STS Peripheral Mobilisations 9 hours Certificated Course
Peripheral joint assessment techniques and Graded mobilisation techniques will be taught on the following areas – Acromio-Clavicular Joint, Shoulder, Elbow, Wrist, Hip, Knee and Ankle.
A Mulligans / traction belt and hard copy manual is included in the course to use and take away following the course.
This course is delivered by David Jenkins BSc(hons) DipSpTh, MSST who has over 20 years experience in professional sports, private practice and in 2017 worked full time for 4 months on set and with a credit as the main cast therapist on the Netflix Film “Outlaw King”. Where due to the physical requirements of the filming, manual therapy techniques were used daily to ensure the cast could act, horsehide and sword fight in full medieval costume with minimal discomfort.
Mobilisation Techniques similar to those used when David worked in professional sports and now applies them to his clients in private practice. A Scottish School of manual Therapy traction belt will be supplied for each candidate to use and keep following the course.
David has over the years and when last year working on “Outlaw King” had the opportunity to apply these techniques daily over a 4 month period with the same cast members therefore measure the successful outcome and order the techniques should be applied.
Who can attend ?
This certificated CPD course is designed for Health Care Professionals qualified and already in clinical practice as a one of the following – Sports Therapist , Physiotherapist, Massage Therapist, Remedial Therapist and Neuromuscular Therapist or currently studying any of the previous mentioned professions. A working knowledge of physiology and anatomy is recommended. Get in touch if you are unsure. Please check with your insurance company that you will be insured to use these techniques on completion of the course.
Course E-manual and traction / physio belt will be supplied for each candidate.
Outline of The Course –
Examination and Assessment Protocols
Before applying a mobilisation technique we have to have a clinical reasoning for each techniques application and hopeful outcome. David will show Musculoskeletal Examination and Assessment techniques for all the joints covered in the course.
Mobilisations, Manual Therapy and Belt Techniques.
- SSMT Grade Mobilisations I,II,III + IV
Clinical Reasoning of Mobilisation Techniques
David will discuss the following as they arise during the course and again at the end of the course,-
- Which techniques should be used following results of the examination and assessment.
- What is the expected physiological response to each technique and what should the outcome be after application.
- Which techniques can be applied pre, post and during sporting events or how to include these techniques into your current practice.
This course as others we run is very practical in nature and you should be physically fit enough to practice these techniques and have them applied during the course. We run this with a maximum of 8 candidates and we are happy to take a deposit to hold your candidate place.
Please note if you book a course with us and cancel within a week of the course start date, we cannot guarantee a refund unless another candidate is found to fill your slot. In certain circumstances we are happy to transfer you to another date or offer attendance on another to the same value of your course. We do understand things happen at short notice so we will always try and accommodate when this happens.
Course investment £400.00
repositioning of one articular surface on its partner with a movement or function.
We always now, when teaching our MWM techniques begin with the When MWMS are applied as an assessment they will tell you immediately they are indicated as a treatment when they have a
There will be no pain felt by the patient with the sustained mobilisation (repositioning) and there will be no pain with the movement taking place.
There will be an immediate improvement in the function being undertaken.
L….Lasting: The improvement gained must be long lasting.
If you do not get the PILL effect, MWMs are not indicated. There is no exception to this rule. However having said that, the good result obtained at the time of delivery may not be retained due to the patient not complying with activity advice given. Because MWMS are never used as a treatment when you do not get the PILL effect one could never be criticised for teaching them and because they are pain free they are safe. This is important in countries where litigation is a thriving industry.
To correctly reposition joint surfaces you need excellent handling skills and knowledge. It is helpful here to remember the
MWMS are a form of manual therapy and thus the contraindications that apply to manual therapy apply to MWMs.
If on applying an MWM it has the desired PILL effect then you would repeat the technique several times. With extremity joints you can apply up to three sets of ten (use common sense).
With spinal joints it is often prudent to just do three repetitions on day one as sometimes after any form of manual therapy the patient can get a latent reaction.
To get the maximum benefit from an MWM you need to apply overpressure. This of course is passive and may be applied by the therapist, patient or a third party.
C…Communication with patient:
The patient must know what you are doing and why you are doing it. You need their cooperation to ensure success. They must for instance tell you immediately if they feel any discomfort. I would not treat a patient that I could not communicate with. You might need an interpreter.
You must be able to sense the movement you are undertaking. This means you need good handling skills. Another sense is common sense and when handling patients
When you reposition joint surfaces, maintain that correction throughout the movement. Start to finish. (Refluxing!)
Today they can be used successfully on all parts of the body. I believe that that the sustained mobilisation corrects minor positional faults. These faults are so insignificant that they are rarely palpable or visible on x-ray. The big exception to this is the shoulder girdle where the scapula can be visibly seen to be sitting irregularly when compared with the other side*. In a study by three American authors they found x-ray evidence of Fibular positional faults in patients with chronic instability of the ankle and there have been other articles published on this subject.
PRINCIPLES OF MWM TREATMENT
- During assessment the therapist will identify one or more objective signs may be;; a loss of joint movement, pain associated with movement, or pain associated with specific functional activities.
- A passive accessory joint mobilizsation is applied following the principles of Kaltenborn (i.e. parallel or perpendicular to the joint plane).
- ensure no pain is recreated. Utilising his/her knowledge of joint arthrology, a well-developed sense of tissue tension and clinical reasoning, the therapist investigates various combinations of glides to find the correct treatment plane and grade of mobilisation.
- While sustaining the accessory glide, the patient is requested to perform the objective sign, which should now be significantly improved.
- The application of overpressure at the end of available range is necessary for lasting improvement.
- The patient typically undertakes 3 sets of 10 pain-free repetitions of the previously provocative movement to promote lasting improvement.
- Failure to improve the objective sign would indicate that the therapist has not found the correct treatment plane, grade or direction of mobilisation, spinal segment or that the technique is not indicated.
Indications: restricted and/or painful movement Guidelines:
- Produce NO PAIN search for direction
- Expect immediate alteration in range of motion
- Use minimum force necessary
- Sustain mobilisation without restricting movement
- Perform repetitions
- Apply overpressure
- Teach self-MWMS
- Tape to sustain positional correction
If symptoms remain unchanged after MWM, it could be
- Improper technique application, try changing
mobilisation direction, force or location
- Incorrect joint selection (i.e. shoulder MWM vs. C4
- Incorrect spinal level
- Poor handling skills
- Poor communication with the patient
- Technique is not indicated
- which may be relieved by using a foam pad
Joint Mobilisation Grading Scale
- Grading based on amplitude of movement & where within available ROM the force is applied.
- Grade I
– Small amplitude rhythmic oscillating movement at the beginning of range of movement
– Manage pain and spasm
- Grade II
– Large amplitude rhythmic oscillating movement within midrange of movement
– Manage pain and spasm
- Grades I & II –often used before & after treatment with grades III & IV
- – Large amplitude rhythmic oscillating movement up to point of limitation (PL) in range of movement
- – Used to gain motion within the joint
- – Stretches capsule & CT structures • GradeIV
- – Small amplitude rhythmic oscillating movement at very end range of movement.
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