Can you palpate psoas major?

I spent a long time looking at psoas major.

• dissected 27 cadavers
• did a biomechanical model of psoas major on the lumbar spine and SIJ; 
• developed a strategy to view the width of the posterior fascicles on CT imaging (with a reliability and validity study)
• assessed the width of the posterior fascicles in acute LBP
• developed a specific motor control exercise (with others) for psoas; 
• did a deep fine wire EMG pilot study
• measured superficial EMG during the specific exercise
• measured fluoroscopy of the femoral head during the specific motor control exercise
• did a clinical trial on specific motor control stability exercises (including the exercise for psoas major) for acute low back pain
• developed a preliminary clinical prediction rule for who will respond to specific motor control exercise (including the one for psoas major)

Since specific motor control exercises are part of my daily practice, so I have routinely looked at psoas major and other muscles with real time ultrasound imaging since 2000.


I remember an old colleague from the Kinetic Control days describing the palpation of psoas major: "if you can palpate the abdominal aorta, you can palpate psoas major". Can you palpate the abdominal aorta?
https://www.aafp.org/afp/1999/0415/p2343a.html

Yes you can (in many people)


There are three potential places that you can palpate psoas major:

• abdominal
• pelvic brim and 
• lesser trochanter. 

Can you palpate psoas major? I don't know if you can palpate it directly. Can you exert force on psoas major? Yes you can likely do this in people with normal BMI. Can you do this reliably? I doubt it, but I don't know. Can you palpate the proposed trigger points in psoas major? I doubt you could do this with reasonable reliability (if they exist). I certainly wouldn't want to do that study.

I know that many years ago I tried palpating it at the lesser trochanter. I always found something "tender" but never knew what I was palpating so gave up. I have never tried palpating it at the pelvic brim (iliopectineal eminence), although some anatomists I worked with said you should be able to in people with normal BMI. Once again though, I am not sure of the reliability. There are a lot of potentially tender structures in there to get confused with.

Do I palpate psoas major in my clinic? It is pretty uncommon actually. But this is due to a few reasons. 1: the issues mentioned above: 2: because I have 30 min with someone and if don't see that as time well spent (most of the time). Since primitive reflex inhibition appears to normalize muscle tone, I would rather spend my time doing that. I also make sure I spend some of my session (if not all) giving education and teaching some form of exercise (most often some form of specific motor control). When would I attempt it? I may do this in someone with normal to below average BMI who is in acute pain and who may benefit from some pain relief to perform their specific motor control exercises better or to better perform primitive reflex inhibition.

Do I teach the palpation of psoas major on courses? No I do not. If you do not know how to palpate abdominal masses, you should not be trying to palpate psoas major at the abdominal region. As well, I try to keep things on courses that have undergone reliability or at least would allow it to easily be assessed with reliability.

So in summary, you should be able to exert some force on psoas major through abdominal palpation in most subjects with normal BMI.

Primitive Reflexes influencing Motor Control & Motor Skill Learning. Come Learn!

Primitive reflexes are essentially what guides infantile movements. They are very easy to rehab. Just low effort resistance in the correct patterns of the reflex.

What do we know about primitive reflexes for musculoskeletal pain?

• Having PR interferes with normal motor control and coordination
• Having PR interferes with learning motor control exercise or normal movement
• PR inhibition helps normal motor control and movement
• PR inhibition helps postural stability and balance
• PR inhibition helps neurocognitive function
• PR inhibition helps body image
• PR are stimulated by a sensory stimulus. Most are vestibular related and some are tactile

Want to Learn?

We are doing this course in:
Ottawa, Canada: March 6-8, 2020
Barcelona, Spain: March 20-22, 2020
Warsaw, Poland: May 8-10, 2020

Please email for further information: stabilityphysio@gmail.com

This course is suitable for orthopaedic, paediatric, neurological, pelvic floor and vestibular physiotherapists

Course Description

Some questions beg answers

How do you rehab someone with poor coordination?

Why does the brain move the body in a harmful way?

Why do some people never regain full ROM?

This course will answer these questions & more!

