Post Graduate Physical Therapy

Post Graduate Course Offerings

YOUR INSTRUCTOR

Robert C. Grossman, PT, OCS graduated in 1981 from the physical therapy program at the University of Maryland Medical School as its valedictorian.  He is board certified as a clinical specialist in orthopaedic physical therapy by the American Board of Physical Therapy Specialists.  He was chairman of the Southern Maryland Orthopaedic Study Group for a decade.  Since his graduation, he has practiced in a number of settings, eventually landing in private practice.  Since 1987 he has practiced at his clinic, Sports and Orthopaedic Therapy Services in Silver Spring, Maryland.

Through the years Mr. Grossman has studied various manual therapy approaches and incorporates their evaluation and treatment procedures where appropriate.  He was given the opportunity early in his career to study with and has taken courses from many osteopathic physicians, and they have left a strong impact on his evaluation and treatment style. He has taught many post graduate continuing education courses across the country including those organized by the Maryland APTA, through the group Chesapeake Clinical Resources, and other organizations.  The topics of these courses vary from evaluation and treatment of somatic dysfunction of the spine and extremities, to assessment and treatment of altered neurodynamics, myofascial release, and positional release.  He has developed new techniques in which he provides instruction called “Closed Chain Manipulation”.  The techniques are used to treat movement restrictions primarily as the result of connective tissue inextensibility.  They are based on the research-based osteokinematics and arthrokinematics of the respective regions of the body.

Mr. Grossman has been teaching postgraduate continuing education classes for over 30 years.  Numerous group practices have availed his services in providing their physical therapy staffs with a cost effective method of reaching their continuing education needs.  He has provided these classes at his clinic in Silver Spring, Maryland, or if the client prefers, he will travel to their destination and provide the learning experience on site.  An obvious benefit for the clinic’s bottom line is decreased cost associated with travel and lodging when their employee is sent to the course.  Another benefit to the clinic occurs when all of the staff is trained in a similar manner, as they may communicate more effectively amongst themselves and also can overlap more easily regarding patient care when a clinician is out of the office.

His clinic in Silver Spring, Maryland has available space to educate up to 18 participants during any of the 2 day seminars.  Small groups allow for greater interaction with the instructor.  This is imperative since all courses consist of palpatory assessment and manual therapy as the primary treatment modality.  All courses begin with a review of his philosophy of care and physiological rationales for the processes which maintain the patient in their dysfunctional state, causing their continued pain and functional deficits.

Benefits:

  1. Cost Effective
  2. Consistent Methodology of Evaluation and Treatment
  3. Effective Manual Therapy Approaches including Closed Chain Manipulation
  4. Improved Rationale for Treatments

Two Day Course Offerings:

Assessment and Treatment of the Upper Quarter: Closed Chain Manipulation

Course Description

With a precise understanding of anatomy and biomechanics of the kinetic chain, restoration of movement of joints in dysfunction is enhanced.  A new technique utilizing specific positioning and patient activation is introduced – “Closed Chain Manipulation.”  These techniques will allow the therapist to provide the patient with a powerfully effective manipulation of any articulation with greater ease for the therapist to perform than typical open chain mobilizations.  “Closed Chain Manipulations” are safe to employ in either acute or chronic conditions.  In this two day seminar the participant will gain increased knowledge of the articulations through their anatomy and biomechanics, followed by specific assessment techniques to identify dysfunctions of the related joint and ligamentous tissue.  “Closed Chain Manipulation” techniques are instructed and practiced which the instructor has found effective in the treatment of altered movement characteristics of the selected articulations.  Self care exercises utilizing the fundamental principles of Closed Chain Manipulation are addressed.

Behavioral Objectives

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

  1. State the mechanical process by which Closed Chain Manipulations affect the connective tissue elements of the body.
  2. State the arthrokinematic and osteokinematic relationships of the articulations covered in the course.
  3. Perform a manual assessment to identify somatic dysfunctions of the selected articulations.
  4. Utilize Closed Chain Manipulations in the treatment of altered movement characteristics of the various articulations.
  5. Devise appropriate home exercises utilizing the concepts of Closed Chain Manipulations.

