The lectures will run from 6-9pm in an as yet to be confirmed Central London location. Attendance will cost £40 for an individaul lecture, or £70 for the pair. Please call reception on 020 7404 6343 to reserve a place. More info as we get it.

Neurological Mechanism of Manual Therapy

 There now exists sufficient evidence to cast serious doubt on the long-standing implication that the efficacy of passive oscillatory or thrust manoeuvres is causally related to their presumed ability to create sustained ‘changes’ in ranges of passive movement. Indeed, the (contrary) evidence is now so ‘specific’ that even seemingly supportive evidence, should this emerge, would require a significant ‘shift in philosophical goal-posts’. Nevertheless, though often modest, positive clinical consequences can be observed with (passive) movement-based therapy. This raises the question as to the mechanisms by which they occur. In this regard, another similarly long-standing but only relatively recently considered possibility is that the movement-based therapies – passive in particular, but also active – are capable of pain inhibition. Where this occurs, such a positive therapeutic experience encourages the logical ‘progression’ to increasingly intense and/or functional therapeutic movement, and subsequent recovery (graduated exposure).  Mechanisms (contributing to informed clinical reasoning) underlying cognitive behavioural and mechanical stimulus sources of pain inhibition proposed to be available with this ‘neurological’ model of manual therapy are discussed. These include the clinically validated entities distraction and its antithesis ‘mindfulness’, habituation, extinction of pain memory and extrinsic stimulation. The last features the (‘new’ for mechanical stimuli) model of synaptic inhibition known as long-term depression (LTD).

An Enduring Mechanical Mechanism for Passive Movement

 The physiotherapy profession has long struggled to propose and demonstrate plausible, therapeutically worthwhile ‘mechanical’ effects for manually applied passive movement. The present proposal is based on the capacity for non-excitable connective tissue cells to ‘sense’ externally applied mechanical stimuli and convert mechanical into internal chemical ‘signalling’, leading to gene transcription. In the presence of tissue damage, gene activation results in the production and secretion of the (mainly collagen) components of extracellular matrix. This takes the form of granulation tissue required for tissue repair and remodelling. The dependence of these (restorative) events on the presence of anatomically specific extracellular mechanical ‘force’ suggests a structurally enduring role for manually applied passive movement in the facilitation of optimal repair and restoration of function.

Dr Mick Thacker, program leader of the renowned Pain: Science and society MSc at King’s College London,  has agreed to run a series of evening courses which will run concurrently over 6 weeks. The courses will involve discussion and self-directed learning and promise to be extremely informative.

We are in discussion with Max Zusman over running some courses in the Spring, where he will possibly looking to lecture on the themes of his recent or soon to be published articles.  

Gary Stebbing has also agreed to run a course provisionally entitled ‘An introduction to strength and conditioning for physiotherapists’ which promises to be extremely practical, yet thought provoking and fun.We have set a provisional date for this course on Saturday 5th February 2011.

More info as we know it, but please feel free to contact us in advance on 020 7404 6343 so that we can notify you when we have more details.

Derek J.B Stevens Grad Dip Phys, Grad Dip Man Ther, MMACP, MCSP HPC

David Stanley BSc (hons) MSc MMACP MCSP HPC

 Course Outline

This course is mainly a practical based course concentrating on refining manual therapy skills on the treatment and assessment of musculoskeletal dysfunction. The two day course develops participant’s skills on performing all manipulation/ high velocity low amplitude thrust techniques. All contraindications and indications for treatment selection will be discussed, along with a clinical reasoning of the effects of manipulation. There will be opportunity for open discussion, with integration of the current evidence base. As the majority of the course will be practical based, there will be lots of opportunity for demonstration of all the techniques and one to one teaching from either of the tutors.

 Learning Outcomes

• Appropriate Anatomy and Biomechanics
• Be able to assess for contraindications to manipulative therapy, including Cervical Artery Dysfunction (CAD)
• Perform and demonstrate “joint end feel” and pre-manipulative “wind-up”
• To be able to perform selected manipulative techniques to Cervical, Thoracic, Lumbar segments and peripheral joints.
• Discuss case studies and research underpinning HVLA techniques.

 Participants

This course is aimed at manual therapists wanting to introduce or refresh their manual therapy skills in particular relation to manipulative (grade V) techniques.

 The course will run with a minimum of 8 and a maximum of 16. All participants will be expected to model for each other, unless otherwise contraindicated.

A course handbook and DVD will be provided

Date: 13th-14th November

Venue: The Hospital of St John and Elizabeth

 Cost: £200

Movement as Antigen

The neurocentric view of pain fails to fully appreciate the importance of other key systems present within the nervous system. The immune system is now known to be actively involved in both the generation and maintenance of pain and neuro-immune interactions which underpin several characteristics of neuropathic related pain.

