Headaches, Neck, Jaw and Face pain are some of the most common reasons for patients presenting to manual therapists. However, the training and experience of many manual practitioners stops at the top of the cervical spine.
Yet the neurological input from structures cephalad, contribute almost one half of the input to the sensory homunculus. Not to mention the integration of the cervical spine, brainstem and the vastly powerful trigeminal network via the trigemino-cervical nucleus and its limbic, cerebellar and cortical connections.
Mechanical units such as the TMJ, the dental occlusion, the masticatory muscles and the myofascia and articulations of the skull, are powerful neuro-active structures that strongly influence the way our brain sees our body and responds functionally. As manual therapists, why would we not want to be able to confidently assess and optimise the function of this trigeminally mediated input system in the care of our patients?
That’s why one of Australia’s most experienced clinicians in the field of TMJ and Craniofacial disorders has put together this comprehensive, hands on, practical workshop on the assessment and treatment of the patient with Jaw, Head and Face, Pain and Dysfunction (both simple and complex).
With over 39 years of clinical experience, education and teaching, Dr Russell Mottram (Chiropractor) has seen most of what practice can dish up.
So, join him for this valuable and enjoyable weekend event.
Regular price – AUD 895
Full Time Student – AUD 650 (limited to 3)
Places strictly limited to 20 participants due to thorough hands-on nature of this seminar.
Dr Russell Mottram, B.App Sc (chiro), graduated in 1983 from Phillip Institute Melbourne, School of Chiropractic. In the late ‘80’s, a personal health issue led to an interest in Craniopathy. Over the next few decades he completed numerous post graduate courses in Chirodontics (Dr Bob Walker Chiropractor), TMJ (with Chilean Professor Mariano Rocobado), Craniofacial Pain (with the European Craniofacial Therapy Academy, CRAFTA), Orofacial Orthopaedics and dental approaches, through his membership of the American Academy of Craniofacial Pain. A few years ago, Russell became a qualiﬁed Orofacial Myologist, an emerging discipline that assesses and treats dysfunctional tongue, lip, swallow and breathing patterns in adults and children, using a largely exercised-based model. He brings this understanding to his teaching and treatment paradigm. His treatment of many complex cases of craniofacial pain has led to an interest in brain-based treatments for chronic pain, recently completing the Neuro Orthopaedic Institute’s (NOI) course on Explain Pain and Graded Motor Imagery (GMI) .
Since the early 2000’s Russell has lectured alone and with his Chiropractic and Dental colleagues to Chiropractic and Dental organisations throughout Australia promoting a multi-disciplinary approach to Craniofacial disorders. He has taught Cranio-mandibular diagnosis and management at RMIT University for the past 25 years. Russell has co-authored a chapter in the internationally published, multidisciplinary, textbook “Headache, Orofacial Pain and Bruxism” Elsevier 2010, and has been bestowed membership of the Australasian College of Chiropractors. He continues to treat patients at his Victorian practices in Hampton and Ocean Grove under the banner TMJcare.com.au
Detailed Course Outline
TMJ and Craniofacial Pain for the Manual Therapist
Saturday 22nd July 2023 8.30am-5.00pm
Sunday 23rd July 2023 8.30am-5.00pm
Please Note: Throughout all sessions over the weekend, attendees will be positioned near treatment tables, in groups of 2 enabling smooth transition from lecture to practical as needed. There will be approximately 12 practical classes over the weekend enabling acquisition of clinical skills that will be immediately applicable on Monday morning.
The Field of Craniofacial Pain
Headache, Jaw and Face pain is a common reason for people attending the clinics of manual therapists of all kinds. Yet too often we stop at the upper cervical spine and occiput in our biomechanical evaluation and treatment.
The function and pathophysiology of the articulations and myofascia of the skull, jaw and stomagnathic system can be a complex and sometimes mysterious realm for many physical therapists, yet treatment targeted at these structures can be pivotal in finding lasting solutions for many suffering from craniofacial pain.
In this introduction, Russell will give you an overview of the field of craniofacial pain, who are the players, what they’re doing and some of the research behind what is being done. He will outline his assessment and treatment paradigm assembled over years of international education with the world’s top clinicians in this field.
The aetiology, epidemiology and functional anatomy will be reviewed, and he will outline the approach that we will take over the next 2 days in bringing you up to speed in your assessment and management of these patients.