Assessment and Treatment of the Lower Quarter: Closed Chain Manipulation

Course Description

With a precise understanding of anatomy and biomechanics of the kinetic chain, restoration of movement of joints in dysfunction is enhanced.  A new technique utilizing specific positioning and patient activation is introduced – “Closed Chain Manipulation.” These techniques will allow the therapist to provide the patient with a powerfully effective manipulation of any articulation with greater ease for the therapist to perform than typical open chain mobilizations.  “Closed Chain Manipulations” are safe to employ in either acute or chronic conditions.  In this two day seminar the participant will gain increased knowledge of the articulations through their anatomy and biomechanics, followed by specific assessment techniques to identify dysfunctions of the related joint and ligamentous tissue.  “Closed Chain Manipulation” techniques are instructed and practiced which the instructor has found effective in the treatment of altered movement characteristics of the selected articulations.  Self care exercises utilizing the fundamental principles of Closed Chain Manipulation are addressed.

Behavioral Objectives

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

  1. State the mechanical process by which Closed Chain Manipulations affect the connective tissue elements of the body.
  2. State the arthrokinematic and osteokinematic relationships of the articulations covered in the course.
  3. Perform a manual assessment to identify somatic dysfunctions of the selected articulations.
  4. Utilize Closed Chain Manipulations in the treatment of altered movement characteristics of the various articulations.
  5. Devise appropriate home exercises utilizing the concepts of Closed Chain Manipulations.

Assessment and Treatment of Altered Neurodynamics of the Upper and Lower Quarter

Course Description

Since 1991 when David Butler published his groundbreaking book “Mobilization of the Nervous System” there has occurred a fundamental change in the way physical therapists evaluate and treat upper and lower quarter pain presentations.  Mr. Butler was instrumental in taking the work of Alf Breig, M.D., and others who had studied the nervous system and its connective tissue coverings and making it useful in the assessment of the extensibility of the nervous system.  Years ago it was considered inappropriate to place tension on the nervous system.  Since this time, it has become common for physical therapists to evaluate and treat patients who demonstrate objective findings indicative of restricted neurodynamics.  This course is designed to allow the participants to better understand the pathophysiology of altered neurodynamics and as a result, determine the most appropriate treatment technique which will resolve the dysfunction.  Coursework will provide the participants with the ability to assess manually for the area of greatest restriction within the pathway of each terminal branch of the plexi in the upper and lower quarter.  Participants will learn methods of direct and indirect treatment to address these areas of restriction, as well as develop home programs appropriate for these conditions.

Behavioral Objectives

At the end of the course, participants will be able to:

  1. Perform/demonstrate testing to identify the presence of abnormal movement of the nervous system for the terminal branches of the brachial plexus, lumbar plexus, sacral plexus, and L4 trunk.
  2. State the two most common pathohysiological processes by which somatic dysfunction are maintained.
  3. State the appropriate treatment approach for patients who present with reactive versus chronic altered neurodynamics.
  4. Perform/demonstrate palpatory assessment to identify tissue texture abnormality in the area of greatest restriction within the pathway of the terminal branches of the brachial plexus, lumbar plexus, sacral plexus, and L4 trunk.
  5. Learn, discuss and practice direct and indirect treatment approaches that may assist in normalizing patients extensibility when they present with altered neurodynamics.
  6. Name the pathways and entrapment sites for all terminal branches of the upper and lower quarter.
  7. Identify how the proximal relationship of the nervous systems is affected by spinal motion and how this relationship affects distal movement patterns of tension of the peripheral nervous system.

Pre-seminar and post-seminar written test questions will be used to assess class participant competency

Assessment and Treatment of the Cervicothoracic Spine and Rib Cage

Course Description

This two day seminar is designed to allow clinicians to effectively evaluate and treat the subcranial, midcervical, and upper thoracic spine.  A muscle energy model of assessment and treatment will be employed.  The strong influence in dysfunctional movement patterns in the spine and extremities caused from restricted neurodynamics, will also be addressed.  The basis of any regional assessment approach requires a thorough understanding of anatomy and biomechanics and will be an emphasis in this course.  Home programs which help maintain and gain movement from a neuromuscular and articular perspective will be discussed.  By course end, each participant will have a refined ability to make a correct functional diagnosis and effectively treat the dysfunctions noted on examination, thereby restoring pain free and friction free motion to the cervicothoracic spine.