Primitive reflexes (PR) are brain stem-mediated, complex automatic movement patterns that commence in utero.  If PR persist beyond their average lifespan they may begin to interfere with normal movement, motor control and brain development. They present in a variety of conditions relevant to you such as MSK pain, concussion, atypical handedness / birth, early-late walking.

The presence of PR will influence motor control and can interfere with normal rehabilitation. 

During this two day course we will cover the assessment and rehabilitation of primitive reflexes in detail.  Strategies for treatment in the clinic and home exercise will be discussed. You will be able to immediately improve movement and motor control in your patients.

Specific examples of what PR can be used to improve highly common clinical problems including:

• Grasp reflex for shoulder upper limb coordination and glenohumeral medial rotation ROM

• Babinski and Foot Tendon Guard for lower limb & gait coordination, and dorsiflexion ROM

• Asymmetrical Tonic Neck & Abdominal Reflexes for abdominal hollowing, & trunk coordination

• Landau for hamstrings and trunk tone

The traditional view that PR are inhibited by normal movement is limited. The cognitive replication, rather than reproduction of PR inhibits them. PR are highly effective at rehabilitating normal movement, and neurocognitive function. 

Course Objectives:

The participant will be equipped to:

• Use primitive reflexes to rehab patients with very poor coordination & motor skill  learning

• Understand the role of primitive reflexes in pain, cognitive function and motor control.

•  Assess and rehabilitate primitive reflexes in children and adults

• Implement a home exercise program for primitive reflex inhibition

• Use primitive reflex inhibition strategies to improve movement & motor control 

Testimonial

"This course is a game changer. Sean continues to push physiotherapists to think beyond the standard orthopedic model, incorporating neurological, neuro-developmental, functional medicine and original research into a model that answers so many questions regarding each patient's unique pain experience. His midline and musculoskeletal body image work is revolutionary"

"Finally, I have a way to treat motor morons"

Chris Barber Physiotherapist

"Finally, I have a way to treat motor morons"

"Movement changes so quickly - and maintains"

Chris Barber Physiotherapist

What will you get from this course that you may not already have?

A rehab option for "Motor Morons". Neurodevelopmental rehab works for these patients

Improve Muscle Tone & Motor Control

Learn how to use PR to reduce tone and muscle tightness, improve movement and coordination.

Stop Wasting Time: quickly rule out the people who have poor motor skill learning

Understand the role of Primitive Reflexes in pain, cognitive function and motor control.  This is also important for neurological rehab.

Concussion

Find out how to help rehab concussion with primitive reflexes

Pediatrics, Neuro, Vestibular, Pelvic Floor Physios

The same primitive reflex inhibition techniques can be used very effectively with these groups 

Regardless of how much knowledge you have you will benefit from knowing:

• Screening who has poor motor skill learning

• Strategies to rehab motor morons

• Which Postural and primitive reflexes to immediately change movement patterns and performance on  specific motor control exercise

 

Facilitator

Sean Gibbons graduated from Manchester University in 1995. He has been rehabilitating movement patterns and chronic pain for over 25 years. Primitive reflexes (PR) play an important role in this. He has identified new PR, and researched and developed clinically relevant interventions. His PhD was on the development of a prescriptive clinical prediction rule for specific motor control exercises in low back pain. Key new sub-classifications were identified: Neurological Factors, which are related to extremely poor movement and motor skill learning; Midline as a sensory system which is critical to for Body Image; and Neuro-Immune-Cardiometabolic-Endocrine dys-regulation, which is critical for Central Sensitization, Psychosocial Factors and muscle tone. His current work follows this and aims to further understand the mechanisms of non mechanical pain and the Individual Factors influencing treatment. His dissection and research into psoas major, gluteus maximus and other muscles has led to the development of new rehabilitation options. He has presented his research at national and international conferences and has several journal publications and book chapters on related topics. He is an Assistant Clinical Professor (Adjunct) at McMaster's Advanced Orthopaedic Musculoskeletal / Manipulative Physiotherapy specialization and lectures at Manchester Metropolitan University's Masters in Advanced Physiotherapy program.

