call today: 412.259.5342

Reconciling Biomechanics with Pain Science with Greg Lehman BKIN, MSC, DC, MSCPT

Mar 2019

At its simplest, this is a BIOMECHANICS and PAIN SCIENCE course. Ideally, we've distilled the best of both to get the best approach to pain and injury management.

Reconciling Biomechanics with Pain Science is a two-day course that mixes a lecture, case study and hands-on learning format. This course has been taught throughout the world with the aim of simplifying the biomechanical approach to injury and pain management. A simplified, yet strongly evidenced based biomechanical approach, allows the therapist to develop skills that address all areas of the biopsychosocial contributors to the pain experience.

This course teaches When Biomechanics Matters along with Therapeutic Neuroscience Education in a Biopsychosocial framework.

Traditional rehabilitation practice is steeped in the biomedical model of treating pain and injuries. While the biopyschosocial model of care is touted as being the superior approach it is often difficult to incorporate traditional biomechanical training within this model. There is the fear that therapists become psychotherapists. The aim of this course is to help reconcile and reconceptualize the biomechanical approach. You will learn that you need not throw the baby out with the bath water when you embrace the biopsychosocial (BPS) approach. Remember, the BPS model starts with "Bio": you will learn how biomechanics matters and how pain science education and cognition changing can fit together.

Objectives

Provide a framework to simplify and improve the role of biomechanics and therapeutic neuroscience in the treatment of pain and injury
demonstrate how biomechanical treatments and explanations can address the multidimensional nature of pain
Provide exercise prescription that is informed by biomechanics and therapeutic neuroscience
Learn to different methods of applying therapeutic neuroscience to a traditional biomedically based practice
learn the practical applications of the best research on tendon pathology, symptom modification and graded motor exposure.
This course is great for anyone working with people in pain or injuries. Physiotherapists, Chiros, Massage Therapists , Osteopaths, Sport Therapists, Movement Pros/Teachers and Strength Coaches are welcome.

Price: Early Bird $425.00 (through Feb 13, 2019)

         Regular Pricing: $475.00

        Student/ Less than 2 year Grad   $320.00

PA PT CE: 12 hours (includes 3.5 DA) pending

**Pricing: group discounts always availabe or any extenuating circumstances - please send me an email greglehmanphysio@gmail.com  

Cancellation Policy: Because we know that plans change refunds available if cancelled 3 weeks or more before the course starting date.

**Occasionally, we have to reschedule a course - the latest this would happen would be 4 weeks before the course start. Please do not book your travel arrangements until after that time.

Embody Physiotherapy is located in the Borough of Sewickley, about 12 miles northwest of Pittsburgh. Easy access to Pittsburgh International Airport, I-79, the Ohio and PA turnpikes and other major thoroughfares. A list of nearby hotels and B&B are attached below. 

Embody will provide coffee and tea, water, snacks, and lunch on Sunday. Lunch on Saturday is on your own; there are several convenient small shops for food within several blocks of our practice. 

Course Outline:

This course is a mix of a discussion based lecture, case studies and practical components. The practical components are used with the case studies to “feel” the interventions. However, there no “specific” techniques. Rather, the point is to show that the framework helps the therapist use their own techniques but in a different way. Further, we can then share “techniques” from all participants in the class. Exercises are demonstrated and time is given to practice these exercises. When exploring how Key Messages relate to pain and changing behaviour the practical component helps the therapist use their own experiences and “stories” to fit with the Key Messages of pain and behaviour change.

OBJECTIVES

● Provide assessment techniques to aid in diagnosis and management common musculoskeletal complaints
● Demonstrate how biomechanical treatments and explanations can address the multidimensional nature of pain
● Demonstrate how cognitive restructuring and goal setting of meaningful activities can be used alongside mechanical treatments to address the multidimensional nature of pain
● Provide and teach exercise prescription that is informed by biomechanics and therapeutic neuroscience
● Explain the “pain science” behind common clinical problems and learn methods of applying therapeutic neuroscience education
● Identify and use their current movement based skills within a graded exposure and graded activity paradigm

LECTURES  Day 1

Treatment Fundamentals Lecture (60 minute practical) 9am to 11 am  
● An alternative to the kinesiopathological model of treatment is produced
● A case for simplicity is made
● Clinical reasoning for safety, potential red flags and contraindications to a biopsychosocial approach
● A simplified framework to incorporate both biomechanical treatments with psychosocial treatments is outlined
● a four 15 minute practical exercise break to introduce the concept of comprehensive capacity and graded exposure to:
■ Achilles tendinopathy
■ Comprehensive shoulder exercise prescription
■ Painful hip adduction
■ Painful lumbar spine flexion