Behavioral Objectives

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

  • State the diagnostic criteria for identifying a somatic dysfunction within the Cervicothoracic spine.
  • Identify through palpation of anatomical landmarks and movement restrictions, a diagnosis of Cervicothoracic and/or common rib cage somatic dysfunction.
  • Position patients and either use muscle energy or counterstrain to treat somatic dysfunctions of the cervical spine, upper thoracic spine, or rib cage.
  • Demonstrate appropriate home exercises to address movement restriction of the cervicothoracic spine.
  • State the two most common pathohysiological processes by which somatic dysfunction are maintained.
  • Clinically examine for restriction in the nervous system.
  • Plan and administer direct treatment to altered neurodynamics affecting the area of greatest restriction as it affects the roots, trunks, brachial plexus and its terminal branches.

Method of assessment will be a pre and post test format.

Format of the course will be didactic lectures and laboratory, 2/3 of course will be laboratory with a high instructor to student ratio

Assessment and Treatment of the Thoracic Spine and RIB Cage

Course Description

This two day seminar examines the movement behaviors of the thoracic spine and the rib cage.  Pain which occurs in the thoracic spine may be from visceral origin and needs to be ruled out from that coming from somatic structures of the thoracic spine and cage.  This will allow for proper referral when assessment does not correlate with dysfunction of the somatic structures of the spine and cage.  Anatomical and biomechanical considerations are paramount in understanding the dysfunctions which will be treated in the course.  Muscle energy, strain/counterstrain, and manipulation techniques will be presented and practiced in the laboratory sessions of the course.  At the end of the course each participant should be able to identify and correctly diagnose, as well as treat all of the common somatic dysfunctions of the thoracic spine as well as structural rib restrictions, inspiratory and expiratory rib restrictions, and torsional rib restrictions.

Behavioral Objectives

At the end of the course, participants will be able to:

  1. State the diagnostic criteria for identifying a somatic dysfunction within the thoracic spine and rib cage.
  2. Identify through palpation of anatomical landmarks and movement restrictions a diagnosis of somatic dysfunction of the thoracic spine and cage.
  3. State the two most common pathohysiological processes by which somatic dysfunction are maintained.
  4. Position patients and either use muscle energy or counterstrain to treat somatic dysfunctions of the thoracic spine and cage.
  5. Demonstrate appropriate home exercises to address movement restriction of the thoracic spine and cage.
  6. State the arthrokinematic and osteokinematic relationships of the articulations covered in the course.

Assessment and Treatment of the Lumbo-Pelvic-Hip Girdle

Course Description

This two-day course examines ilio-sacral and sacro-iliac movement behaviors in conjunction with those of the lumbar spine which may present as somatic dysfunctions.  An osteopathic muscle energy model for assessment will be presented which will provide the participants with a framework for identifying the various types of somatic dysfunctions noted in this region.  Anatomical and biomechanical considerations are paramount in understanding the dysfunctions which will be treated in the course.  Muscle energy, strain/counterstrain, and manipulation techniques will be presented and practiced in the laboratory sessions of the course.  At the end of the course each participant should be able to identify and correctly diagnose, as well as treat all of the common ilio-sacral, sacro-iliac, and pubic symphysis lesions typically seen in an outpatient orthopedic facility.

Behavioral Objectives

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

  1. State the diagnostic criteria for identifying a somatic dysfunction within the pelvic girdle.
  2. Identify through palpation of anatomical landmarks and movement restrictions a diagnosis of pelvic girdle somatic dysfunction.
  3. Position patients and either use muscle energy or counterstrain to treat somatic dysfunctions of the pelvic girdle.
  4. Demonstrate appropriate home exercises to address movement restriction of the pelvic girdle.

Method of assessment will be a pre and post test format.

Format of the course will be didactic lectures and laboratory, 2/3 of course will be laboratory with a high instructor to student ratio.