A deeper and common sense look at RICE, PRICE, POLICE, PEACE & LOVE

It was "RICE" when I went to school. However any potential benefits must be considered against potential harms. We all here about the negative consequences of rest. Caution has to be exerted about telling at risk individuals to rest. That shouldn't really need a discussion. I have seen numerous people create neurogenic and even neuropathic pain by using ice continuously where injuries have appeared to occur that are near peripheral nerves. Ice seems to have a variable influence on aspects of sensory motor function, which everyone agrees is important. Compression also has the potential to adversely influence neurodynamics. These points don't seem to be in the discussion. So how evidence based are these recommendations?

If You Rehabilitate Movement or Motor Control You Should Know About Primitive Reflexes: Learn in Ottawa

Primitive reflexes can be used for:
Ortho Physio:

• Rehab movement in people that cannot learn
• Improve body image
• Use them in place of other techniques (e.g. muscle energy techniques) to help movement and motor control
• Use to treat central pain

If you think "movement dysfunction is the underlying cause - think again". What makes you move differently? Primitive reflexes are one of the main causative factors. What about the people who can't learn? Primitive reflex inhibition is an option.

Neurophysio:

• Improve tone
• Improve normal movement
• Treat unilateral neglect and Thalamic Pain
• Improve gait by treating Babinski and Foot Tendon Guard reflexes
• Improve upper limb function by treating the Grasp Reflex

Pediatric Physio:

• Rehab Neurodevelopmental Disorders
• Treat certain Specific Learning Disorders

We all know the rehab of postural responses and normal movement helps, but what about those that don't respond or that take forever? Primitive reflex inhibition fills a very important void and will replace some of what you do.

Pelvic Floor Physio:

• Improve motor control around the pelvis
• Quickly change asymmetries in the pelvic floor

Vestibular Rehab:

• Stimulate the vestibular system and treat central and peripheral vestibular disorders

Specific Examples
Clinical examples will be covered to illustrate how PR can be used to improve many common clinical presentations.

Already Familiar with Primitive Reflexes?
Our original research has changed our treatment of PR to make it more functional and faster.

Parfrey K, Gibbons SGT, et al 2014 Head and limb position influence superficial EMG of abdominals during an abdominal hollowing exercise. BMC Musculoskeletal Disorders. 15:52. DOI: 10.1186/1471-2474-15-52

Want to Learn? 
Ottawa Nov 22-24, 2019

email: stabilityphysio@gmail.com

Facilitator

Sean Gibbons graduated from Manchester University in 1995. He shares his time between clinical practice, teaching and research. He has been rehabilitating movement for his whole career and has closely looked at the underlying mechanisms as to why movement is altered. Primitive reflexes (PR) play an important role in this. He has identified new PR, and researched and developed clinically relevant interventions. His PhD was on the development of a prescriptive clinical prediction rule for specific motor control exercises in low back pain. Key new sub-classifications were identified: neurocognitive, sensory motor function which is related to extremely poor movement and the ability to learn; body image pain and neuroimmune-endocrine dys-regulation.  His current work aims to further validate the sub-classification model. He has presented his research at national and international conferences and has several journal publications and book chapters on related topics. He is an associate researcher at MUN and is part of the teaching faculty at McMaster's Advanced Orthopaedic Musculoskeletal/Manipulative Physiotherapy Specialization

Some relevant posts:

https://www.linkedin.com/pulse/movement-mechanism-low-back-pain-what-cause-sean-gibbons/

https://www.linkedin.com/pulse/what-happens-stretching-just-doesnt-work-get-range-movement-gibbons/

https://www.linkedin.com/pulse/you-can-do-muscle-energy-technique-primitive-reflex-sean-gibbons/

https://www.linkedin.com/pulse/primitive-reflex-inhibition-sensory-motor-training-improves-gibbons/

https://www.linkedin.com/pulse/you-rehabilitate-movement-should-know-primitive-reflexes-sean-gibbons/

Testimonials
“I can't recommend Sean Gibbons and Smarterehab courses enough. I have found the sub-classification system to be easy to use and revolutionary in removing a lot of the guesswork in my patient management. The courses have been transformative in my practice in that it has wide applicability across a spectrum of conditions that would normally constitute ‘difficult’ patients. I can't recommend these courses highly enough! Chris Barber MCSP BSc (Hons) Musculoskeletal & Sports Physiotherapist, Director: Advanced Physiotherapy Centres Ltd.

