Texas Chiropractic Continuing Education

• Describe the early health care utilization for occupational low back pain
• Determine which factors are important in predicting outcome after a spinal stabilization exercise program
• Assess lumbar disc surgery rates before and after implementation of nonsurgical spine clinics
• Determine whether kinematic compromise can be used to predict spine loading in low back pain (LBP) patients under realistic lifting efforts in a workplace
• Determine the effects of subacute LBP and limitation of the straight leg raise on lumbar and hip kinematics during sit-to-stand and its reverse

• Summarize the effect of whiplash on neck muscle strength
• Discuss the effects of manipulation vs. mobilization on head and neck pain in whiplash patients
• Assess the effects of thoracic manipulation in whiplash patients
• Describe a study predicting the response of neck pain patients to neck strengthening exercise
• Introduce the smooth pursuit neck torsion test and its application in whiplash disorders

• Identify the anatomy of upper motor neuron tract systems and discuss the functionality of upper motor neuron tract systems
• Explain the effects of a spinal cord injury
• Discuss the anatomy and functionality of regions of the brain
• Describe complications post injury of brain and spinal cord injury
• Describe standard treatment procedures prior to rehabilitation of brain and spinal cord injured patients
• Explain the difference between neurological deficit rigidity versus disuse atrophy/spasm of spinal cord and head injured patients
• Describe treatment options for rehabilitation of spinal cord and head injured patients
• Explain treatment methods to transition C curve locomotion to S curve locomotion
• Explain treatment methods for atrophy and spasm
• Discuss most current curative research for spinal cord and head injured patients

• Outline the anatomy of cervical spine proprioception
• Review clinical studies investigating cervical spine proprioception
• Assess existing literature on the reliability of cervical spine joint position sense
• Assess the effect of spinal adjustments/manipulation on cervical spine proprioception

• Summarize the central role of muscle protein in whole-body metabolism and muscle mass
• Outline the role of skeletal muscle metabolism in health and disease (such as diabetes, obesity, osteoporosis)
• Describe the role of hormones for influencing muscle metabolism and health
• Identify the catabolic and anabolic mediators of muscle metabolism
• Specify ways to maximize muscle mass and metabolism to promote wellness

• Explain the anatomical constituents of the core musculature
• Consider implications of weak or inadequate core muscles
• Emphasize the importance of the gluteal muscle group in rehabilitation
• Illustrate common compensation patterns when individuals have weak core musculature with clinical examples
• Explain the concept of neural adaptation
• Review reciprocal inhibition and it's clinical application
• Discuss physiological overflow and its clinical application

• Discuss conventional situps and their pitfalls
• Provide a logical rationale for core training
• Explain and demonstrate a logical progression of exercises for core training, emphasizing skill, then endurance and strength

• Recognize some of the common mistakes with conventional sit ups and how to correct them
• View and narrate the ideal sit up
• Recognize the importance of the brain and cortex in core training
• Discuss how inhalation and exhalation affect muscular activity, and how to utilize this in training
• Point out the pitfalls of abdominal hollowing and core training
• Examine the importance of the thoracolumbar fascia
• Analyze what cues to look for when evaluating a bench press exercise

• Demonstrate the proper patient positioning for the lunge and squat exercises
• Explain and show common problems with the lunge and squat exercises
• Explain and show Dr cues for proper patient positioning of the lunge and squat exercises
• Explain, evaluate, compare and demonstrate variations of the squat exercise, including ball squats, theraband squats, potty squats, squat shuffles
• Explore and demonstrate how foot function and shoe type impacts squat and lunge activities
• Introduce, explain and demonstrate proper and improper performance of additional, advanced gluteal activation exercises including the Texas walk, ball squats, drops, roman chair and 1 legged dead lifts

• Outline the neuroendocrine-immune interactions and communication pertaining to exercise
• Contrast sprint training with endurance training regarding performance adaptations and cardiac output
• Identify the benefits and underlying mechanisms of agonist-antagonist paired set training for improving strength and power
• Summarize the validity of dehydration signs, compared with body weight change, in marathon runners
• Describe methods for developing maximal neuromuscular power

• Apply contemporary rehabilitation strategies for anterior cruciate ligament patients
• Illustrate the importance of proximal stability and rehabilitation in patients with patellofemoral pain syndrome
• Outline the relationship between quadriceps strength, proprioception and knee osteoarthritis
• Discuss the potential value of gait retraining for improving lower limb biomechanics in runners with patellofemoral pain
• Contrast lower extremity kinematics & muscle activation in patients with and without patellofemoral pain syndrome

• Discuss a proposed model for the logical sequence of active rehabilitation
• Review ‘the core’, its healthy functional role and how it is commonly changed in people with spinal and pelvic girdle pain syndromes
• Describe core muscle activity during physical fitness exercises
• Provide an introduction to dynamic neuromuscular (core) stabilization and athletic performance
• Introduce the basics of exercise prescription

• Illustrate the effects of external pelvic compression on the passive, active and neuromotor control systems of the lumbopelvic region and thigh
• Summarize the importance of core stability assessment and rehabilitation in lumbosacral radiculopathy cases
• Assess the differences in torso motion and muscle activity between elliptical trainer use and treadmill walking
• Discover how even small amounts of daily exercise can positively impact patients with neck and shoulder pain
• Critique and apply periodization concepts to rehabilitation for patients with non-specific low back pain

• Outline the relationship between exercise and brain health
• Describe the evidence for the links between physical activity/exercise and brain function across the lifespan
• Discuss the neurobiology of exercise
• Assess whether exercise is neuroprotective or not
• Summarize the effect of exercise on motor performance

