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Advanced Dry Needling Concepts: Comprehensive Approach to the Cervical and Thoracic Spine

Course Description:

In this 16 hour lab-based course, the clinician will learn how to integrate dry needling techniques with a manual therapy focused approach to address movement impairments of the cervical spine and thoracic spine. Emphasis will be placed on specific advanced dry needling strategies that facilitate manual therapy to improve dysfunction of the cervical and thoracic spine.

This course will specifically address the atlanto-occipital joint, atlanto-axial joint, mid cervical facet joints, cervico-thoracic junction, and the thoracic joints. Advanced manual therapy labs will focus on cervical and thoracic mobilizations, manipulations, and muscle energy techniques. The integrated approach to dealing with complex diagnosis will be reviewed through a discussion of case studies, current research, and the instructor’s specialty clinical expertise. Patient directed self corrective techniques will be described to improve carryover of manual interventions and drive progress.

Areas of the body to be covered in class include:

  • LOCAL Pathologies of the cervical and thoracic spine (specific mm, nerves, joint restrictions/ pathology, area specific pathology, radiculopathy)
  • Atlanto-occipital Pathologies (Rectus capitus posterior minor, recuts capitus posterior major, capitus oblique superior, sub occipital nerve, greater occipital nerve, 3rd occipital nerve, atlanto-occipital joint restrictions)
  • Atlanto-axial (capitus oblique inferior, captifs oblique superior, levator scap, middle scalene, greater occipital nerve, atalnto-axial joint rotation restrictions)
  • Mid-cervical joints (C3-C6) (anterior scalene, middle scalene, post scalene, levator scapulae, Median Nerve, Radial Nerve, Ulnar Nerve, individual nerve roots, mid-cervical closing restrictions, mid cervical opening restrictions, uncovertebral joint restrictions)
  • Cervico-Thoracic joint (levator scap, anterior scalene, middle scalene, post scalene, serrates posterior, rhomboids, 1st rib restrictions, 2nd rib restrictions, CTJ closing restrictions CTJ opening restrictions)
  • Thoracic- Spine (Trapezius upper/middle/lower, PVSMs, Rhomboids, longissimus cervicis, TX PVSMs, Thoracic facet joint restrictions, costovertebral inhalation/exhalation restrictions)

Upon completion of this course participants will confidently be able to:

  • Consider mechanism of injury for the patient and how the injury can affect the cervical spine/ thoracic spine mechanics, functional ADL restrictions and overall movement dysfunction.
  • Consider safety implications of the cervical spine and be able to perform upper cervical instability testing, vertebral artery testing, and appropriate history taking to rule out possible contraindications.
  • Perform specific differential diagnoses of the cervical and thoracic spine via segmental mobility testing to implement a focused corrective strategy.
  • Integrate surface anatomy palpation and layered anatomy application for safety considerations when inserting a dry needle into a patient.
  • Utilize muscle origin, insertion, and action to confirm needle placement.
  • Considering structural and soft tissue anatomy, appropriately insert a dry needle and consider depth and angle for application of safe and effective intervention to address patient complaints and therapist expected outcomes,
  • Demonstrate a continuum of manual therapy mobilizations, manipulations, and muscle energy techniques to address cervical and thoracic spine joint restrictions.
  • Demonstrate proficient instruction of corrective exercises to improve carry over of manual interventions.
  • Be able to thoroughly explain an assigned case study including differential diagnosis, appropriate intervention including mobilization and dry needling to achieve a favorable outcome.
  • Demonstrate techniques in a practical exam

All supplies necessary for the course will be provided with the following exception:

  • If you have a latex allergy, it is recommended for you to bring your own gloves for use during lab. A latex free option is available for use, but supplies are limited based on the number of people with an allergy. Therefore, it is recommended to bring a box of latex free gloves with you for use.

Course Supplies Requirements:

  1. An anatomy reference
    1. Human Anatomy Atlas for iPad/iPhone/Android - $24.99 App Store
      1. You should have received the code for a free one-year download after taking the Foundations for Dry Needling. If code has expired, please contact us for an updated code: info@structureandfunction.net

Prerequisites:

  • Structure and Function’s Foundations in Dry Needling for Orthopedic Rehabilitation and Sports Performance
  • Other medical licensing per below. Professionals who may take this course include:
    • Physical Therapists
    • Athletic Trainers
    • Chiropractors
    • Medical Doctors
    • Doctors of Osteopathic Medicine
    • Physician Assistants
    • Nurse Practitioners
    • If you do not see your health care profession listed, or practice outside of the United States, please contact Sue Falsone directly for more information.

Required Reading:

  1. Dunning J, Buts R, Mourad F, Young I, Flannagan S Perreault T. Dry needling: a literature review with implications for clinical practice guidelines. Phys Ther Rev. 2014;19(4):252-65
  2. Perreault TD, J. Butts, R. The local twitch response during trigger point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2017;47(3):133-49

Suggested Reading:

  1. Dung, H. Acupuncture: An Anatomical Approach. 2nd Edition. CRC Press: Boca Raton, FL; 2014.

Recommendations:

Each Therapist is to bring a concise summary of a current or former challenging cervical/ thoracic spine patient that they have treated and will discuss alternative strategies for pain management and return to function.

You will receive an email 7-10 days prior to the course you register for with the fol-lowing:

  1. Any course specific instructions such as location reminder, parking instructions etc.
  2. A code for the Visible Body App
    1. Instructions for the use of this code will be provided at that time. Please be sure to download and successfully access this app prior to class.
  3. Log-in information and instructions for the back end of www.structureandfunction.net
    1. This log in information will allow you to access power points, class forums, helpful forms, etc
    2. Please be sure to log in successfully to the back end of the website prior to class

For more information on CEU approval, please click here

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