II edition

Course Content:

·         Why treating functional deficits of the cerebellum, vestibular system and brainstem is vitally important when dealing with any patient in pain. We will discuss in detail how to maximize the nervous system's ability to modulate pain, and how to avoid further pain sensitization.

·         How anything from a painful neck muscle to dry eyes, sinus or TMJ problems, Asthma or heartburn can contribute to headaches through sensitisation of the trigeminal pain pathway.

·         Why adjusting an upper cervical spinal fixation can sometimes alleviate a headache, but at other times can make it much worse. We will discuss how to detect and manage mechanical allodynia and how to treat a patient appropriate to their brain imbalance and neuronal metabolic capacity.

·         What cortical spreading depression is; how it relates to migraine, and how to prevent it from happening.

·         Nutritional strategies for headache, migraine and chronic pain patients.

·         How to address functional neurological problems using your existing techniques.

·         Novel treatment interventions to address brain imbalances, including coupled-motion adjusting, fast-stretching, proprioceptive- and vestibular stimulation. Various physical and mental exercises designed to activate different regions of the brain will be explained and demonstrated.
·         We will also show you sinus release techniques, which are invaluable for many headache patients.

·         How to improve your assessment and treatment of brain dysfunction with emphasis on the cerebral cortex, basal ganglia  and limbic system.

·         Review of the effects of joint manipulation and other manual therapies on brain function.

·         Review of the effects of brain dysfunction on the musculoskeletal system.

·         How dysfunction at a cortical and subcortical level has a major influence on pain sensitivity and pain tolerance.

·         Introduction to specific conditions affecting cortical and subcortical regions, including depression, anxiety, dyslexia, dyspraxia, attention deficit disorder, epilepsy and dystonia.

·         Assessment and treatment of 'subclinical' disorders of cortical and subcortical regions, such as word finding difficulties, problems remembering names or recognising faces, poor navigational skills, sensory abnormalities, light or sound sensitivity, motor or vocal tics, perfectionist or obsessive tendencies, reading difficulties and various frontal lobe problems listed under the next bullet point.

·         Use of specific eye movement exercises to:

o    change abnormal head tilts/rotations

o    improve spatial awareness of different body parts in order to increase conscious proprioception and reduce pain

o    improve the reading ability of people in whom often undiagnosed oculomotor problems are causing 'dyslexic' tendencies

o    help rehabilitate frontal lobe problems, such as poor concentration or attention, difficulty learning new information, emotional problems, behavioural disturbances, motivation issues and forward thinking difficulties

·         Blind-spot testing as a window into cortical function and an outcome measure of therapeutic interventions.

·         Use of light, sound and smell as therapeutic modalities.

·         Low-tech physical and cognitive exercises to address specific patterns of brain dysfunction

·         Computer programmes and smart phone / tablet apps that can be used to rehabilitate different brain areas. 

Soft tissue injury and alteration of spinal biomechanics after whiplash and mild traumatic brain injury.

·         Common peripheral and central neurological manifestations of head and neck injuries.

·         The three pathophysiological subtypes of concussion as described in recent indexed scientific literature, which will help direct your treatment and formulate a more accurate prognosis.

·         What questions to ask and what examination procedures to perform to avoid missing often subtle neurological compromise that can have long-term detrimental effects on the patient's life.

·         Why people who have suffered a head/neck are often grumpy, unable to concentrate and frequently have difficulty sleeping for weeks after the injury - and it is not solely related to being angry about the damage to their car or the stress of having to deal with insurance companies.

·         Why it is not uncommon for brand new symptoms to appear several weeks after a whiplash injury, e.g. low back pain, dizziness or paraesthesia.

·         Factors that help predict recovery times and long-term outcome (with literature references) - very useful when arguing a medico-legal report.

·         Therapies to treat acute and chronic head and neck injuries, including physical modalities, tissue offloading, proprioceptive and vestibular rehabilitation, and cognitive therapies.

·         Nutritional approaches and other strategies to reduce neural inflammation in whiplash and mild traumatic brain injury.

·         Practicals throughout the day will provide opportunity to learn examination and treatment procedures.

·         Review of the cerebellum, vestibular system as well as vestibulospinal, vestibulo-ocular and vestibulo-autonomic projections.

·         How to assess for proprioceptive, vestibular and ocular abnormalities without spending thousands on high-tech equipment.

·         How to assess and treat various different causes of head tilt and other abnormal head or body posturing.

·         Why spinal dysfunction or pain that develops as a consequence of vestibular-induced postural or muscle imbalances is unlikely to respond to adjusting alone and usually requires vestibular rehabilitation to achieve more complete recovery.