• Identify how the sciatic nerve and adjacent nervous structures respond to tensioning and sliding techniques
• Appraise the potential benefit of adding forward head posture corrective exercise to the management of lumbosacral radiculopathy
• Compare clinical and muscle function outcomes of patients randomized to one of two early multimodal rehabilitation programs following single-level lumbar discectomy
• Analyze the influence of neck strength and muscle activation status on resultant head kinematics after impulsive loading to the head/neck
• Assess the efficacy of corrective exercise interventions for reducing thoracic hyper-kyphosis

• Recognize and document preferred outcomes that result from properly executed active care techniques
• Establish rehab protocols for both cervical and lumbar conditions with suggested core exercise recommendations
• Properly advance a patient through their customized exercise protocol in a systematized fashion
• Identify and document progress on a routine visit basis for patients participating in active care rehab

• Evaluate the long-term effect of exercise therapy in addition to patient education on a patient’s need for total hip replacement (THR)
• Integrate clinical and laboratory research on the function and assessment of abductor muscles about the hip and pelvis 
• Understand how hip weakness can potentially contribute to knee pain and altered running mechanics
• Outline the nomenclature, definition, diagnosis, imaging and management of inguinal disruption (‘Sportsman’s Groin’) 
• Assess the efficacy of exercise interventions for lateral ankle sprains, Achilles tendinopathy and plantar fasciitis 

• Recite 3 risk factors for developing rotator cuff tendonosis
• State the purpose of the scapula reposition and scapula assistance test.
• Explain how to perform the external rotation lag sign and recall the purpose of this test
• Paraphrase one evidence - based test cluster for diagnosing a rotator cuff tear.
• Recall two indications/goals for performing posterior glenohumeral joint mobilizations.
• Cite the clinical prediction rule (CPR) for favorable outcome in patients undergoing conservative management for rotator cuff disorders
• Identify two criteria for phase I rehabilitation exercises for rotator cuff disorders

• Recall 3 potential reasons, based on expert opinion, that may contribute to the high re-tear rate following rotator cuff repair.
• Recite 4 factors that impact the rehabilitation program for patients following rotator cuff repair.
• Summarize the DeOrio classification for rotator cuff tear size.
• State 3 appropriate exercises during weeks 0-2 following rotator cuff repair
• Provide 2 appropriate exercises during weeks 6-8 following rotator cuff repair
• Name 3 appropriate exercises during weeks 8-12 following rotator cuff repair

Hour 1:

• Describe common biomechanically terminology related to rehabilitation such as work, force, mass, vector, strength and power.
• Comprehend the functional biomechanics of the lunge, and squat.
• Identify regressive and progressive nature to common squat and lunge exercises.
• Describe the appropriate standard of care and the process associated with the doctor-patient encounter regarding the evaluation, and management of patients using rehabilitative exercises.   

Hour 2:

• Classify the “McGill Big 3,” and discuss their clinical significance with those with spinal pain.
• Describe an appropriate hip hinge technique for your patients.
• Describe the differences between abdominal bracing and hallowing techniques.
• Review common evidence-based exercise procedures for spinal pain.

• Apply the scientific foundations of neuromuscular re-education, and explore major guidelines and evidence-based practices for spinal pain.
• Construct a treatment plan and exercise script for patient centered care.
• Describe a case scenario involved spinal degeneration and how to create a treatment plan.
• Synthesize the justification and efficacy of evidence-based exercises for different axial spine protocols.

• Enumerate three physical / clinical examination findings associated with rupture of the quadriceps tenon.
• List 3 patient specific factors that need to be considered when following a rehabilitation program following repair of the quadriceps or patella tendon.
• Recall three goals during phase 1 (0-2 weeks) of a rehabilitation program following repair of the quadriceps or patella tendon.
• Identify three goals during phase 3 of a rehabilitation program following repair of the quadriceps or patella tendon.
• Cite five return to play criteria that need to be met following repair of the quadriceps or patella tendon.

• Summarize the key difference between the cartilage restoration vs cartilage reparation procedures.
• List 3 personal (health and demographic) factors that need to be considered when following a rehabilitation program following cartilage restoration/reparative procedures.
• Enumerate 3 lesion-specific factors that need to be considered when following a rehabilitation program following cartilage restoration/reparative procedures.
• Recall three goals during phase 1 (0-2 weeks) of a rehabilitation program following cartilage restoration/reparative procedures.
• Cite five return to play criteria that need to be met following cartilage restoration/reparative procedures.
• Summarize the evidence-based outcomes for the 3 most common cartilage restoration/reparation techniques.

Hour 1

• Recall 2 pathological pitching mechanical patterns that may lead to injury
• List 3 injury risk factors in in the overhead athlete
• Provide 4 injury prevention screening tests for the overhead athlete
• With respect to shoulder strength, cite 3 metrics  that can be used as red flags to identify players who are at higher risk for incurring an injury to the shoulder /elbow

• Recall 2 pathological pitching mechanical patterns that may lead to injury
• List 3 injury risk factors in in the overhead athlete
• Provide 4 injury prevention screening tests for the overhead athlete
• With respect to shoulder strength, cite 3 metrics  that can be used as red flags to identify players who are at higher risk for incurring an injury to the shoulder /elbow
• Describe 1 clinical test to evaluate anterior and posterior shoulder instability
• List the 3 components of an evidence -based test cluster  to assess rotator cuff pathology in the overhead athlete
• Identify 2 components in the rehabilitation program for shoulder instability
• List and define the 3 types of shoulder impingement
• Recall 2 Performance factors in pitching
• Cite 2 return to play criteria for the overhead athlete
• Identify one advantage of weighted ball holds
• Identify one disadvantage of weighted ball programs