Assessment and Treatment of the Shoulder Girdle: Closed Chain Manipulation, Counterstrain, and Muscle Energy Procedures

Course Description

This two day seminar is designed to give clinicians a thorough understanding of assessment and treatment techniques to effectively normalize function of both intrinsic and extrinsic components of the shoulder girdle.  The ability to assess and accurately state the functional diagnosis at any region of the body is essential for effective treatment.  The intrinsic components of the shoulder girdle consist of the upper thoracic spine, sternoclavicular joint, acromioclavicular joint, scapulothoracic physiological joint, and the glenohumeral joint.  Each articulation will be discussed in detail from an anatomical and biomechanical perspective allowing the clinician to better evaluate each are in order to assess if for dysfunctional movement patterns.  Extrinsic components of the shoulder girdle will also be discussed.  Treatment procedures will be instructed to normalize function through utilization of muscle energy, counterstrain, and closed chain manipulation.  Home programs which assist and maintain gains in movement made from clinical treatment are given that address both neuromuscular control and articular restriction.

Behavioral Objectives:

By the completion of the course, participants will be able to:

  1. State the arthrokinematic and osteokinematic relationships of the articulations covered in the course.
  2. State the mechanical process by which Closed Chain Manipulations affect the connective tissue elements of the body.
  3. Perform a manual assessment to identify somatic dysfunctions of the selected articulations
  4. Devise appropriate home exercises utilizing the concepts of Closed Chain Manipulations
  5. State the two most common pathophysiological processes by which somatic dysfunction are maintained.
  6. Devise appropriate home exercises utilizing the concepts of Closed Chain Manipulations.
  7. Acknowledge the impact from intrinsic and extrinsic structures on motion abnormalities at the shoulder girdle.

Method of assessment will be a pre and post test format.

Format of the course will be didactic lectures and laboratory, 2/3 of the course will be laboratory with a high instructor to student ratio.

 

 

Seminar Fees and Expenses

$1250 per day of instruction

Travel Expenses – I prefer to make my own travel arrangements because I will know my schedule better than will you.  I will always try to fly in the evening before the seminar will be given.  I will always choose to fly Southwest Airlines (if possible) which has reasonable fares.  This can be accomplished two ways: either I receive a ticket bought by the facility or I can purchase the ticket and then be reimbursed by the facility.  The problem arises if I have purchased the ticket and then somehow or other the course needs to be cancelled.  Airline Tickets are frequently non-refundable now, making the facility responsible for any costs I might have incurred regardless if the course is cancelled.  If I have to travel via car to the facility I will expect to be reimbursed for the usual and customary mileage expense as put forth by the IRS which as of January 1, 2010 is 50 cents per mile.

Per Diem Expenses –

  1. Lodging- The facility can save money when I stay at the home of one of the participants or organizers, otherwise I expect to be staying at a hotel/motel of first rate quality near the seminar location.  All courses are two days, so lodging will need to be arranged for two days, usually the Friday before and Saturday with intention of leaving on the evening of Sunday.  Sometimes, I will wish to stay over an additional day to do sightseeing, etc and the facility will not be responsible for covering any of my additional expenses.  I also sometimes travel with my wife, and obviously any expenses incurred by her would not be the responsibility of the facility.
  2. Transportation to and from the teaching site can be accomplished without my hiring a car or renting one for the weekend.  Often the hotel will have a courtesy car, but if one is not available and no one will transport me to and from, then the cost of car rental would have to be reimbursed.
  3. Food– $50.00 per day covers my nourishment requirements.

Groups using my facility to put on the seminar will pay an additional $350 to rent my office.  Break snacks will be the responsibility of the group hiring me to provide the seminar.

Mr. Grossman encourages the facility to advertise the course (if they do not have more than 18 participants) in the local community so they may defray some of their costs by charging outside professionals to attend the course.  I would recommend a charge of between $350-450 per participant for the two day courses.  The maximum number of participants should be in a range from 12-18 to allow for a greater student-teacher ratio.

For this type of laboratory course, it is best to limit the number of participants to 16 to 18.  Each couple of participants should have access to a treatment plinth, meaning that a minimum of eight to nine plinths would be best.  The instructor will also require an LCD projector for delivering the didactic portion of the course from a PowerPoint presentation.  The course organizers are also responsible for any laundry needs, pillows, and course refreshments during breaks.  Lunch time can be modified from 30 minutes to one hour and is the responsibility of each participant.  If the facility is unable to provide adequate treatment plinths, etc., Mr. Grossman’s outpatient facility can be used for a small fee to be determined later.  This course will have a total of 14 contact hours equaling 1.4 CEU’s

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