As a clinic owner and have seen a trend in Canadian physiotherapy towards spinal manipulation and needling techniques. While these techniques are valuable, the transformative learning that takes place in a SmarteRehab course is the direction I am dedicated to bringing our profession. As Physiotherapists, if we wish to distinguish ourselves from chiropractors, massage therapists, athletic therapists, osteopaths etc., we need to move away from technique based therapy. Sean is masterful at explaining the complex relationship between Central Sensitization, Central Pain, Sensori-Motor Function and how it relates to Motor Control dysfunction and pain. No other approach I have seen, heard of, or even read about does such a complete job of integrating neurological rehabilitation techniques and treatment. I now have junior therapists who are able to reason their way through the most complex of chronic pain cases and can formulate treatment plans that are effective and get results. Most importantly they can explain to these patients the nature of their problem in a way that they can understand. It is so rewarding to see patients, empowered with this knowledge, resolve problems that have sometimes existed for decades. Equally as rewarding is watching a junior Physio quickly solve by identifying the underlying movement dysfunction and easily explaining it’s cause. Thank you for what you have done and continue to do for our Profession. Dave Holmes Owner and Physiotherapist at Tower Physiotherapy & Sports Medicine 

If you find yourself stuck and frustrated with chronic, generalized, weird pain patients who don't respond to usual treatments, this is what this course is all about. Sean's courses are truly unique and bring practical, guidelines that are untouched by other institutions. Jean-Michel Cormier, Physiotherapist Max Health Institute, Shediac, NB, Canada

The courses that I have taken with Sean have completely changed my pelvic floor practice and the way I practice as a physical therapist! Sean's courses are a must in order to help a variety of clientele and especially those who do not respond to conventional treatments! He has researched and developed new techniques that are essential for pelvic floor therapists. Erica Lafontant, pht, B. Sc, M.Sc.A Rééducation périnéale et . Action Physio. Ville Mont-Royal, QC,

What Causes the Neurodynamic Reactivity During testing? Learning in Calgary

Well...it isn't exactly known.

The functional causes are easier to focus on:
(1) Is there a history of trauma?
(2) Is there a history of disease (including low grade inflammation)?
(3) Is there an abnormal movement system or motor control placing stress on the nervous system?

Keep in mind, if 1 & 2 are present, it doesn't mean that movement still isn't placing stress on the nervous system.

Some simple tests can give us the answers.

Want to Learn?

We are doing this course in Calgary, Alberta Canada Dec 13-15, 2019 (2pm Friday start)

Course Description

The nervous system may become reactive and sensitized through many processes. One such process is through abnormal movement patterns. On this course the base neurodynamic tests are reviewed we will show how correcting movement patterns can influence neurodynamic reactivity. Examples will be highlighted where movement control rehabilitation and neurodynamics do not agree i.e. when the ideal movement pattern actually places more stress on neural structures. 

This course will provide participants with skills in analysing movement in relation to neurodynamic reactivity. Specific motor control retraining strategies will be introduced using a comprehensive and clinical reasoning process. 

Strategies will also be covered to combine traditional neural mobilization with motor control exercise.

The course will cover the neck and upper quadrant as well as the trunk and lower quadrant.

Course Objectives:  The participant will be able to:

• Understand how uncontrolled movement patterns and poor motor control may contribute to reactivity of the nervous system
• Use motor control retraining strategies to treat neurodynamic reactivity
• Understand when normal movement can aggravate sensitive neural tissue and problem solve to use other techniques
•  Use movement pattern control rather than time frames as a predictor of outcome

WHAT WILL YOU GET THAT YOU MAY NOT ALREADY HAVE?

How do you mobilize the nervous system and control movement? How do you use to unload the nervous We'll show you!