• Recall the most common types of lumbar spine injuries among athletes participating in different sports.
• Identify one advantage and one disadvantage of the treatment-based classification system as it applies to the treatment of the athlete’s lumbar spine.
• List 3 contemporary treatment models that can be applied to the management of lower back pain in the athlete.
• Recall the definition and importance of red and yellow flags during the medical screening process.
• Identify 3 red flags that may implicate a non-mechanical source of lower back pain.
• List the difference between central and peripheral sensitization.
• List one treatment goal in phase 2 rehabilitation of the athlete’s lumbar spine.
• Cite one treatment principle in phase 3 rehabilitation of the athlete’s lumbar spine.
• Summarize two variations of the squat exercises that can be used to decrease strain on the lumbar spine.
• Recall three variations of the deadlift exercises that can be used to decrease strain on the lumbar spine.
• Summarize the McGill core endurance ratio tests that can be used to guide the return to sport decision making processes

Hour 1

• Recall the most common types of lumbar spine injuries among athletes participating in different sports.
• Identify one advantage and one disadvantage of the treatment-based classification system as it applies to the treatment of the athlete’s lumbar spine.
• List 3 contemporary treatment models that can be applied to the management of lower back pain in the athlete.

Hour 2

• Recall the definition and importance of red and yellow flags during the medical screening process.
• Identify 3 red flags that may implicate a non-mechanical source of lower back pain.
• List the difference between central and peripheral sensitization.

Hour 3

• List one treatment goal in phase 2 rehabilitation of the athlete’s lumbar spine.
• Cite one treatment principle in phase 3 rehabilitation of the athlete’s lumbar spine.
• Summarize two variations of the squat exercises that can be used to decrease strain on the lumbar spine.
• Recall three variations of the deadlift exercises that can be used to decrease strain on the lumbar spine.
• Summarize the McGill core endurance ratio tests that can be used to guide the return to sport decision making processes

• Recall two important functions of the fascial system.
• Cite 3 factors which impact the mechanical properties of fascia.
• State one structural/ anatomical difference between the fascia of young vs. older individuals.
• List two ways that fascial training can cause remodeling of the fascia.

• Outline the evidence regarding rehabilitation interventions following anterior cruciate ligament (ACL) or meniscal injury
• Evaluate the effectiveness of rehabilitation interventions for patients who have undergone anterior cruciate ligament reconstruction surgery 
• Examine the comparative effectiveness of surgery versus rehabilitation treatments after an anterior cruciate ligament (ACL) rupture 
• Compare the effectiveness of exercise therapy with non-steroidal anti-inflammatories (NSAIDs) and opioids for the management of pain in patients with knee osteoarthritis 
• Determine the patellofemoral joint reaction forces during everyday activities, therapeutic exercises, and physical interventions in healthy individuals and those with patellofemoral pain or osteoarthritis

• Identify exercise physiology concepts related to core conditioning
• Determine the anatomy related to the core and its function in core strength
• Design and implement a core conditioning program
• Summarize the role of psychological motivation in core conditioning
• Examine the various movements associated with core conditioning

Hour 1

• Define blood flow restriction training
• Present a brief history of BFRT
• Describe the physiological adaptations, and changes that occur with BFRT
• Show various applications of BRFT
• Provide a literature review of BFRT 

Hour 2

• Provide a literature review of BFRT (continued)
• Review BFRT equipment available
• Explain various protocols of BFRT
• Define patient indications and contraindications
• Discuss case studies with patient management

• Explain the biological mechanisms of Virtual Reality (VR) distraction, specifically the Gate Control Theory of pain and the process of descending inhibition.
• Differentiate between immersive VR and simple distraction, identifying the technical and psychological factors that contribute to the "being there" feeling required for clinical efficacy.
• Recognize the clinical benefits of VR for patients with kinesiophobia and chronic pain conditions, including documented reductions in pain intensity of 20% to 50%.
• Identify the legal distinctions between FDA-cleared Class II medical devices and consumer-grade wellness devices, including the requirements for prescriptions and "intended use" labeling.
• Define the appropriate scope of practice for non-mental health providers using VR, specifically focusing on its role as a physiological therapeutic adjunct rather than a primary mental health treatment.
• Implement essential safety screening protocols for VR therapy, including contraindications for epilepsy, motion sickness, and pregnancy.
• Draft comprehensive informed consent addendums that explicitly address VR-specific risks such as cybersickness and seizure triggers.
• Execute proper billing and documentation procedures to mitigate the risk of insurance audits, claim denials, and clawbacks.

• Explain the anatomy and functionality of healthy soft tissue components
• Explain the effects of injury on soft tissue
• Define effects of injured soft tissue on functionality of the spine and extremities
• Discuss patterns of musculoskeletal relationships of recruiting other structures after injury and their effects on functionality
• Describe various methods of treatment for dysfunctional soft tissue
• Explain relationship of injured tissue to its surrounding structures, its effects and treatment
• Explain compensation and recruitment of healthy tissue to the broader scope of complications and the effective treatment of primary and now secondary effects of injury
• Describe rehabilitation exercises in relation to proprioception

• This contains all courses with the educational objectives listed from Soft Tissue Injuries 101 to Soft Tissue Injuries 104 

