections show

no relief after 6 weeks

bull Mixed data on bracing

bull Short term relief

bull Possibly inferior to corticosteroids or NSAIDS

Barr et al 2009 Stasinopoulos et al 2009 Johnson et al 2010 Johnson et al 2007

Integrated MTY

Lateral Epicondylitis Algorithm

ldquoPre-posturesrdquo and postures to address strength and facilitate conscious relaxation and meditation include Top Prayer HandsShoulder Lock Left Middle Row Arm Spiral Downward facing dog prep Bottom Eagle Arms

(with flexed and extended elbows) Left bottom ndash incorrect form Right bottom ndash correct form

Shoulder LockDDPEagle Arms

Figure 8

1 5 clockwisecounterclockwise directions

2 Loose hold no gripping of finger

3 30 second hold (stretch)

bull Breath receives priority

bull Stability over mobility

bull Identification ofchange for faulty movement patterns

bull Contrast repetitive stress contributors with yoga program design

AcuteThree Tier ldquoYoga Couchrdquo amp Cow Arms

Arm Spiral

Subacute

Top Shoulder Opener and

eccentric wrist extflexion (weighted and nonweighted)

Left Inversions ndash Strap Assisted

Downward Facing Dog

Right ndash Inversions - NWB

Headstand

bullLeft Hand Balances

bull Use hand balances such as crane (at

right) scales or plank to reinforce new

motor patterns for preventing RSS

bull These should be added last when

there are no symptoms remaining

bullBottom Staff

bull With and without liftoff

bull good posture strength flexibility

Sub-Acute Progression

ldquoIn all postures teach progressive relaxation for

biofeedback for conscious

dissociation and releaserdquo

Chronic Considerations

bull Marma Point Massage

(kurpara) to the extensor or

flexor muscle mass

bull Followed by a directed stretch

to the area

bull Ice massage to minimize

localized inflammation

bull TFM MWM Protocol

Bisset L Beller E Jull G Brooks P Darnell R Vicenzino B Mobilisation with movement and exercise

Contraindications

A patient is unable to perform pre-

asanapostures with safety and self-correction because of the following

bull Performing asana quickly and without proper biomechanical

alignment

bull Not introducing low level force loads

for dynamic stability during asana

AVOID Yoga postures that cause co-contraction or gripping of the forearm musculature in the acute phase such as

bull Plank Side plank

bull Downward facing dog prep Downward facing dog

bull Bounding transitions from hands

bull Forearm balances Headstand (NWB)

bull Similar closed kinetic chain (WB) upper extremity postures

Program Impact

Post-Test Results (3 months fu)

bull Negative lateral epicondyle test

bull MMT 55 and painfree

bull No tenderness to palpation over extensor muscle mass

Yoga in America Trends and Culture

bull 16 million practitioners aged 35-54

bull 6 billion spent annually

bull 2008 - 494 reported that they started practicing yoga to improve their overall health

bull 2003 - 56

bull Almost 50 - reported yoga would be beneficial if they were undergoing treatment for a medical condition

Source 2008 Harris Interactive Service Bureau on behalf of Yoga Journal

Evaluating Existing YogaYoga

Therapy Programs

bull Yoga ndash YA wwwyaorgbull Voluntary Registry

bull Self-reportingOversightbull Registry Levels

bull Trade

bull IAYT ndash wwwiaytorgbull Self-proposed Educational Standards and Regulation 2012bull Proliferation of Programs 2006-2008

bull Trade to undergraduate

bull PYT ndash Medical Therapeutic Yoga wwwprofessionalyogatherapyorgbull Medical amp third party oversight legal scope of practicebull Pre-requisites

bull Consumer Risk and Safetybull Graduate post-graduate CECME

Medical Therapeutic Yoga

Model for Integrated Interdisciplinary Care

Interdisciplinary Support for

CAM can be used as a provision of OT services when it is used as ldquopreparatory method or purposeful activity to facilitate the ability of clients to engage in their daily life occupationsrdquo (AOTA 2011 p S27)

ldquoCAM may be used responsibly by OTrsquos as part of a comprehensive approach to enhance engagement in occupation by people organizations and populations to promote their health and participation in liferdquo (AOTA 2011 p S26)

ldquoCAM practices systems and products may be appropriately incorporated into OT practice to encourage a clientrsquos engagement in meaningful occupationsrdquo(AOTA 2011 S29)

