Sue DuPont – A Total Approach for Treating Neck & Scapular Disorders

Outline

Introduction

• Why we need to understand the neck and shoulder girdle better
• Review of current biomechanical theories and research on cervical spine
  • Using Classification Systems and Functional Index findings to guide treatment planning
  • Causes of neck pain and disability—biomechanical and neurological changes

Common Hyper- and Hypo-Mobility Diagnoses Therapists Treat in the Cervical and Scapular-Thoracic Region

• Whiplash, Herniated Nucleus Pulposus (HNP), spondylosis, radiculopathy, scoliosis
• Hypo-mobility diagnoses—stenosis, kyphosis, facet joint dysfunction, Degenerative Disk Disease (DDD)

How Do We Stabilize?

• Review of relevant functional anatomy of the cervical-scapulo-thoracic region
• Discuss biomechanical model of the Cervical Motion Segment and effects of instability
• Effects of posture and aging on tissue structure and motor control

Lab 1: Palpation AND Posture Assessment

• Bony structures and gross muscle testing
• Posture observations and documentation of scoliosis and scapular winging
• Special tests—Jull’s Test for Cranio-cervical stability, Standing Arm Elevation, Axial compression, vertebral artery, Spurling’s test, and Scapular Balancing Index

Common Surgical and Non-Surgical Treatments

• Laminectomy, discectomy, cervical fusion, disc replacement
• Pain management strategies—spinal injections, trigger point injections, Botox, and acupuncture
• Clinical Modalities—iontophoresis, manual vs. mechanical traction

Lab 2: Hands-On Treatment Techniques

• Mobility testing and TMJ screening
• Soft Tissue Mobilization—passive release, muscle energy release, and tissue unwinding
• Demonstration of advanced mobilization techniques—MET and Mobilization with movement

Neuromuscular Re-Education: Clinical Applications AND Treatments

• Pressure biofeedback for deep neck flexors and scapular stability exercises
• Specialized taping techniques using kinesio-taping and McConnell taping strategies

Stabilization for Neck AND Scapula

• Critical links and 3 Postural Zones
• Weak links in the Stability Chain
• Progression of Exercise Programs

Lab 3: Stabilization AND Scapular Mobility Exercises

• Deep neck flexor training and Cervical “clock” exercises
• Connecting the postural zones
• Mobilization exercises for Scapular-thoracic region
• Building scapula-thoracic postural control
• Advanced exercise techniques—gliding discs, yoga, PNF, and dynamic reaction training