• Explain the types of soft tissue
• Demonstrate and discuss diagnostic evaluation of soft tissue injury
• Explain pain patterns of neurological injury for differential diagnosis
• Discuss types of soft tissue injuries
• Evaluate soft tissue changes associated with pain
• Discuss the mechanisms of healing soft tissue injuries
• Describe diagnostic tools in determining soft tissue injuries
• Explain the use of ice and heat in soft tissue injuries
• Demonstrate and discuss stretching; passive, active and postfacilitation
• Demonstrate and discuss somatic technique
• Demonstrate and discuss strain/counterstrain
• Demonstrate and discuss friction massage
• Demonstrate and discuss Postisometric relaxation
• Demonstrate and discuss electrical muscle stimulation and ultrasound
• Demonstrate and discuss triggerpoint ultrasound in treatment
• Discuss massage therapy
• Demonstrate and discuss myofascial release
• Demonstrate and discuss active release
• Demonstrate and discuss Neuromuscular Therapy (NMT)
• Discuss cold laser therapy
• Demonstrate and discuss exercise rehabilitation and muscle strengthening
• Discuss mobilization and manipulation

• Explain the structural anatomy of the shoulder and its soft tissue
• Explain the functional anatomy of the shoulder and its soft tissue.
• Demonstrate the active and passive examination of the shoulder and soft tissue.
• Describe pathological conditions of the bony structures, joints, ligaments, tendons, bursa and muscles of the shoulder
• Describe sports injures to the shoulder.
• Describe injuries to the nerves, blood vessels and fascia of the shoulder.
• Demonstrate soft tissue treatments for pathological conditions of the bony structures, joints, ligaments, tendons, bursa and muscles of the shoulder.
• Demonstrate soft tissue treatments for the nerves, blood vessels and fascia of the shoulder.
• Define functional relationships of the shoulder with associated regions

• Explain the structural anatomy of the elbow, wrist, and hand and associated soft tissue
• Explain the functional anatomy of the elbow, wrist, and hand and associated soft tissue
• Demonstrate the passive examination of the elbow, wrist, and hand and associated soft tissue
• Demonstrate the active examination of the elbow, wrist, and hand and associated soft tissue
• Describe pathological conditions of the bony structures, joints, ligaments, tendons, muscles, fascia, bursa and nerves of the elbow, wrist, and hand
• Demonstrate soft tissue treatments for pathological conditions of the bony structures of the elbow, wrist and hand
• Demonstrate soft tissue treatments for the joints, ligaments, tendons, muscles, fascia, bursa and nerves of the elbow, wrist and hand
• Define functional relationships between the elbow, wrist and hand and with other regions

• This contains all courses with the educational objectives listed from Soft Tissue Injuries 105 to Soft Tissue Injuries 107 

• Explain the structural anatomy of the bones and joints of the cervical spine, ligaments and muscles of the cervical spine and the nerves, blood vessels and fascia of the cervical spine
• Explain the functional anatomy of the bones and joints of the cervical spine, the ligaments and muscles of the cervical spine and the nerves, blood vessels and fascia of the cervical spine
• Demonstrate the passive examination of the bones and joints of the cervical spine, the ligaments and muscles of the cervical spine and the nerves, blood vessels and fascia of the cervical spine
• Demonstrate the active examination of the bones and joints of the cervical spine, the ligaments and muscles of the cervical spine and the nerves, blood vessels and fascia of the cervical spine
• Discuss imaging of the cervical spine
• Discuss advanced testing of the soft tissue of the cervical spine
• Describe pathological conditions of the bony structures, joints, ligaments, tendons, muscles, nerves, blood vessels and fascia of the cervical spine
• Explain the mechanism of acceleration/deceleration impact
• Explain the effects on the cervical spine from acceleration/deceleration injury, and specifically the effects on the soft tissues structures
• Explain the grading system for acceleration/deceleration injury
• Demonstrate soft tissue treatments for the pathological conditions of the bony structures, joints, ligaments, tendons, muscles, blood vessels, nerves and fascia of the cervical spine
• Demonstrate soft tissue treatments for the sequela of acceleration/deceleration injury
• Define relationships of the cervical spine with other regions

• Explain the structural anatomy of the TMJ and its soft tissue
• Explain the functional anatomy of the TMJ and its soft tissue
• Demonstrate the passive examination of the TMJ and soft tissue
• Demonstrate the active examination of the TMJ and soft tissue
• Describe pathological conditions of the bony structures of the TMJ
• Describe pathological conditions of the joints of the TMJ
• Describe pathological conditions of the ligaments of the TMJ
• Describe pathological conditions of the muscles of the TMJ
• Describe injuries to the nerves, blood vessels and fascia of the TMJ
• Describe injuries from acceleration/deceleration impact to the TMJ
• Demonstrate soft tissue treatments for the joints of the TMJ
• Demonstrate soft tissue treatments for the ligaments of the TMJ
• Demonstrate soft tissue treatments for the muscles of the TMJ
• Demonstrate soft tissue treatments for the nerves, blood vessels and fascia of the TMJ
• Demonstrate soft tissue treatments for acceleration/deceleration injury to the TMJ
• Define functional relationships of the TMJ with associated regions

• Explain the structural anatomy of the bones, joints, ligaments, muscles nerves, blood vessels and fascia of the thoracic spine and rib cage
• Explain the functional anatomy of the bones, joints, ligaments, muscles nerves, blood vessels and fascia of the thoracic spine and rib cage
• Demonstrate the passive examination of the bones, joints, ligaments, muscles nerves, blood vessels and fascia of the thoracic spine and rib cage
• Demonstrate the active examination of the bones, joints, ligaments, muscles nerves, blood vessels and fascia of the thoracic spine and rib cage
• Discuss imaging of the thoracic spine and rib cage
• Describe pathological conditions of the bones, joints, ligaments, muscles nerves, blood vessels and fascia of the thoracic spine and rib cage
• Demonstrate soft tissue treatments for the bones, joints, ligaments, muscles nerves, blood vessels and fascia of the thoracic spine and rib cage
• Discuss relationships of the thoracic spine and ribs with other regions