Biggins K OTD PYT Capstone Using Yoga in OT 2013 AOTA CAM Position Paper 2011

Aspects of OT Domain

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Context and environment

Activity

demands

-ADLrsquos-IADLrsquos-Rest and sleep-Education-Work-Play-Leisure-Socialparticipation

-Values beliefs and spirituality-Body functions-Body structures

-Sensory perceptual skills-Motor and praxis skills-Emotionalregulation skills-Cognitive skills-Communication skills

-Habits-Routines-Roles-Rituals

-Cultural-Personal-Physical-Social-Temporal-Virtual

-Objects used and their properties-Space demands-Socialdemands-Sequencing and timing-Required actions-Required body functions-Required body structures

Biggins K OTD PYT Capstone Using Yoga in OT 2013 AOTA 2008 2nd ed OT Practice Framework

Intervention Approaches

Intervention approaches Examples of using yoga as intervention

Create promote (health promotion) Create and promote Transversus Abdominis Thoraco-diaphragmatic breathing (yoga breath) with goal of facilitating a clear mental state and core stabilization

Establish restore (remediation) Restore range of motion in shoulder after injury for effective overhead reach

Maintain Maintain core and trunk stability for postural alignment and ultimate upper body motion

Modify (compensation adaptation) Modify yoga practice through use of props to support performance

Prevent (disability prevention) Prevent stress and pain through incorporating meditative and mindfulness techniques

Purposeful Movement through Yoga

Exercise-Purposeful activity Continuum through Biomechanical Frame of

Reference incorporating yoga (adapted from Dutton 1989)

Movements more easily achieved through

exercise (preparation)

Yoga examples(preparation)

Movements more easily achieved through purposeful activity

Yoga examples(purposeful

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

Increase in range of

motion

Excessive resistance for strength

-Mountain pose with TATD breath

-Sun salutation

-Forward fold

-Warrior and reverse warrior

-High lunge for

hip flexors

-Down dog for shoulder complex

Coordinated movement

Arrhythmical movement

Diagonal movement

Asymmetrical movement

Maintenance of range of motion

Maximal repetitions for endurance

-Mudras

-Isolatedmovements of a posture

-Triangle

-Twist

-Cow face pose

-Vinyasa

Biggins K 2013 OT and Yoga AOTA 2008 2nd ed OT Practice Framework

Resources

wwwprofessionalyogatherapyorg

Spine Stabilization Foundations (distance learning)

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

bull Module 14 (spine GI) and 15 ndash (all physiological movements including inversions)

Related Spine Courses

bull Cervical Spine Course

bull Lumbopelvic Spine Course

bull Sacroiliac Joint Course

Sources

bull Shiri R Viikari-Juntura E Varonen H and Heliovaara M Pervalance and Determinants of Lateral and Mediail Epicondylitis A Population Study Am J Epidemiol (2006) 164 (11) 1065-1074

bull Walz DM Newman JS Konin GP Ross G Epicondylitis Pathogenesis imaging and treatment Radiographics 201030(1)167-184

bull Stasinopoulos D Stasinopoulos I Pantelis M Stasinopoulou K Comparison of effects of a home exercise programme and a supervised exercise programmefor the management of lateral elbow tendinopathy Br J Sports Med 201044579-583 Published Online First 3 November 2009

bull American Journal of Occupational Therapy (2011)Complementary and Alternative Medicine Supplement 65(6) S26-31

bull World Health Organization Towards a common language for functioning disability and health ICF the international classification of functioning Geneva World Health Organization2002