How do you rehab the Slump Test when there is also excessive Lumbar Flexion? There does not seem to be a logical way to rehab both of these problems. We'll show you how!

The ideal scapular position can change when neurodynamics is present

Based on anatomy, biomechanics, motor control and clinical research we have an ideal scapular position this can change when neurodynamic reactivity is present – hence what we think is good rehab can be harmful some people

Upper Trapezius is a Good Muscle – find out why!

Taping

There are some great taping techniques for shoulder girdle, forearm and neurodynamic problems.

Neck rehab is so much more than the Deep Neck Flexors! In the deep neck flexors when neurodynamic reactivity is present frequently aggravates symptoms.

Popliteus is one of the missing links in of anterior knee pain and lower limb dysfunction. What does it do? How do we retrain it?

Why Do We Move Differently?

We'll review some key Primitive Reflexes that are involved in neurodynamics and discuss the known mechanisms of altered movement.

Testimonials

“I can't recommend Sean Gibbons and Smarterehab courses enough. I have found the sub-classification system to be easy to use and revolutionary in removing a lot of the guesswork in my patient management. The courses have been transformative in my practice in that it has wide applicability across a spectrum of conditions that would normally constitute ‘difficult’ patients. I can't recommend these courses highly enough!Chris Barber MCSP BSc (Hons) Musculoskeletal & Sports Physiotherapist, Director: Advanced Physiotherapy Centres Ltd.

As a clinic owner and have seen a trend in Canadian physiotherapy towards spinal manipulation and needling techniques. While these techniques are valuable, the transformative learning that takes place in a SmarteRehab course is the direction I am dedicated to bringing our profession. As Physiotherapists, if we wish to distinguish ourselves from chiropractors, massage therapists, athletic therapists, osteopaths etc., we need to move away from technique based therapy. Sean is masterful at explaining the complex relationship between Central Sensitization, Central Pain, Sensori-Motor Function and how it relates to Motor Control dysfunction and pain. No other approach I have seen, heard of, or even read about does such a complete job of integrating neurological rehabilitation techniques and orthopaedic treatment. I now have junior therapists who are able to reason their way through the most complex of chronic pain cases and can formulate treatment plans that are effective and get results. Most importantly they can explain to these patients the nature of their problem in a way that they can understand. It is so rewarding to see patients, empowered with this knowledge, resolve problems that have sometimes existed for decades. Equally as rewarding is watching a junior Physio quickly solve an orthopaedic complaint by identifying the underlying movement dysfunction and easily explaining it’s cause. Thank for what you have done and continue to do for our Profession.Dave Holmes Owner and Physiotherapist at Tower Physiotherapy & Sports Medicine 

If you find yourself stuck and frustrated with chronic, generalized, weird pain patients who don't respond to usual treatments, this is what this course is all about. Sean's courses are truly unique and bring practical, guidelines that are untouched by other institutions. Places are limited.

Jean-Michel Cormier, Physiotherapist Max Health Institute, Shediac, NB, Canada

Testimonial- Pelvic Floor Therapist

The courses that I have taken with Sean have completely changed my pelvic floor practice and the way I practice as a physical therapist! Sean's courses are a must in order to help a variety of clientele and especially those who do not respond to conventional treatments! He has researched and developed new techniques that are essential for pelvic floor therapists.

Erica Lafontant, pht, B. Sc, M.Sc.A

Rééducation périnéale et

Action Sport Physio

Ville Mont-Royal, QC,

Facilitator

Sean Gibbons graduated from Manchester University in 1995. He has been rehabilitating movement patterns for over 20 years. He is an international expert in specific motor control exercise and has researched and developed numerous advances the cognitive control of movement to make the rehab process better. These include predicting who can learn, understanding who can learn but will not respond, and integrating which postural and primitive reflexes influence movement and key aspects neurodevelopment. His PhD was on the development of a prescriptive clinical prediction rule for specific motor control exercises in low back pain. Key new sub-classifications were identified: Neurological Factors, which are related to poor movement and the ability to learn; Midline as a sensory system which is critical to Body Image Pain; and Neuro-Immune dysregulation, which is critical for Central Sensitization and Psychosocial Factors. His current work involves further researching the sub-classification model. His dissection and research into psoas major, gluteus maximus and other muscles led to the development of new rehabilitation options. He has presented his research at national and international conferences and has several journal publications and book chapters. He is an Assistant Clinical Professor (Adjunct) at McMaster's Advanced Orthopaedic Musculoskeletal / Manipulative Physiotherapy specialization and lectures at Manchester Metropolitan University's Masters in Advanced Physiotherapy program.