When Biomechanics Matters (11am - 1pm)  
● an exploration of the utility and limitations of the biomechanical model in pain and injury management
● introduction to how the current biomedical model can be simplified and modified to be consistent with the best evidence of both pain science and biomechanical science
● Exploration of spine stability theory, scapular dyskinesis and common kinesiopathology models of pain and dysfunction
● A framework for when movement quality is important for pain and injury
● The importance of habit interruption as a rationale for changing movement quality

Expose or Protect: the role of spinal flexion in low back pain and injury (2pm - 3pm)  

Symptom Modification Model of Injury/Pain Management (3:00 to 5pm - Practical 45 minutes)  
● the comprehensive capacity and graded exposure approach to injury and pain treatment will be detailed
● Techniques from various schools of thought (Mulligan, ART, myofascial release, Sahrmann, CFT, tendinopathy research) are demonstrated and reconceptualized to fit into a simpler clinical decision making framework
● We’ve distilled common biomechanical treatments to justify those treatments within an alternative model
● students will learn a framework and simplified clinical reasoning tool to help guide therapy
● Symptom modification as clinical reasoning to guide interventions as demonstrated through case studies
● simplifying both manual therapy, movement based interventions and exercise therapy via understanding the commonalities amongst our most popular interventions
● traditional manual therapy techniques will be reframed to be maximize a biopysychosocial intervention approach
● active and passive approaches to the symptom modification interventions and how these manual therapy approaches are supported by exercise interventions will be taught.

Day 2

The comprehensive capacity model of exercise prescription. (9:00-12 am - practical 30 minutes) 
● A simplified approach to exercise prescription is shown
● The importance of comprehensive capacity and movement options is highlighted and illustrated when it is necessary
● an evidence based approach to understanding pain and rehabilitating common conditions
● an approach to understand the assessment of sensitivity in exercise prescription
● demonstrations of the exercise interventions
● case study autopsies are performed illustration common themes behind various treatment approaches and how a simplified intervention can be effective

● A review of common themes in tendinopathy and how that research can guide much clinical practice

The Point of Pain Science and Key Messages Workshop (1-3 pm) 
● Pain science primer
● Identifying potential false beliefs that might influence pain and disability
● How to deliver Key Messages that are chosen by false beliefs
● Interviewing techniques are illustrated to help change opinions and ultimately change behaviour
● case studies are presented by the class and solved with facilitation from the instructor and the group
● a reconceptualization of common clinical tests is demonstrated to show that much of our current testing can be modified to still be useful
● Specific examples demonstrating how to begin meaningful treatment “when everything hurts” and all manual therapy and exercise therapy has failed

Recommended Reading:

Moseley GL, Butler DS. Fifteen Years of Explaining Pain: The Past, Present,and Future. J Pain. 2015 Sep;16(9):807-13. doi: 10.1016/j.jpain.2015.05.005. Epub 2015 Jun 5. Review. PubMed PMID: 26051220.

Nijs J, Lluch Girbés E, Lundberg M, Malfliet A, Sterling M. Exercise therapy for chronic musculoskeletal pain: Innovation by altering pain memories. Man Ther.2015 Feb;20(1):216-20. doi: 10.1016/j.math.2014.07.004. Epub 2014 Jul 18.

Ng L, Campbell A, Burnett A, Smith A, O'Sullivan P. Spinal Kinematics of Adolescent Male Rowers With Back Pain in Comparison to Matched Controls During
Ergometer Rowing. J Appl Biomech. 2015 Aug 6. [Epub ahead of print] PubMed PMID: 26252195.

O'Keeffe M, Purtill H, Kennedy N, O'Sullivan P, Dankaerts W, Tighe A,
Allworthy L, Dolan L, Bargary N, O'Sullivan K. Individualised cognitive
functional therapy compared with a combined exercise and pain education class for patients with non-specific chronic low back pain: study protocol for a
multicentre randomised controlled trial. BMJ Open. 2015 Jun 1;5(6):e007156. doi: 10.1136/bmjopen-2014-007156. PubMed PMID: 26033941; PubMed Central PMCID:PMC4458611.

Sanchis M, Lluch E, Nijs J, Struyf F, Kangasperko M. The role of central sensitization in shoulder pain: A systematic literature review. Semin Arthritis
Rheum. 2015 Jun;44(6):710-6. doi: 10.1016/j.semarthrit.2014.11.002. Epub 2014 Nov 13. Review. PubMed PMID: 25523242.

Struyf F, Lluch E, Falla D, Meeus M, Noten S, Nijs J. Influence of shoulder
pain on muscle function: implications for the assessment and therapy of shoulder disorders. Eur J Appl Physiol. 2015 Feb;115(2):225-34. doi:
10.1007/s00421-014-3059-7. Epub 2014 Nov 28. PubMed PMID: 25431129.

Greg's Bio is attached below. 

Announcements

Dynamic Core Confidence & Pelvic Power Yoga PLUS 8 Week Class Series Information and register here

EmbodyPhysio Yoga Classes Information and Class Passes