OMTC Program Overview

The program will answer important clinical questions using a clinical reasoning framework and emphasis on practical element. Different assessment, differential diagnosis and treatment strategies will be used, including:

• Exercise therapy
• Manual therapy
• Motor control strategies
• Patient education

Key Clinical Questions. These are only few examples of what we cover in the program.

• How can you use the subjective examination as a treatment tool?
• How can you screen and exclude red flags to keep patients safe?
• What are the essential physical examination steps that every clinician must follow?
• What is central sensitivity and is it different from psychological pain

Upper Quadrant

(Cervical Spine – Thoracic Spine – Shoulder – Elbow)

This section focuses on differential diagnosis, manual therapy, and exercise therapy.

1. Cervical Spine
   • Safe manual therapy strategies for patients with cervical disc bulge and myelopathy
   • Assessment of cervical instability with stabilization exercise and manual therapy
   • Assessment of cervicogenic headache with manual therapy and motor control exercise
   • Role of sensory training in managing neck pain
2. Thoracic Spine
   • Thoracic spine pain and movement limitation – differential diagnosis, manual therapy and exercise therapy
   • T4 syndrome, costovertebral and costotransverse joint dysfunction – manual therapy and exercise therapy
3. Shoulder
   • Shoulder pain of spinal origin – differential diagnosis, manual therapy and exercise therapy
   • Shoulder differential diagnosis (Frozen shoulder – soft tissue or articular)
   • Shoulder mobility strategies
   • Shoulder motor control strategies with movement retraining and exercise therapy
   • Shoulder tendon pathology – differential diagnosis and effective loading exercise with supportive manual therapy
4. Wrist and Elbow
   • Four common sources of lateral and medial elbow pain:
   • Tendon pathology
   • Cervical spine referral
   • Radioulnar joint dysfunction
   • Radial / Ulnar nerve involvement or scapular dyskinesis

Lower Quadrant

(Lumbar Spine – SIJ – Hip – Knee – Ankle)

This section focuses on differential diagnosis, manual therapy, and exercise therapy.

1. Lumbar Spine
   • Lumbar spine instability – assessment, stabilization exercise and manual therapy.
   • Lumbar radicular symptoms – differential diagnosis, neural mobility exercise and manual therapy.
   • Lumbar spinal stenosis and disc sequestration – clinical reasoning, exercise therapy and safe manual therapy.
   • Lumbar spine motor control and mobility strategies – movement retraining and manual therapy.
   • Pain Patterns – Differential Diagnosis
     • Sciatic pain – possible causes: Lumbar spine origin
       • Piriformis involvement.
       • Hamstring-related pain.
       • Neural mobility dysfunction.
     • Anterior thigh pain – possible causes: Lumbar spine referral
       • Femoral nerve involvement.
       • Soft tissue dysfunction.
2. SI Joint (SIJ)
   • SIJ and hip differential diagnosis
   • SIJ mobility dysfunction – manual therapy and mobility exercise.
   • SIJ motor control strategies – stabilization exercises.
3. Hip
   • Hip mobility restriction – manual therapy and mobility exercise.
   • Hip motor control strategies with motor control exercise and functional movement.
   • Differential Diagnosis.
     • Greater Trochanter Pain – Differential Diagnosis
       • Lumbar spine referral.
       • Gluteus medius tendon pathology.
     • Lateral Thigh Pain
       • Lumbar spine referral.
       • Iliotibial band dysfunction.
       • Lateral femoral cutaneous nerve involvement.
       • Fascial restrictions.
     • Femoral Impingement (FAI)
       • Lumbar spine referral.
       • Muscle tightness around hip (flexors, adductors).
   • Managed strategies:
     • Manual therapy to improve hip joint mobility and soft tissue flexibility.
     • Motor control exercise for hip control and functional movement.
     • Load modification strategies to reduce impingement pain.
4. Knee
   • Mechanical knee problems:
     • Knee osteoarthritis
     • Patellofemoral pain syndrome
     • Meniscal-related knee pain
   • Differential diagnosis with manual therapy, motor control exercise, and movement retraining.
   • Emphasis on the role of proximal motor control (hip and trunk) in knee pain and injury prevention.
5. Lateral Lower Limb Pain
   • Iliotibial band pain syndrome – possible sources: Lumbar spine referral
     • ITB dysfunction.
     • Lateral femoral cutaneous nerve involvement.
     • Fascial restriction.
   • Managed with manual therapy, motor control exercise, and movement correction.
6. Ankle and Foot
   • Ankle mobility limitation – manual therapy and mobility exercise.
   • Ankle instability – proprioception, motor control exercise, and supportive manual therapy.
   • Rehabilitation strategies for recurrent ankle sprain and mechanical dysfunction.

Flexibility and Motor Control Concepts (Upper and Lower Quadrant)

1. Different types of flexibility training (static, dynamic, functional)
2. Role of active inhibitory re-stabilisation
3. Exercise strategies to improve flexibility in over-protective or hyper-mobile patients
4. Manual therapy as an adjunct to improve movement and reduce guarding