Sources (2)

bull American Occupational Therapy Association(2008) Occupational therapy practice framework Domain and process (2nd ed) American Journal of Occupational Therapy 62 625-683

bull Bisset L Paungmali A Vicenzino B Beller E A systematic review and meta-anaylsis of clinical trials on physical interventions for lateral epicondylalgia Br J Sports Med 200539411-42210

bull Bisset L Beller E Jull G Brooks P Darnell R Vicenzino B Mobilisationwith movement and exercise corticosteroid injection or wait and see for tennis elbow randomised trial BMJ 2006 333939

bull Barr S Cerisola FL and Blanchard V Effectiveness of corticosteroid injections compared with physiotherapeutic interventions for lateral epicondylitis A systematic review Physiotherapy Volume 95 Issue 4 December 2009 Pages 251-265

Sources (3)

bull Calfee RP Patel A DaSilva MF Akelman E Management of lateral epicondylitis Current concepts J Am Acad Orthop Surg 200816(1)19-29

bull Levin D Nazarian LN Miller TT et al Lateral epicondylitis of the elbow US findings Radiology 2005237(1)230-234

bull Biggins K OTD OTRL CHT PYT The use of yoga as a modality to treat varied diagnoses of the upper extremity An evidence-based educational workshop Rocky Mountain University of Health Professions 2013

bull Garner G Medical Therapeutic Yoga (PYT I-IV Manuals 2001-2014) Prospectus for publication 2025 UK

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Our Loss Whorsquos Gain

Changing the Conversation

ldquoI dont want to survive I want to liverdquo

ldquoI donrsquot want to survive I want to liverdquo~wall-e

Mind Over Matter

in All Health Outcomes

Researchrdquo

WHO ICF Model

EastWest Model for

Systemic Health

1 Mindful Eating -

Systems-Based

Team Approach

BPS Model

Change Stress

Response

Experiential

learning amp

practice

Intuitive

Bio-energetic

methodsOR

Integrated Rehab

Clinical Scenario

Is this very common

Is this serious

bull Impingement

Pain Mapping

bull Age - gt40

Scapular Dyskinesis

dimension

Conclusions

bull SAT

bull SRT

101136bjsports-2013-092425

SD Classification

elevation with

Am200991378-389

Surg200211550-556

Deltoid amp RTC

Sports Med 200939(8)663-685

2002 May20(3)439-46

bull 35-65 - MD

bull 10 - IS

bull 2 - AD

Posterior Cuff

scapula

bull SA rules

elevation

Impingement

To Be or Not To Be

Empty Can

Full Can

kinematics

Matrix

WHO ICF Model

impingement

prevents working

BPS Model in Action

Physical

Energetic

self correction

Psycho-emotional

Intellectual

Contraindications

bull Cow arms

bull Eagle arms

bull Dolphin dive

bull WB headstand

bull Shoulder stand

shoulder elevation)

firing of LT

201347(14)877-885

(Lucas 2007)

Easy Seated Pose

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

bull TATD breath

Subtle Body

Gross Body

Postural alignment

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Researchrdquo

WHO ICF Model

EastWest Model for

Systemic Health

1 Mindful Eating -

Systems-Based

Team Approach

BPS Model

Change Stress

Response

Experiential

learning amp

practice

Intuitive

Bio-energetic

methodsOR

Integrated Rehab

Clinical Scenario

Is this very common

Is this serious

bull Impingement

Pain Mapping

bull Age - gt40

Scapular Dyskinesis

dimension

Conclusions

bull SAT

bull SRT

101136bjsports-2013-092425

SD Classification

elevation with

Am200991378-389

Surg200211550-556

Deltoid amp RTC

Sports Med 200939(8)663-685

2002 May20(3)439-46

bull 35-65 - MD

bull 10 - IS

bull 2 - AD

Posterior Cuff

scapula

bull SA rules

elevation

Impingement

To Be or Not To Be

Empty Can

Full Can

kinematics

Matrix

WHO ICF Model

impingement

prevents working

BPS Model in Action

Physical

Energetic

self correction

Psycho-emotional

Intellectual

Contraindications

bull Cow arms

bull Eagle arms

bull Dolphin dive

bull WB headstand

bull Shoulder stand

shoulder elevation)

firing of LT

201347(14)877-885

(Lucas 2007)