If you can do a muscle energy technique you can do primitive reflex inhibition.

Primitive reflexes are essentially what guides infantile movements. They are very easy to rehab. Just low effort resistance in the correct patterns of the reflex.
What do we know about primitive reflexes for musculoskeletal pain:

• Having PR interferes with normal motor control and coordination
• Having PR interferes with learning motor control exercise or normal movement
• PR inhibition helps normal motor control and movement
• PR inhibition helps postural stability and balance
• PR inhibition helps neurocognitive function
• PR inhibition helps body image

Musculoskeletal Body Image (MBI) is the way one’s body feels to its owner. If you close your eyes, and think about a part of your body, are you aware of the outline of your body? This includes, the shape, contours, alignment in space, and sense of weight distribution. MBI is closely related to motor imagery. So this feeling is also dynamic. Ideally this motor imagery would be intrinsic and not extrinsic. MBI is believed to depend on sensory motor input. It is very plastic and can change quickly.

This has widespread implications for:

• coordination and motor skill learning
• non mechanical pain
• behavioral conditions

Original research has identified a fascinating new assessment and rehabilitation approach. This is addition to the neurodevelopmental process we have been researching and developing for over two decades.

This highly integrative and evidence based course is suitable for numerous therapists if you treat pain, movement or sensory motor function.

You will have rehab options for patients you could not help or for those that hit a plateau.

Want to Learn?

We are doing a course on this in: Ottawa, Ontario Canada Nov 22-24.

Email for a course brochure: stabilityphysio@gmail.com

Interested in hosting a course?
Contact us: stabilityphysio@gmail.com

Testimonials
“I can't recommend Sean Gibbons and Smarterehab courses enough. I have found the sub-classification system to be easy to use and revolutionary in removing a lot of the guesswork in my patient management. The courses have been transformative in my practice in that it has wide applicability across a spectrum of conditions that would normally constitute ‘difficult’ patients. I can't recommend these courses highly enough! Chris Barber MCSP BSc (Hons) Musculoskeletal & Sports Physiotherapist, Director: Advanced Physiotherapy Centres Ltd.

As a clinic owner and have seen a trend in Canadian physiotherapy towards spinal manipulation and needling techniques. While these techniques are valuable, the transformative learning that takes place in a SmarteRehab course is the direction I am dedicated to bringing our profession. As Physiotherapists, if we wish to distinguish ourselves from chiropractors, massage therapists, athletic therapists, osteopaths etc., we need to move away from technique based therapy. Sean is masterful at explaining the complex relationship between Central Sensitization, Central Pain, Sensori-Motor Function and how it relates to Motor Control dysfunction and pain. No other approach I have seen, heard of, or even read about does such a complete job of integrating neurological rehabilitation techniques and treatment. I now have junior therapists who are able to reason their way through the most complex of chronic pain cases and can formulate treatment plans that are effective and get results. Most importantly they can explain to these patients the nature of their problem in a way that they can understand. It is so rewarding to see patients, empowered with this knowledge, resolve problems that have sometimes existed for decades. Equally as rewarding is watching a junior Physio quickly solve by identifying the underlying movement dysfunction and easily explaining it’s cause. Thank you for what you have done and continue to do for our Profession. Dave Holmes   Owner and Physiotherapist at Tower Physiotherapy & Sports Medicine 

If you find yourself stuck and frustrated with chronic, generalized, weird pain patients who don't respond to usual treatments, this is what this course is all about. Sean's courses are truly unique and bring practical, guidelines that are untouched by other institutions. Places are limited. Jean-Michel Cormier, Physiotherapist Max Health Institute, Shediac, NB, Canada