• Explain the structural anatomy of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the lumbopelvic spine
• Explain the functional anatomy of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the lumbopelvic spine
• Explain biomechanics of the lumbopelvic spine
• Demonstrate the passive examination of bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the lumbopelvic spine
• Demonstrate the active examination of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the lumbopelvic spine
• Discuss radiographic imaging of the lumbopelvic spine
• Discuss advanced testing of the soft tissue of the lumbopelvic spine
• Describe pathological conditions of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the lumbopelvic spine
• Demonstrate soft tissue treatments for the pathological conditions of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the lumbopelvic spine
• Define relationships of the lumbopelvic spine with other regions

• Explain the structural anatomy of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the hip and knee
• Explain the functional anatomy of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the hip and knee
• Explain biomechanics of the hip and knee
• Demonstrate the passive examination of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the hip and knee.
• Demonstrate the active examination of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the hip and knee
• Discuss radiographic imaging of the hip and knee
• Discuss advanced testing of the soft tissue of the hip and knee
• Describe pathological conditions of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the hip and knee
• Demonstrate soft tissue treatments for the pathological conditions of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the hip and knee
• Define relationships of the hip and knee with other regions

• Explain the structural anatomy of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the ankle and foot
• Explain the functional anatomy of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the ankle and foot
• Explain biomechanics of the ankle and foot
• Demonstrate the passive examination of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the ankle and foot
• Demonstrate the active examination of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the ankle and foot
• Discuss radiographic imaging of the ankle and foot
• Discuss advanced testing of the soft tissue of the ankle and foot
• Describe pathological conditions of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the ankle and foot
• Demonstrate soft tissue treatments for the pathological conditions of the bones, joints, ligaments, muscles, bursa, nerves, blood vessels and fascia of the ankle and foot
• Define relationships of the ankle and foot with other regions.

• Discuss the development of strain/counterstrain
• Describe the theory of strain/counterstrain
• Describe the physiology of neuromuscular function
• Describe the diagnosis of tenderpoints and treatment  prioritization
• Discuss the technique of strain/counterstrain
• Explain tenderpoints
• Discuss method to locate tenderpoints
• Describe conditions that respond to strain/counterstrain
• Discuss treatment for the spine, TMJ and extremities
• Discuss treatment for craniosacral dysfunctions

• Discuss the benefits and protocols of stretching
• Discuss the theory and protocols of exercise rehabilitation
• Discuss the evaluation of posture
• Demonstrate postural corrections for the whole body
• Discuss proprioception in relation to core stability
• Demonstrate stretching and strengthening for the core
• Demonstrate balance work in relation to core strength
• Demonstrate stretching and strengthening for the foot, ankle, anterior compartment,  hamstrings, quadratus femoris, tensor fascia lata, adductor group, gluteal group, and iliopsoas, lumbar spine, thoracic spine, ribs, chest, cervical spine, TMG, shoulder, arm, forearm, wrist and hand
• Describe Yoga and Pilates for the whole body

• Explain the function of soft tissues
• Describe the development of scar tissue and adhesions in fascia, connective tissue, muscles, tendons, ligaments and joint capsules
• Discuss the benefits of deep tissue muscle and fascial release
• Define friction massage
• Describe friction massage for the upper extremity, lower extremity, spine and TMJ
• Define myofascial release
• Describe myofascial release for the upper extremity, lower extremity, spine and TMJ
• Define active release
• Describe active release for the upper extremity, lower extremity, spine and TMJ
• Define trigger point ultrasound
• Describe trigger point ultrasound for the upper extremity, lower extremity, spine and TMJ

• Educate patients on the function of soft tissues and the benefits of deep tissue muscle and fascial release.
• Describe the development of scar tissue and adhesions in fascia, connective tissue, muscles, tendons, ligaments and joint capsules.
• Perform postfacilitation stretch to the upper extremity, lower extremity and spine
• Perform somatic technique for the upper extremity, lower extremity and spine
• Utilize active release with your patient population
• Perform postisometric relaxation for the upper extremity, lower extremity and spine
• Apply therapeutic exercise and rehabilitative stretching with patients