·         Why adjusting to reduce spinal stiffness in the presence of vestibular dysfunction frequently produces greater post-treatment pain and sensations of disequilibrium, vertigo or dizziness.

·         A detailed approach to specific individualized vestibular and proprioceptive rehabilitation that does not over-stimulate the patient, cause unpleasant side effects or take up hours of their day.

·         Assessment & treatment considerations for specific conditions

o    Benign Paroxysmal Positional Vertigo (BPPV)

o    Cervicogenic vertigo

o    Vestibular migraine

o    Motion/travel sickness

o    POTS (positional orthostatic tachycardia syndrome)

o    Visual vertigo (e.g. supermarket aisles, watching fast-moving objects or movement on screens)

·         Why vestibular stimulation is incredibly valuable for patients with a wound-up sympathetic nervous system.

·         The association between vertigo/balance disorders and anxiety.

·         Various case studies to help put the material into clinical context.

Comprehensive review of the functional roles of the basal ganglia and cerebellum within the motor system.

The concept of surround inhibition for fine motor control.

Neurological wind-up as a consequence of basal ganglionic and cerebellar cortex dysfunction; how this can adversely affect patients both neurologically and in terms of their general health, how this manifests clinically, and how to manage it. 

How proprioceptive deficits and central sensory processing problems interfere with proper control and coordination of movement, and how this contributes to musculoskeletal and movement disorders. 

Musculoskeletal consequences, abnormal movement patterns and injury susceptibility related to basal ganglionic and cerebellar dysfunction. 

How to rehabilitate fine motor control and movement timing with easy-to-prescribe no-tech exercises

Cognitive consequences of basal ganglionic and cerebellar dysfunction, and how this relates to conditions such as anxiety, OCD, depression and various childhood developmental disorders. 

Treatment strategies for hyperkinetic movement disorders, including surround inhibition training, specific sensory afferentation, sensory tricks and visuo-sensory therapy. 

Special considerations for cervical dystonia. The Parkinson's patient - strategies to preserve their functional capacity for as long as possible.

Movement necessitates postural stabilisation. Whether a person is simply walking, working on a computer, performing household activities or participating in high-level sports, appropriate stabilisation of the moving joints and the body as a whole is required to prevent falls, injuries and loss of strength for the movement in question.This seminar will discuss dynamic postural stabilisation in detail and show you how to assess and rehabilitate it. We will also explore how to determine whether the neurological imbalances you find in a patient are likely to be significantly contributing to their musculoskeletal condition; this will help you to distinguish between the musculoskeletal patients who simply require the 'usual' chiropractic approach and those who require more specific neuro-rehabilitation

Dynamic postural stabilisation:

The relationship between postural stabilisation and musculoskeletal injury

Assessment of the systems involved and how to train them to function better - sensory, motor and central sensorimotor integration and processing

Rehabilitation of neurologically-mediated dynamic postural destabilisation

Falls in the elderly: causes, prevention and rehabilitation strategies

How to determine whether or not the neurological imbalances you find in a patient are contributing to their musculoskeletal problem: The concept of neurological challenges in motor assessments.

The material is relevant to a broad spectrum of paediatric patients; from babies with feeding and gastrointestinal dysfunction, children with postural and coordination problems, to children with learning disorders. Delayed development is common, affecting 10% of children born in the last decade. In addition to teaching you the clinical skills needed to treat these conditions, we will provide you with the understanding and the 'language' that will enable you to effectively communicate with parents and teachers. We explores the cortical dysfunction in Dyspraxia, ADD, ADHD (and its subgroups), Dyslexia, Tourette's syndrome, OCD and mild to moderate Autistic Spectrum Disorders

The key learning objectives are: 

What is different about the brains of children with learning and developmental disorders.

How to assess this from baby-age onward so that you can identify problems early.

Ways to promote brain development with manual therapies, neuro-rehabilitative exercises, hemispheric integration and nutritional advice.

Course Content: 

Predisposing factors for neurological developmental delay.

The functional neurological assessment for child development and learning disorders to localise regions of brain dysfunction.

The effects of manual therapies on the developing brain.

Primitive or retained reflexes, and what they tell us.

4 ways to overcome a retained reflex.

Consideration of metabolic and immune factors.

Hemispheric imbalances or functional disconnects in ADD, ADHD, dyspraxia, dyslexia, Tourette's syndrome, OCD and ASD.

Putting this together with case studies to create a treatment programme, which includes:

Manual therapies

Dietary interventions

Home-based exercise

Computer programmes and APPs

Co-management with other health care professionals

And (rather importantly) how to manage and help their parents.