The courses that I have taken with Sean have completely changed my pelvic floor practice and the way I practice as a physical therapist! Sean's courses are a must in order to help a variety of clientele and especially those who do not respond to conventional treatments! He has researched and developed new techniques that are essential for pelvic floor therapists. Erica Lafontant, pht, B. Sc, M.Sc.A Rééducation périnéale et . Action Physio. Ville Mont-Royal, QC,


Sean Gibbons graduated from Manchester University in 1995. He has been rehabilitating movement patterns for over 20 years. He is an international expert in specific motor control exercise and has researched and developed numerous advances the cognitive control of movement to make the rehab process better. These include predicting who can learn, understanding who can learn but will not respond, and integrating which postural and primitive reflexes influence movement and key aspects neurodevelopment. was on the development of a prescriptive clinical prediction rule for specific motor control exercises in low back pain. Key new sub-classifications were identified: Neurological Factors, which are related to poor movement and the ability to learn; Midline as a sensory system which is critical to Body Image Pain; and Neuro-Immune dysregulation, which is critical for Central Sensitization and Psychosocial Factors. His current work involves further researching the sub-classification model. His dissection and research into psoas major, gluteus maximus and other muscles led to the development of new rehabilitation options. He has presented his research at national and international conferences and has several journal publications and book chapters. He is an Assistant Clinical Professor (Adjunct) at McMaster's Advanced Orthopaedic Musculoskeletal / Manipulative Physiotherapy specialization and lectures at Manchester Metropolitan University's Masters in Advanced Physiotherapy program.

 

Neurodynamic Treatment with Specific Motor Control Retraining in Calgary

What is the cause of the reactivity of a neurodynamic test? Is there an abnormal nerve or is there a normal nerve forced to move through an abnormal motor system? Is NICE syndrome causing neurodynamic reactivity (Neuro-Immune-Cardiometabolic-Endocrine dysregulation)

There are numerous muscles and movements which can unload the neurodynamic system. For example:

• A depressed shoulder girdle can place stress on the brachial plexus
• Excessive tibial external rotation can place stress on the common peroneal nerve
• Muscle tone can place stress on various neural tissues. Primitive reflex inhibition can reduce this tone.

Want to Learn?

We are doing this course in Calgary, Alberta Canada Dec 13-15, 2019 (2pm Friday start)

Course Description

The nervous system may become reactive and sensitized through many processes. One such process is through abnormal movement patterns. On this course the base neurodynamic tests are reviewed we will show how correcting movement patterns can influence neurodynamic reactivity. Examples will be highlighted where movement control rehabilitation and neurodynamics do not agree i.e. when the ideal movement pattern actually places more stress on neural structures. 

This course will provide participants with skills in analysing movement in relation to neurodynamic reactivity. Specific motor control retraining strategies will be introduced using a comprehensive and clinical reasoning process. 

Strategies will also be covered to combine traditional neural mobilization with motor control exercise.

The course will cover the neck and upper quadrant as well as the trunk and lower quadrant.

Course Objectives:  The participant will be able to:

• Understand how uncontrolled movement patterns and poor motor control may contribute to reactivity of the nervous system
• Use motor control retraining strategies to treat neurodynamic reactivity
• Understand when normal movement can aggravate sensitive neural tissue and problem solve to use other techniques
•  Use movement pattern control rather than time frames as a predictor of outcome

WHAT WILL YOU GET THAT YOU MAY NOT ALREADY HAVE?

How do you mobilize the nervous system and control movement? How do you use to unload the nervous We'll show you!

How do you rehab the Slump Test when there is also excessive Lumbar Flexion? There does not seem to be a logical way to rehab both of these problems. We'll show you how!

The ideal scapular position can change when neurodynamics is present

Based on anatomy, biomechanics, motor control and clinical research we have an ideal scapular position this can change when neurodynamic reactivity is present – hence what we think is good rehab can be harmful some people

Upper Trapezius is a Good Muscle – find out why!

Taping

There are some great taping techniques for shoulder girdle, forearm and neurodynamic problems.

