Day 1 ‘Headache’: starts at 8.30 a.m. and finishes at 5.00 p.m.
Day 2 ‘TMD’: starts at 9.00 a.m. and finishes at 5.00 p.m.
After registration, a short overview of headaches will be presented, following the guidelines of the International Headache Society. For primary headaches, the scientific literature indicates tension-type headache, and to a lesser extent, migraine may have an underlying neuromusculoskeletal contribution. Secondary headaches with a neuromusculoskeletal etiology and that are therefore potentially amenable to interventions within the physical therapy scope of practice include cervicogenic headache, occipital neuralgia, and headache associated with temporomandibular disorder (TMD). The history, physical and manual diagnostic examination, and therapy options for each of these five headaches will be presented.
One of the main objectives of the examination will be to identify whether the presenting headache complaint can in fact be classified as one of these five headache types. Potentially most relevant to history-taking and the diagnostic process is the identification of red flag indicators. The relevance of interpreting the history and examination findings, with special attention to myofascial factors and red flags, will be pointed out. The afternoon of day 1 will be practical with a dry needling review of the neck muscles, including the sternocleidomastoid and suboccipital muscles.
Temporomandibular disorders (TMD) is a condition that physical therapists are likely to encounter in everyday clinical practice. An evaluation will be presented with a definition and diagnosis of TMD, sensitisation and biomechanical hypotheses. TMD includes a constellation of symptoms, of which pain is the most common. Other symptoms include joint sounds, TMJ catching, limited jaw opening and deviation on opening. A brief screening history regarding pain and activities that make the pain worse can help determine if a patient has a potential TMD problem. A clinical examination that incorporates an assessment of pain and joint sounds is recommended and practiced. The examination also includes palpation of the muscles of mastication and the TMJ, and the combined findings are used to determine the diagnoses.
A multidisciplinary approach often includes physical therapy and self-management treatment strategies. These are beneficial for most patients, with very few patients requiring non-reversible treatment. These treatment options will be reviewed, with special attention for myofascial and cervical spine therapies. The afternoon of day 2 is filled with practical sessions such as the assessment of TMD, clinical reasoning and several therapies, including dry needling of the masseter, temporalis and pterygoid muscles.
* Articles will be emailed beforehand.
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