Also, the beginnings of the process required to decide a simple from complex craniofacial pain patient and detection of red flags for the clinician.
1A. The aetiology, epidemiology, risk factors for, and treatment approaches to, craniofacial pain.
1B. Regional anatomy review
1C. Is it an INPUT, CENTRAL PROCESSING or OUTPUT problem in this patient or a combination? Introduction to assessing the difference. Use of the Central Sensitisation Inventory (CSI).
1D. The relevant elements of history taking for the craniofacial pain patient.
Craniofacial Assessment and Examination
Understanding how to quickly and efficiently assess a patient who presents with head, jaw or face pain is essential. In this session demonstration and practice will be integrated. You will be shown the fundamentals of an assessment of the cervico-craniomandibular region and guided through performance of these procedures.
Participants will be provided with forms that will form the basis for an assessment of your colleagues on the day and can be utilised in practice into the future.
2A. Screening exam for dysfunction of the cranio-mandibular region
2B. Rationale for performing assessment of the jaw joint. Normal and abnormal.
2C. A quick look at imaging procedures for the TMJ.
2D. Detailed assessment of the TMJ for the purposes of diagnosis and management.
HANDS-ON PRACTICAL OBJECTIVES:
2A. Development of the observational and manual skills necessary to assess the function of the craniomandibular region and the TMJ.
2B. Observation and assessment of cervico-cranial head posture, cranial structural distortion, active and passive TMJ ROM, myofascia, joint noise, joint play and pain mapping. How to practically record your findings.
Assessment of dental occlusion, dental treatment approaches and multidisciplinary co-operation
The management of TMJ disorder requires a basic understanding of the way the teeth come together and the part this may play in the development and perpetuation of craniofacial pain. As manual therapists we need to be able to look inside a mouth and determine if the occlusion may be a factor in aetiology and/or may need to be a focus for treatment.
We also need to have some appreciation for what can be done dentally to contribute to the management of this patient. In acquiring this knowledge, we are better able to determine if we need dental assistance.
Understanding the way that dentists manage this type of patient and some of the procedures they use, contributes greatly to better coordination of treatment and avoids conflicting information that may confuse the patient. It also enhances communication between treating practitioners.
3A. What to look for with the dental occlusion and why.
3B. What are some common dental approaches to the treatment of TMJ disorder.
3C. How to find a dentist that might be useful in co-treatment
HANDS-ON PRACTICAL OBJECTIVES:
3a. Acquisition of the skills necessary to evaluate the dental occlusion for risk factors for TMD
TMJ disorder diagnosis and management
Putting together the information we have acquired in the examination process we are able then to, hopefully, come up with a differential diagnosis.
In this session Russell will outline the criteria for making a diagnosis of the patient’s condition. He will then move on to the therapeutic prescriptions for treatment suggested by these diagnoses and demonstrate the basic manual therapeutic procedures required to manage these patients.
4A. Understanding the decision-making processes required to accurately diagnose craniofacial pain
4B. Understand the target tissues and their pathophysiology
4C. Understanding the theory behind the application of certain therapeutic intervention
4D. Observe and learn self-help exercises
HANDS-ON PRACTICAL OBJECTIVES:
4a. Learn and practice the skills required to effectively apply therapeutic intervention.
4b. Learn how to choose and demonstrate therapeutic exercises.
Introduction to assessment and management of the Articulations and Myofascia of the Skull and Face
All manual therapy approaches (Chiro, Physio, Osteo) have a tradition of manipulation and mobilisation of the articulations and myofascia of the skull and face. Some of these approaches are more controversial than others as to scientific validity and effectiveness, yet can have a vital role in a holistic approach to management of craniofacial pain
In this session Russell will have a look at the history, theory and basis for cranial therapy. He will review the literature and attempt to demystify a body of knowledge that has persisted for a century or more despite significant scepticism. He will put forward a scientifically sound, rational treatment approach designed to bring this form of treatment into the evidence-based mainstream.
5A. The history, theories and practices of cranial therapy
5B. Towards a scientifically sound approach to manipulation and mobilisation of the articulations and myofascia of the skull and face
5C. Assessment and treatment approaches to the cranium
HANDS-ON PRACTICAL OBJECTIVES:
5a. Acquisition of the fundamentals of basic cranial manipulation techniques
5b. Acquisition of the basics of assessment of biomechanical function of the cranium and its functional components