Easy Seated Pose

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

bull TATD breath

Subtle Body

Gross Body

Postural alignment

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

BPS Model

Change Stress

Response

Experiential

learning amp

practice

Intuitive

Bio-energetic

methodsOR

Integrated Rehab

Clinical Scenario

Is this very common

Is this serious

bull Impingement

Pain Mapping

bull Age - gt40

Scapular Dyskinesis

dimension

Conclusions

bull SAT

bull SRT

101136bjsports-2013-092425

SD Classification

elevation with

Am200991378-389

Surg200211550-556

Deltoid amp RTC

Sports Med 200939(8)663-685

2002 May20(3)439-46

bull 35-65 - MD

bull 10 - IS

bull 2 - AD

Posterior Cuff

scapula

bull SA rules

elevation

Impingement

To Be or Not To Be

Empty Can

Full Can

kinematics

Matrix

WHO ICF Model

impingement

prevents working

BPS Model in Action

Physical

Energetic

self correction

Psycho-emotional

Intellectual

Contraindications

bull Cow arms

bull Eagle arms

bull Dolphin dive

bull WB headstand

bull Shoulder stand

shoulder elevation)

firing of LT

201347(14)877-885

(Lucas 2007)

Easy Seated Pose

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

bull TATD breath

Subtle Body

Gross Body

Postural alignment

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Change Stress

Response

Experiential

learning amp

practice

Intuitive

Bio-energetic

methodsOR

Integrated Rehab

Clinical Scenario

Is this very common

Is this serious

bull Impingement

Pain Mapping

bull Age - gt40

Scapular Dyskinesis

dimension

Conclusions

bull SAT

bull SRT

101136bjsports-2013-092425

SD Classification

elevation with

Am200991378-389

Surg200211550-556

Deltoid amp RTC

Sports Med 200939(8)663-685

2002 May20(3)439-46

bull 35-65 - MD

bull 10 - IS

bull 2 - AD

Posterior Cuff

scapula

bull SA rules

elevation

Impingement

To Be or Not To Be

Empty Can

Full Can

kinematics

Matrix

WHO ICF Model

impingement

prevents working

BPS Model in Action

Physical

Energetic

self correction

Psycho-emotional

Intellectual

Contraindications

bull Cow arms

bull Eagle arms

bull Dolphin dive

bull WB headstand

bull Shoulder stand

shoulder elevation)

firing of LT

201347(14)877-885

(Lucas 2007)

Easy Seated Pose

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

bull TATD breath

Subtle Body

Gross Body

Postural alignment

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Clinical Scenario

Is this very common

Is this serious

bull Impingement

Pain Mapping

bull Age - gt40

Scapular Dyskinesis

dimension

Conclusions

bull SAT

bull SRT

101136bjsports-2013-092425

SD Classification

elevation with

Am200991378-389

Surg200211550-556

Deltoid amp RTC

Sports Med 200939(8)663-685

2002 May20(3)439-46

bull 35-65 - MD

bull 10 - IS

bull 2 - AD

Posterior Cuff

scapula

bull SA rules

elevation

Impingement

To Be or Not To Be

Empty Can

Full Can

kinematics

Matrix

WHO ICF Model

impingement

prevents working

BPS Model in Action

Physical

Energetic

self correction

Psycho-emotional

Intellectual

Contraindications

bull Cow arms

bull Eagle arms

bull Dolphin dive

bull WB headstand

bull Shoulder stand

shoulder elevation)

firing of LT

201347(14)877-885

(Lucas 2007)

Easy Seated Pose

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

bull TATD breath

Subtle Body

Gross Body

Postural alignment

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Pain Mapping

bull Age - gt40

Scapular Dyskinesis

dimension

Conclusions

bull SAT

bull SRT

101136bjsports-2013-092425

SD Classification

elevation with

Am200991378-389

Surg200211550-556

Deltoid amp RTC

Sports Med 200939(8)663-685

2002 May20(3)439-46

bull 35-65 - MD

bull 10 - IS

bull 2 - AD

Posterior Cuff

scapula

bull SA rules

elevation

Impingement

To Be or Not To Be

Empty Can

Full Can

kinematics

Matrix

WHO ICF Model

impingement

prevents working

BPS Model in Action

Physical

Energetic

self correction

Psycho-emotional

Intellectual

Contraindications

bull Cow arms

bull Eagle arms

bull Dolphin dive

bull WB headstand

bull Shoulder stand

shoulder elevation)

firing of LT

201347(14)877-885

(Lucas 2007)

