Advanced Dry Needling to the Cervical and Thoracic Spine (SFDN-CTS)

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, cervicothoracic 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.

Click HERE to view our Course Map to understand how pre-qualification works for course registrations.

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)

**Attendance Policy – Prior to registering for the course, make sure you are able to attend the entire weekend. Exceptions to this rule will not be allowed. For more details, please see the cancellation and attendance policy.

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

Prerequisites:

• SFDN1 – 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 healthcare profession listed, or practice outside of the United States, please contact us for more information.

Required Reading:

1. Acupuncture Effect and Central Autonomic Regulation. Qian-Qian Li
   • Qian-Qian Li, Guang-Xia Shi, Qian Xu, Jing Wang, Cun-Zhi Liu, Lin-Peng Wang. Acupuncture Effect and Central Autonomic Regulation. Evid Based Complement Alternat Med. Evid Based Complement Alternat Med. 2013; 2013: 267959.
2. Does acupuncture help patients with spasticity? A narrative review. Zhu Y
   • Zhu Y, Yang Y, Li J Does acupuncture help patients with spasticity? A narrative review. Ann Phys Rehabil Med. 2019 Jul;62(4):297-301. doi: 10.1016/j.rehab.2018.09.010. Epub 2018 Nov 5.
3. Pertinent dry needling considerations for minimizing adverse effects. Halle JS
   • Halle JS, Halle RJ. Pertinent dry needling considerations for minimizing adverse effects – PART ONE. Int J Sports Phys Ther. 2016;11(4):651-662.

Suggested Reading:

1. Anatomy for the acupuncturist–facts & fiction 1: the head and neck region. Peuker E
   • Peuker E, Cummings M. Anatomy for the acupuncturist–facts & fiction 1: the head and neck region. Acupunct Med. 2003 Jun;21(1-2):2-8.
2. Anatomy for the acupuncturist–facts & fiction 2: the chest, abdomen, and back. Peuker E
   • Peuker E, Cummings M. Anatomy for the acupuncturist–facts & fiction 2: the chest, abdomen, and back. Acupunct Med. 2003;21(3):72–79.

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.

Required Course Supplies:

1. An Anatomy Reference – Preferred references below, however any anatomy reference will be acceptable.
   1. Visible Body – Human Anatomy Atlas app.
   2. Trail Guide to the Body 5th Edition
   3. Palpation Techniques: Surface Anatomy for Physical Therapists
2. Portable TENS Unit
   1. Analog 250 TENS unit
   2. Alligator Clips
3. If you have a latex allergy, it is recommended for you to bring your own gloves for use during lab.

You will receive an email prior to the course you register for with the following information:

1. Any course specific instructions such as location reminder, parking instructions, course check-in times, etc.
2. Log-in information and instructions for your account on the online education platform
   1. Your account information will allow you to access power points, class forums, course resources, course certificate, etc.
   2. Please be sure to log in successfully to the back end of the website prior to class

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