• Describe the kinematics of acceleration/deceleration impact.
• Comprehend the history and development of acceleration/deceleration research.
• Defend injury manifestation using Whiplash guidelines and models.
• Apply current model theories to better understand injury from acceleration/deceleration impact.
• Explain to the patient the effects on the body during front, rear and side collisions.
• Educate the patient on variables such as vehicle size and direction and the effects on the human frame during acceleration/deceleration impact.
• Apply the variables of patient age, gender, size, etc during acceleration/deceleration impact.
• Express an understanding of incidence, prevalence, injury and risk factors associated with acceleration/deceleration impact.
• Describe the normal biomechanics of the cervical spine.
• Discuss cervical spinal anatomy vulnerable to injury.
• Define the nature of soft tissue structures; joints, ligaments, muscles, bursa, nerves, blood vessels and fascia.
• Inform your patients of the symptoms and changes to soft tissue structures after acceleration/deceleration impact.
• Explain the differences between scleratomal, dermatomal and myofascial pain.
• Discuss prognosis after acceleration/deceleration impact.
• Describe the normal biomechanics of the TMJ and associated soft tissue structures.
• Discuss injury to the TMJ and associated soft tissue structures.
• Explain the effects of trauma to the soft tissue of the spine, structures of the shoulder, elbow, wrist, hand, hip, knee, ankle and foot after acceleration/deceleration impact.
• Describe the normal biomechanics of the thoracic spine and rib cage.
• Describe the normal biomechanics of the lumbopelvic spine.
• Educate the patient on complicating factors for treatment after acceleration/deceleration impact.
• Determine the necessity and value of imaging and advanced diagnostic imaging after acceleration/deceleration impact.
• Perform complete examination of the soft tissue structures of the cervical spine, TMJ, thoracic spine, rib cage, lumbopelvic spine, shoulder, elbow, wrist, hand, hip, knee, ankle and foot after acceleration/deceleration impact.
• Utilize treatment protocols for soft tissue damage after acceleration/deceleration impact.
• Perform soft tissue treatments such as strain/counterstrain, postisometric relaxation, postfacilitation stretch, somatic technique, active and myofascial release, exercise and stretch, mobilization, manipulation and modalities.
• Utilize above mentioned soft tissue techniques to treat the cervical spine, TMJ, thoracic spine, rib cage, lumbopelvic spine, shoulder, elbow, wrist, hand, hip, knee, ankle and foot after acceleration/deceleration impact.
• Communicate to your patients the late effects of soft tissue injury after acceleration/deceleration impact.

• Describe biomechanics of movement of the joints, ligaments, muscles, tendons, bursa, nerves and fascia of the lower extremity, pelvis and spine, TMJ and upper extremity.
• Explain weight distribution and movement of ligaments, muscle and fascia in relation to the feet as foundation.
• Discuss soft tissue movement during standing, walking, running, twisting, bending, reaching and grasping.
• Relate movement interactions and stresses on soft tissues from one body region to another.
• Demonstrate to your patients, correct posture from the feet as foundation to the cervical spine.
• Educate and demonstrate the correct use of the core in posture.
• Show patients how to relax their shoulders using the thoracic spine as a lever.
• Describe and demonstrate appropriate gait in relation to correct posture.
• Explain to your patient how the soft tissue adapts to an unstable scoliosis.
• Apply understanding of injury dynamics in individual soft tissue structures (ligament, musculotendon, bursa, nerve, fascia).
• Interrelate soft tissue contractures from one region of the body to another.
• Learn passive and active examination techniques for all soft tissue structures of the soft tissue structures mentioned in Educational Objective 1.
• Review Applied Kinesiology as a tool for muscle isolation and clinical testing.
• Differentiate muscle strength testing from the proprioception evaluation of Applied Kinesiology.
• Integrate Applied Kinesiology examination and treatment into soft tissue evaluation and case management.
• Clinical examination of soft tissue structures of the soft tissue structures mentioned in Educational Objective 1.
• Apply examination findings into differentially diagnosing soft tissue fibrosis, scar tissue and adhesions, trigger points and pain radiation patterns.
• Inter-relate different regions of the body with local soft tissue findings.
• Discern appropriate clinical application for advanced imaging studies and soft tissue.
• Apply treatment protocols for ice, heat, stretching, Somatic Technique, Strain/counterstrain, friction massage, post-isometric relaxation, modalities, massage techniques, myofascial release, active release, Neuromuscular therapy, cold laser, exercise rehabilitations, mobilization and manipulation.
• Apply techniques mentioned in Educational Objective (above) as well as Applied Kinesiology to all joints, ligaments, muscles, tendons, bursa, nerves and fascia of the lower extremity, pelvis and spine, TMJ, and upper extremity.
• Relate treatments to improved movement locally, regionally and other affected regions and educate your patient to reasonable goals.
• View the soft tissue structures of the body as a whole with recognizable patterns of dysfunction and treat these soft tissues for greater flexibility and function.

Hour 1

• Discuss the soft tissues of the body for examination protocol and differential diagnosis.
• Correlate soft tissue pain radiation patterns and history to focus examination to appropriate soft tissues.
• Explain to your patient the types of soft tissue pain and injuries related to their condition.
• Identify soft tissue dysfunction consistent with injury.
• Utilize passive examination techniques to accurately record the effects of soft tissue injury to local and regional soft tissues.

Hour 2

• Utilize active examination techniques to accurately record the effects of soft tissue injury to local and regional soft tissues.
• Discern between neurological muscle strength testing, proprioceptive muscle strength testing using Applied Kinesiology and actual muscle fiber strength.
• Apply biomechanics of the upper and lower extremities, spine and TMJ to soft tissue examination protocol.
• Relate the biomechanical movement of the soft tissues of the foot and ankle to associated soft tissues during evaluation.
• Perform examination of the soft tissue structures of the foot and ankle as the biomechanical foundation of the body.

Hour 3

• Apply biomechanics of the entire lower extremity to soft tissue examination protocol.
• Relate the biomechanical movement of the soft tissues of the knee to associated soft tissues for evaluation.
• Perform examination of the soft tissue structures of the knee.
• Relate the biomechanical movement of the soft tissues of the hip to associated soft tissues during evaluation.

Hour 4

• Perform examination of the soft tissue structures of the hip.
• Relate the biomechanical movement of the soft tissues of the lumbopelvic spine to associated soft tissues for evaluation.
• Describe the movement of the soft tissues of the lumbar spine and sacroiliac joints for better patient compliance.
• Perform passive examination of the soft tissue structures of the lumbopelvic spine.