Easy Seated Pose

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

bull TATD breath

Subtle Body

Gross Body

Postural alignment

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Scapular Dyskinesis

dimension

Conclusions

bull SAT

bull SRT

101136bjsports-2013-092425

SD Classification

elevation with

Am200991378-389

Surg200211550-556

Deltoid amp RTC

Sports Med 200939(8)663-685

2002 May20(3)439-46

bull 35-65 - MD

bull 10 - IS

bull 2 - AD

Posterior Cuff

scapula

bull SA rules

elevation

Impingement

To Be or Not To Be

Empty Can

Full Can

kinematics

Matrix

WHO ICF Model

impingement

prevents working

BPS Model in Action

Physical

Energetic

self correction

Psycho-emotional

Intellectual

Contraindications

bull Cow arms

bull Eagle arms

bull Dolphin dive

bull WB headstand

bull Shoulder stand

shoulder elevation)

firing of LT

201347(14)877-885

(Lucas 2007)

Easy Seated Pose

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

bull TATD breath

Subtle Body

Gross Body

Postural alignment

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

bull SAT

bull SRT

101136bjsports-2013-092425

SD Classification

elevation with

Am200991378-389

Surg200211550-556

Deltoid amp RTC

Sports Med 200939(8)663-685

2002 May20(3)439-46

bull 35-65 - MD

bull 10 - IS

bull 2 - AD

Posterior Cuff

scapula

bull SA rules

elevation

Impingement

To Be or Not To Be

Empty Can

Full Can

kinematics

Matrix

WHO ICF Model

impingement

prevents working

BPS Model in Action

Physical

Energetic

self correction

Psycho-emotional

Intellectual

Contraindications

bull Cow arms

bull Eagle arms

bull Dolphin dive

bull WB headstand

bull Shoulder stand

shoulder elevation)

firing of LT

201347(14)877-885

(Lucas 2007)

Easy Seated Pose

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

bull TATD breath

Subtle Body

Gross Body

Postural alignment

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Deltoid amp RTC

Sports Med 200939(8)663-685

2002 May20(3)439-46

bull 35-65 - MD

bull 10 - IS

bull 2 - AD

Posterior Cuff

scapula

bull SA rules

elevation

Impingement

To Be or Not To Be

Empty Can

Full Can

kinematics

Matrix

WHO ICF Model

impingement

prevents working

BPS Model in Action

Physical

Energetic

self correction

Psycho-emotional

Intellectual

Contraindications

bull Cow arms

bull Eagle arms

bull Dolphin dive

bull WB headstand

bull Shoulder stand

shoulder elevation)

firing of LT

201347(14)877-885

(Lucas 2007)

Easy Seated Pose

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

bull TATD breath

Subtle Body

Gross Body

Postural alignment

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

scapula

bull SA rules

elevation

Impingement

To Be or Not To Be

Empty Can

Full Can

kinematics

Matrix

WHO ICF Model

impingement

prevents working

BPS Model in Action

Physical

Energetic

self correction

Psycho-emotional

Intellectual

Contraindications

bull Cow arms

bull Eagle arms

bull Dolphin dive

bull WB headstand

bull Shoulder stand

shoulder elevation)

firing of LT

201347(14)877-885

(Lucas 2007)

Easy Seated Pose

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

bull TATD breath

Subtle Body

Gross Body

Postural alignment

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Impingement

To Be or Not To Be

Empty Can

Full Can

kinematics

Matrix

WHO ICF Model

impingement

prevents working

BPS Model in Action

Physical

Energetic

self correction

Psycho-emotional

Intellectual

Contraindications

bull Cow arms

bull Eagle arms

bull Dolphin dive

bull WB headstand

bull Shoulder stand

shoulder elevation)

firing of LT

201347(14)877-885

(Lucas 2007)

