How can Physical Therapists effectively evaluate, assess, and treat neck pain? Most importantly, how can PTs avoid losing sight of the patient while combing through the latest research? This past weekend, I found out how by taking the Cervical Spine Manipulation course hosted by the Institute of Clinical Excellence (ICE) at the Fyzical Balance Center in Summerlin (Las Vegas area). Jeff Moore led the discussion and clinical practice along with contributions from Zac Morgan, Dan Crusoe, and Jamie Schwartz. Before I begin, I would like to thank the team and appreciate the culture of learning. Granted, despite being a DPT student, I was pleasantly surprised by the representation of new grad alumni from my campus at Touro University Nevada. Also, I had the pleasure of pairing up with my partner in crime who is a fellow DPT student from my cohort that endured the atrocities of our lab practicals. Video of the DPT student experience demonstrating a MMT of the abs for humor.
Was this experience worth it? Absolutely! Even for a student? Yep! There is a nice discount referenced on the course website (see below at the end of this post). Jeff Moore began with the most essential component of why Physical Therapists are excellent clinicians and able to see patients “off the street” through direct access without orders from a physician. For a short snippet on how to operate a successful private practice through direct access and direct marketing, check out my previous blog post. The research demonstrates that cervical spine manipulation is safe yet clinicians in the field are wary. The truth of the matter is that our job is to catch patients with a “hidden” red flag, known as a non-ischemic vertebral artery dissection. The rest of the course content you will have to wait and find out for yourself but red flags are NO JOKE. When the patient’s history seems “off”, then it is in her/his best interest to be assessed by the appropriate healthcare professional who can determine whether or not sinister pathology is ruled out. Referring out is our duty when there is any doubt. When we are able to proceed with examination, that’s when the fun begins as a PT. Sorry for the tease but you should check out the course if you are interested. If anything, simply understanding the mechanism of the pain science and neurophysiological cascade will blow your mind (pun intended).
A relevant topic to include with cervical spine management is concussion. Concussion research is in its infancy yet Dan Crusoe provided the keys to get started with understanding how to interpret the available evidence and translate the findings to clinical care. The interesting part was how collaborative this portion of the course felt within the Fyzical Balance Center because the majority of the ICE students are familiar with using these assessment tools in the clinic. I appreciated that I witnessed the first offering of this specific lecture and would say that this greatly benefits clinicians who are not as familiar with assessment of the vestibular system, which is one of the key components of maintaining balance.
Overall, the experience was amazing. It is always enlightening to be taught by a PT as smart and passionate as Jeff Moore. Maybe it’s the beard! The metaphors? “Crisp it up!” Who knows? I was thankful for the clear answers and cues from the ICE team, especially Zac Morgan. My mind was preoccupied with ALL of the material from 2 years of a DPT program because I had to take the PEAT exam, a practice test for the PT board. However, the fellow clinicians (PTs and PTAs) were also helpful with this learning experience, which is never something to take for granted as a DPT student.
As a little aside, I had my own experiences as a DPT student learning from RJ (PT who manages branches of Fyzical in the Las Vegas area) when he would offer guest lectures for our DPT Program at Touro University Nevada. Known as the “Balance Guy”, RJ had a way of simply explaining the basic anatomy and lab techniques that are applicable for evaluating and treating patients with a chief complaint of “dizziness”. Needless to say, it was interesting being in a position where we are both students BUT this reinforces the point that we never stop learning as clinicians regardless of degrees, certifications, or years of experience. We must continuously challenge our ideas to improve our quality of care and share with others in healthy discussions.
For more information, check out the Institute of Clinical Excellence website!