The classical view of antigens is of foreign bodies, normally pathogens, which stimulate the production of antibodies. Newer ideas, particularly from the field of psychoneuroimmunology, have expanded the concept of antigens to include the construct of self-antigens. Self-antigens comprise tissues, cells and chemical mediators including neurotransmitters that are released as a consequence of evoked activity in neurones and that allow recognition of the body’s own tissues. This self-antigen derived self-recognition has been termed the immunological homunculus by Cohen and the immunculus by Poleteav; and represents a context of ‘normal state’ to the immune system. Therefore under normal circumstances self-antigens have homeostatic functions preventing unwanted immune/inflammatory responses, whilst allowing the normal release of transmitters, trophic signals and cytokines within the nervous system. However, under circumstances of ‘contextual change’ such as pain and stress, self-antigens may become the basis of neuro-immune responses that initiate and/or amplify on-going dysfunction within the nervous system.

In this talk Mick will hypothesise that a contextual change within the self-antigenic system produces immune-like responses to movement and, in extreme circumstances, to the thought of movement, which may lead to pain and movement dysfunctions commonly seen in the clinic. The idea of a movement induced sterile inflammatory response within the brain will be presented and ideas for potential research and management strategies based on these concepts will be discussed.

Date: Wednesday 30th June 7-9pm

Venue: Brampton House, The Hospital of St John and Elizabeth

Cost: £25

Please contact reception@central-health.com or ring 020 7404 6343 to register your interest.

Course aims

• provide participants with the relevant background information
in exercise rehabilitation and return to sport criteria to
provide successful rehabilitation to both ACL deficient and
reconstructed clients
• provide participants with the skills necessary to appropriately manage ACL deficient or reconstructed clients, and monitor treatment progress towards a successful outcome

Course content

• ACL anatomy and biomechanics
• Injury mechanisms
• Specific and functional assessment of ACL injury
• Identifying the ACL deficient ‘coper’
• Surgical reconstruction options and implications for rehabilitation
• ACLR and ACLD rehabilitation
• Outcome measures and goal setting
• Complications
• Return to sport criteria
• Prevention of ACL injuries; an introduction to the sportsmetrics program

Date: Saturday 23rd October 930-430

Venue: Central Health Performance Centre

For more details contact reception on 02074046343 or go to the Central Health website

Principal of Evoluto Training, based at the Performance and Wellbeing Centre in Charterhouse Street

Specialisation
Gary Stebbing is a Performance Development and Conditioning Expert with 24 years experience of sport and performance at the highest levels. In the last 14 years he has accumulated almost 15,000 contact and training hours helping clients achieve their personal and business goals. He divides his time between performance coaching, conditioning and learning. His skills and abilities are sought by high performers in life, sport, and business.
Other experience
A frequent speaker on a diverse range of topics, Gary has presented both at home and internationally on subjects ranging from Golf Conditioning to Professionalism and Ethics to Transformational Training.
As an author he has written articles for PGA Profile, PGA Professional, Total Golf, City AM, Australian Fitness Network and UK Fitness Professionals as well as several articles on the web.
Passionately committed to increasing standards of practice in conditioning and fitness Gary also co-ordinates a Training and Coaching Practice Group based in London.

With more and more practitioners creating training facilities to deliver exercise interventions as part of their treatment package, interest in the methods and means of designing training that gets results has never been greater.

The key to understanding the prescription of effective exercise does not lie in the complex, but in understanding how to deliver simple and basic principles well.

The Essentials series of one day courses is designed to do precisely that.

Beginning with the Essentials of Barbell Training, each session will offer insight into the fundamentals of different methods of conditioning and training. Over the course of 4 sessions a range of common and easily available implements and equipment items will be covered.

Each session will review basic training principles, and cover safety, equipment, and techniques of use. Progressions will be explored to offer options whether it be in the exercise, training or rehabilitation realms.

Attendees at each session will learn how to effectively perform the basic core lifts and movement patterns, in an easy to do, step-by-step process. They will also learn how to recognise and correct basic errors in technique.

Using a highly practical format, these sessions will focus on combining theoretical understanding with real world applications. Although designed as a complete series, each session can also be attended as a standalone. Whichever method you choose, you will not only leave smarter, you will leave with ideas that can immediately and simply be applied to the work you do every day.

Essentials of Barbell Training – TBC.

Essentials of Cable and Band Training – TBC.

Essentials of Bodyweight and Medicine Ball Training – TBC.

Essentials of Kettlebell Training – TBC.

Fee: £100 per course or £300 for all 4

Venue: Central Health Performance and Wellbeing Centre, central London

Tutors: Gary Stebbing BSc, CSCS ; Central Health Physiotherapists

Ring 020 7404 6343 or email reception@central-health.com for more information