Easy Seated Pose

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

bull TATD breath

Subtle Body

Gross Body

Postural alignment

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

WHO ICF Model

impingement

prevents working

BPS Model in Action

Physical

Energetic

self correction

Psycho-emotional

Intellectual

Contraindications

bull Cow arms

bull Eagle arms

bull Dolphin dive

bull WB headstand

bull Shoulder stand

shoulder elevation)

firing of LT

201347(14)877-885

(Lucas 2007)

Easy Seated Pose

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

bull TATD breath

Subtle Body

Gross Body

Postural alignment

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

shoulder elevation)

firing of LT

201347(14)877-885

(Lucas 2007)

Easy Seated Pose

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

bull TATD breath

Subtle Body

Gross Body

Postural alignment

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

of Movement

Biomechanical

2 Science of Action

Physiological

3 Safety

Clinical Efficacy

bull TATD breath

Subtle Body

Gross Body

Postural alignment

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

RiseIncorrect form

teres major LD

42) LD (55 +-27)

Questions

bull DDP (right)

Garner 2015

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

bullSub-Acute

Program -Pre-Asana

Shoulder

ldquoOpenerrdquo

Kinematics

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Review

Program Impact

Pre-Test Results

bull Special Tests

Post-Test Results

painfree

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Resources

Sources (2)

RMIT University

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Sources (3)

Sources (4)

Sources (5)

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Spinal Kinematics

Part 2

bull Case Scenario

bull Epidemiology

Contraindications

Objectives

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

may work

Is this very common

Is this serious

bull Reproductive

bull Oncological

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

How did this happen

bull Anxiety

bull Depression

bull Obesity

bull Older age

bull Being female

bull Physically

strenuous work

bull Sedentary work

bull Stressful job

bull Smoking

bull Poor nutrition

bull Atlasaxis

bull C3-7

bull T1-T12

bull L1-L5

bull Sacrum and

coccyx

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Spinal Biomechanics

surfaces

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

which follow)

bull Yogic context

Somatic Dysfunction

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Recalibrating

Table 53 Revolved

CraniumC1

Cook et al 2006

Cranium-C1 Movement

C2-C7 Rotation

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

bull 75 sidebending

Sizer et al

(unloaded)

bull T4-T8 11

bull T1-T4 ndash 18

bull T4-T8 ndash 99

UE flexion

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

bull AMA hierarchy

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Modified Noose

(Pasasana)

2013 692 - 697

involvement

General Indications

Compression

Torque

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Selected Sources

Sources (2)

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Clinical Update on

Integrated Care

of the Elbow

Part 3

Objectives

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Case Scenario

questions

Is this very common

bull Pronation

bull Supination

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Wrist extension

Gripping

Wrist flexion

Insidious onset

How did this happen

bull Smoking

bull Working age

bull Obesity

Autoworkers

Chefscooks

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Anatomy Review

Injury Prevention

bull Obesity

bull Smoking

bull Diabetes

bull Lack of rest

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Medical Management

WHO ICF Model

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Acute Management

relief

Integrated MTY

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Figure 8

Arm Spiral

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Subacute

Downward Facing Dog

Headstand

bullBottom Staff

flexor muscle mass

to the area

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Contraindications

alignment

Program Impact

bull 2003 - 56

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Therapy Programs

bull Trade

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Areas of

Occupation

Client

factors

Performanc

e skills

Performanc

e patterns

Activity

demands

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

simulation)

Isolated movement

Rhythmical movement

Linear movement

Reciprocal movement

motion

-Sun salutation

-Forward fold

-High lunge for

hip flexors

Diagonal movement

-Mudras

-Triangle

-Twist

-Cow face pose

-Vinyasa

Resources

bull Module 6

bull Module 7

Spine Lab (on-site)

bull Module 8

Sources

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Sources (2)

Sources (3)

Part 1 Handoutpdf

Part 2 Handoutpdf

Part 3 Handoutpdf

Documents

Course Outline Hour 1 - Allied Health Education · Escamilla RF, Yamashiro K, Paulos L, Andrews JR. Shoulder muscle activity and function in common shoulder rehabilitation exercises