Hour 5

• Perform active examination of the soft tissue structures of the lumbopelvic spine.
• Relate the biomechanical movement of the soft tissues of the thoracic spine and rib cage to associated soft tissues for evaluation.
• Describe the movement of the soft tissues of the thoracic spine and rib cage for better patient compliance.
• Perform passive and active examination of the soft tissue structures of the thoracic spine and rib cage.

Hour 6

• Summarize biomechanics of the soft tissues of the cervical spine in their relation to the cranium.
• Relate the biomechanical movement of the soft tissues of the cervical sp8ine to associated soft tissues for evaluation.
• Perform soft tissue passive and active examination of the cervical spine.
• Determine cervical soft tissue dysfunction and its effects on the trunk, upper extremity and TMJ.

Hour 7

• Explain to patients the biomechanics of the TMJ in relation to their pain; and jaw and cervical spine dysfunction.
• Relate TMJ dysfunction in relation to biomechanical disturbances to the soft tissue of the cervical spine.
• Perform examination of the soft tissues of the TMJ with objective measurements to determine, record and track dysfunction and improvement.
• Describe the biomechanical movements of the shoulder.
• Relate the biomechanical movements of the shoulder to associated soft tissue structures of the cervical spine and thoracic spine and rib cage.

Hour 8

• Summarize biomechanics of the soft tissues of the elbow, wrist and hand for the purposes of examination.
• Relate the rotational movement of the shoulder, elbow, wrist and hand to determine soft tissue injury and dysfunction to associated soft tissue structures.
• Perform examination of the soft tissues of the elbow, wrist and hand to determine injury and dysfunction.
• Utilize appropriate advanced imaging methods for particular soft tissue structures.

Hour 1:

• Comprehend the human frame as interrelated biomechanical systems.
• Relate the functional anatomy of soft tissue structures to the movement of the human frame.
• Discern the six types of soft tissue end feel for evaluation of injury.
• Perform passive and active examination according to protocol developed by James Cyriax, MD.
• Distinguish between the types of injury and their effects on the soft tissues.

Hour 2:

• Identify soft tissue changes associated with injury.
• Discern which phase of healing is associated with the current presentation of injury.
• Apply mechanisms of healing to treatment protocol.
• Discuss diagnostic tools used to identify soft tissue injury.
• Utilize appropriate ice, heat and stretch protocols in the treatment of soft tissue injury.

Hour 3:

• Explain and perform Somatic Technique and Strain/Counterstrain.
• Understand friction anesthesia and palpatory methods for identifying trigger points.
• Differentiate between Postisometric Relaxation and Postfacilitation Stretch.
• Apply specific modalities for particular soft tissue injury patterns.
• Perform soft tissue restriction release methods.

Hour 4:

• Discern between mobilization and manipulation.
• Apply biomechanics of foot arch function to injury.
• Explain dynamic changes of foot during weight bearing, and walking on even and uneven surfaces.
• Utilize treatment protocols for common ankle sprains.
• Perform osseous manipulation to the bones of the foot and ankle.

Hour 5:

• Perform Strain/Counterstrain on the foot and ankle as an effective tool to release spasm and fixations.
• Discern and treat various pathological conditions related to the knee.
• Utilize myofascial release techniques to treat entrapment syndromes of the lower extremity.
• Explain functional movement of the hip.
• Apply functional kinesiology to the evaluation and treatment of the muscles associated with the hip.

Hour 6:

• Utilize treatment methods for contracted soft tissues of the lateral hip.
• Perform treatment protocols for the hamstrings/quadratus femoris.
• Explain the dynamics of correct posture.
• Recognize normal versus abnormal gait in patient observation.
• Describe nutation and counternutation of the pelvis.

Hour 7:

• Understand the various movements and fixations patterns in the Sacroiliac joints.
• Perform Strain/Counterstrain for the pelvis.
• Utilize a disc pump correction for mild to moderate disc lesions.
• Demonstrate James Cyriax MD protocol from manipulation of the low back.
• Devise a treatment protocol for sprain of the iliolumbar ligament.

Hour 8:

• Apply movement dynamics of the lumbopelvic spine to soft tissue injury.
• Utilize chest movement dynamics to help determine injury to the thoracic spine and rib cage.
• Provide affective treatment of the rib cage specific to rib articulations.
• Perform somatic Technique to the trapezius muscle for muscle awareness.
• Apply treatments to soft tissues of the rib cage without using electric modalities.

Hour 9:

• Discuss cervical spine mechanics as it applies to soft tissue injury.
• Create muscle awareness of the cervical extensor group with Somatic Technique.
• Reduce pain and spasm in an acute cervical spine injury using Strain/Counterstrain.
• Apply myofascial release to the soft tissues of the posterior cervico-thoracic spine.
• Educate the patient on corrective scoliosis exercises.

Hour 10:

• Relate the functional anatomy of the TMJ to soft tissue injury.
• Discern between Acute Closed lock and Acute Open Lock of the TMJ.
• Apply soft tissue treatments to the muscles of the TMJ.
• Use movement dynamics of the shoulder to better evaluate injury.
• Utilize a variety of soft tissue treatment in the treatment of adhesive capsulitis of the shoulder.

Hour 11:

• Differentially diagnose acromioclavicular joint injury and apply treatment to grades 1-3.
• Use soft tissue methods to treat the muscles of the rotator cuff.
• Discern and treat soft tissue structures related to the scapula.
• Perform a scapula mobilization technique to free up the functional scapulo-thoracic joint.
• Apply mechanisms of throwing to soft tissue injury and treatment.