Neck rehab is so much more than the Deep Neck Flexors! In the deep neck flexors when neurodynamic reactivity is present frequently aggravates symptoms.

Popliteus is one of the missing links in of anterior knee pain and lower limb dysfunction. What does it do? How do we retrain it?

Why Do We Move Differently?

We'll review some key Primitive Reflexes that are involved in neurodynamics and discuss the known mechanisms of altered movement.

Testimonials

“I can't recommend Sean Gibbons and Smarterehab courses enough. I have found the sub-classification system to be easy to use and revolutionary in removing a lot of the guesswork in my patient management. The courses have been transformative in my practice in that it has wide applicability across a spectrum of conditions that would normally constitute ‘difficult’ patients. I can't recommend these courses highly enough!Chris Barber MCSP BSc (Hons) Musculoskeletal & Sports Physiotherapist, Director: Advanced Physiotherapy Centres Ltd.

As a clinic owner and have seen a trend in Canadian physiotherapy towards spinal manipulation and needling techniques. While these techniques are valuable, the transformative learning that takes place in a SmarteRehab course is the direction I am dedicated to bringing our profession. As Physiotherapists, if we wish to distinguish ourselves from chiropractors, massage therapists, athletic therapists, osteopaths etc., we need to move away from technique based therapy. Sean is masterful at explaining the complex relationship between Central Sensitization, Central Pain, Sensori-Motor Function and how it relates to Motor Control dysfunction and pain. No other approach I have seen, heard of, or even read about does such a complete job of integrating neurological rehabilitation techniques and orthopaedic treatment. I now have junior therapists who are able to reason their way through the most complex of chronic pain cases and can formulate treatment plans that are effective and get results. Most importantly they can explain to these patients the nature of their problem in a way that they can understand. It is so rewarding to see patients, empowered with this knowledge, resolve problems that have sometimes existed for decades. Equally as rewarding is watching a junior Physio quickly solve an orthopaedic complaint by identifying the underlying movement dysfunction and easily explaining it’s cause. Thank for what you have done and continue to do for our Profession.Dave Holmes Owner and Physiotherapist at Tower Physiotherapy & Sports Medicine 

If you find yourself stuck and frustrated with chronic, generalized, weird pain patients who don't respond to usual treatments, this is what this course is all about. Sean's courses are truly unique and bring practical, guidelines that are untouched by other institutions. Places are limited.

Jean-Michel Cormier, Physiotherapist Max Health Institute, Shediac, NB, Canada

Testimonial- Pelvic Floor Therapist

The courses that I have taken with Sean have completely changed my pelvic floor practice and the way I practice as a physical therapist! Sean's courses are a must in order to help a variety of clientele and especially those who do not respond to conventional treatments! He has researched and developed new techniques that are essential for pelvic floor therapists.

Erica Lafontant, pht, B. Sc, M.Sc.A

Rééducation périnéale et

Action Sport Physio

Ville Mont-Royal, QC,

Facilitator

Sean Gibbons graduated from Manchester University in 1995. He has been rehabilitating movement patterns for over 20 years. He is an international expert in specific motor control exercise and has researched and developed numerous advances the cognitive control of movement to make the rehab process better. These include predicting who can learn, understanding who can learn but will not respond, and integrating which postural and primitive reflexes influence movement and key aspects neurodevelopment. His PhD was on the development of a prescriptive clinical prediction rule for specific motor control exercises in low back pain. Key new sub-classifications were identified: Neurological Factors, which are related to poor movement and the ability to learn; Midline as a sensory system which is critical to Body Image Pain; and Neuro-Immune dysregulation, which is critical for Central Sensitization and Psychosocial Factors. His current work involves further researching the sub-classification model. His dissection and research into psoas major, gluteus maximus and other muscles led to the development of new rehabilitation options. He has presented his research at national and international conferences and has several journal publications and book chapters. He is an Assistant Clinical Professor (Adjunct) at McMaster's Advanced Orthopaedic Musculoskeletal / Manipulative Physiotherapy specialization and lectures at Manchester Metropolitan University's Masters in Advanced Physiotherapy program.