The concept of restricted neural dynamics is not new, however its impact on our Neural Mobilization patients' daily activities and movement tolerance is often overlooked during the examination and treatment of our patients. This course covers concepts for examination and quantifying restricted neural dynamics and intervention strategies to address the dura, nerve bed, and peripheral nerves.

Included is a critical review of the most up-to-date literature in peer-reviewed journals regarding the use of neural mobilization as an examination and treatment technique. This course is appropriate for physical therapists, occupational therapists, and athletic trainers; both assessment and treatment concepts will be covered to aid in the care of their patients. This course includes laboratory sessions in which participants will practice neural mobilization and examination techniques.

Participants are encouraged to wear loose, comfortable clothing. Shorts are recommended as well as halter or swim suit tops for women in order to allow for proper practice of techniques.

Course Prerequisite: EB abstracts will be emailed to participants prior to the course.

During hands-on lab sessions, the course instructor(s) will evaluate each participant's techniques/skills learned to determine proficiency for course completion. If 3/5 criteria are not attained, the instructor will work with the attendee until all the criteria is met. Post-test at end of course will be used as a tool to review answers and rationale, ensuring attendees have gained all content knowledge.

By the end of this course, participants will:

• Identify the 3 components of the brachial plexus
• Describe 3 possible pathologies of the nervous system as covered in this course
• Identify 3 symptoms of brachial plexopathy of the upper quadrant
• Following the course and given 3 case scenarios the participant will match all appropriate testing of the UE using novel neural mobility grading scales (0-5) for biasing the Brachial Plexus, Radial, Median and Ulnar nerves
• Apply 3 basic treatment techniques based on results obtained from neural mobility testing of the upper extremity for a patient with lateral epicondylagia.
• Apply 2 basic treatment techniques based on results obtained from neural mobility of the LE with metric measurements (of the hip or knee) using: the Straight Leg Raise with biasing of the Tibial and Fibular nerves, Prone Knee bend with biasing of the Femoral and Saphenous nerves for a given case study.
• Apply the concept of structural differentiation as referenced in the literature to determine neural vs non-neural tissue movement restrictions of the UE through joint positioning, palpation and symptom behavior
• Apply the concept of structural differentiation as referenced in the literature to determine neural vs non-neural tissue movement restrictions of the LE through joint positioning, palpation and symptom behavior
• Design a comprehensive intervention plan including exercises, manual techniques and home exercises based on exam results from a given case study

Mark W. Butler, PT, DPT, OCS, Cert. MDT, is a board-certified orthopedic clinical specialist and McKenzie certified specialist for mechanical diagnosis and treatment of the spine. He started his own practice 18 months after graduating from the Philadelphia College of Pharmacy and Science (now the University of Science in Philadelphia), which he sold to NovaCare in 1997.

He is an Adjunct Assistant Professor at UMDNJ, guest lecturer at Stockton College in New Jersey, and Medical College of Virginia where he lectures on Advanced Orthopedics, Neural Mobilization, Radiology, and Evaluation and Treatment of TMJ Disorders. Mark is also a continuing education speaker on Evaluation and Treatment of Brachial Plexopathies, Neural Mobilization, the lumbar spine, and the shoulder. He was honored in 2006 with the James Tucker Excellence in Clinical Practice and Teaching Award by the APTA. He presented at the national conference in Hollywood of the American Society of Hand Therapists on Evaluation and Treatment of the Brachial Plexopathy Patient. His lecture series was selected as the featured topic on CD ROM to be available to the ASHT membership.

Mark is a frequent presenter at conferences, including the APTA annual conference, the InNovations and Sports Medicine conferences at the Philadelphia Eagles Complex, and the Cincinnati Fracture conference. He authored the shoulder chapter in the textbook Fundamentals of Hand Therapy: Clinical Reasoning and Treatment Guidelines for Common Diagnoses of the Upper Extremity, which was published in 2014. Mark continues to manage the NovaCare Medford outpatient clinic, where the majority of his caseload is brachial plexopathy, shoulder, and spine patients.

DAY ONE
07:30 - 08:00 Course Sign-in/Continental Breakfast
08:00 - 09:00 Introduction of Topic
Anatomy & Physiology
Pathology
09:00 - 10:30 Palpation Lab
10:30 - 10:45 BREAK
10:45 - 12:00 Mobility Assessment Lab, Part 1
12:00 - 12:45 LUNCH
01:00 - 02:30 Mobility Assessment Lab, Part 2
02:30 - 02:45 Documentation of Findings
02:45 - 03:00 BREAK
03:00 - 03:15 Indications for Neural Mobility Assessment
03:15 - 05:30 Basic Teaching Case Studies Lab/Lecture
Concepts covered: Misdiagnosed conditions; structural differentiation; test modification to track outcomes. Treatment principles: Flossing; tensioning
Meralgia Paresthetica
Lateral Epicondylalgia
Restless Leg Syndrome
TKR with persistent burning in the anterolateral lower leg
Little League Elbow
Softball player with eversion sprain from sliding into second base

DAY TWO
07:30 - 08:00 Course Sign-in/Continental Breakfast
08:00 - 08:30 Literature Review
08:30 - 10:00 Review of Examination Techniques, Lab
10:00 - 10:45 The Thoracic Outlet Syndrome
10:45 - 11:00 BREAK
11:00 - 11:45 Examination & Treatment Lab
11:45 - 12:30 Complex Case Studies & Problem-Solving Lab, Part 1
Focus activities: Identify potential sources of symptoms; develop examination strategy; provide comprehensive intervention plan
Baseball pitcher with 'Dead Arm' Syndrome & SICK Scapula
Marathon runner with buttock, thigh, & heel pain - no back pain
12:30 - 01:30 LUNCH
01:30 - 02:45 Complex Case Studies & Problem-Solving Lab, Part 2
Stockbroker who recently returned to surfing with facial & chest wall pain plus numbness of the ring & small fingers
LPN with burning along the medial scapular border, posterior shoulder, lateral epicondyle, & into the dorsum of the hand occurring after transferring a patient
Weekend tennis player recovering from Achilles tendon repair with persistent burning along the lateral heel
02:45 - 03:00 BREAK
03:00 - 04:00 Complex Case Studies, Continued
04:00 - 04:15 Post-Test
04:15 - 04:30 Review, Q&A