Hour 12:

• Describe various soft tissue treatments for the elbow, wrist and hand and related functional dynamics of injury.
• Osseously manipulate the joints of the elbow, wrist and hand.
• Perform soft tissue treatment methods for injury to the myofascia associated with the upper extremity.
• Discern and treat all injured tendon sheath components of the wrist using soft tissue treatment methods.
• Differentially diagnose and treat nerve entrapment syndromes for the upper extremity.

• Explain the structural components of soft tissue.
• Relate impact forces to functional movements of soft tissue and the development of scar tissue and adhesions.
• Demonstrate diagnostic evaluation of soft tissue injury.
• Differentially diagnose types of soft tissue injury.
• Discuss the patterns of healing of soft tissue injuries.
• Describe the diagnostic tools in determining soft tissue injuries.
• Relate stress responses of soft tissues to development of structural and functional changes to injured tissues and their associated regions.
• Perform diagnostic tests and order imaging to best determine injury to soft tissue.
• Instruct the patient on correct application of ice and wet heat for soft tissue injury.
• Perform and explain proper stretching; passive, active and postfacilitation of soft tissues.
• Learn which therapy machines are best suited for your practice.
• Utilize infrared and electrical muscle stimulation in soft tissue injury.
• Apply appropriate contraindications of electric modalities to the individual patient’s care.
• Discern between the various EMS options for each soft tissue and injury (Interferentail current, galvanic, microcurrent, sine wave, Russian stimulation).
• Determine the most effective type of ultrasound for treatment of particular soft tissue injuries.
• Learn the benefits and applications of cold laser therapy.
• Understand the variety of massage therapy protocols and their applications.
• Discuss the benefits of each form of modality with your patient.
• Demonstrate and discuss exercise rehabilitation and muscle strengthening.
• Apply a combination of modalities for specific conditions of the upper and lower extremities and the spine.

• Discuss the normal function of soft tissues for support and movement to relate soft tissue injuries to postural anomalies. 
• Utilize the evaluation of the feet as a foundation for full body postural adaptations.
• Relate normal biomechanics of the foot, ankle, knee, hip, pelvis, spine, TMJ and upper extremities to normal posture and movement.
• Apply findings of injured soft tissues of the foot, ankle, knee, hip, pelvis, spine, TMJ and upper extremities to evaluation of normal and abnormal postural distortions.
• Discuss dynamic muscle stabilizers in the pelvis and abdominal core in relation to normal movement and fixations in the hip and pelvis.
• Relate the thoracic spine and rib cage to dynamic movement and postural adaptations in the spine, upper and lower extremities.
• Evaluate cervical joint dynamics in relation to compensations from the thoracic spine and rib cage, upper extremity and TMJ.
• Discern impact of TMJ function on cervical spine posture and head tilt.
• Relate abnormal scapular, glenohumeral joint and rotator cuff function to specific spinal and upper extremity postural distortions.
• Educate the patient in normal standing, seated, computer ergonomic, reclined, recumbent positions and normal gait to discern and recognize postural abnormalities.
• Relate functional dynamics during Acceleration/Deceleration Impact to soft tissue injury and postural adaptations to those injuries.
• Define causative factors for Scoliosis and relate muscle disparities of the multifidus to spinal, pelvic, rib cage and shoulder postural distortions for treatment protocol.
• Educate on causes of shoulder rounding, shoulder elevation; and backpack, throwing, tennis, golf, swimming, overhead sports injuries and their effects on spinal posture for rehabilitation.
• Understand and apply soft tissue treatment methods for the three posture types of Somatic Technique Theory: Red Light, Green Light and Dark Vise.
• Use Strain/Counterstrain, Friction Massage and Postisometric Relaxation as an effective tool for soft tissue damage contributing to postural distortion.
• Apply soft tissue treatment methods, modalities and rehabilitation to Pelvic Crossed Syndrome and Shoulder Crossed Syndrome.
• Apply Yoga for full body and regional postural corrections.
• Understand and explain proper postures for dance, martial arts, running, cycling, baseball, golf, tennis, standing, walking, sitting, computer ergonomics and sleeping.

• Utilize the World Health Organization (WHO) definition and classifications of headache complexes.
• Discern headache types using the International Headache Society definition and classifications of headache complexes.
• Integrate the Cleveland Clinic Headache classifications, descriptions, causes and treatment protocols.
• Compare efficacy in Cleveland Clinic treatment protocols of stress management, biofeedback, pharmaceuticals and prevention guidelines with manual medicine for outcome for your patients.
• Explain headache complexes in children and adults.
• Discuss Craniopathy and Cranial Osteopathy and its application in treating headaches.
• Apply the three approaches for Cranial Osteopathy; meningeal, reflex and sutural.
• Determine appropriate conditions indicated for use of Craniopathy and contraindications.
• Examine cranial bone anatomy.
• Integrate brain and spinal cord anatomy in relation to cranial bone anatomy and function.
• Relate spinal dural anatomy to dural torque in the cervical spine and cranium and its relationship to headaches.
• Collate signs and symptoms of traumatic brain injury into the evaluation of the cranium and headaches.  
• Relate the function of the cranial bones with the temporomandibular joint (TMJ).
• Utilize the structural and functional anatomy of the soft tissues of the TMJ for differential diagnosis of headaches and jaw dysfunction.
• Apply functional anatomy of the TMJ to functional anatomy of the cranial bones and cervical spine in relation to headaches.
• Demonstrate the evaluation of mandibular gait and disc condyle gait, normal and pathological.
• Define muscles of the jaw and cranium and their interrelationship regarding headaches and cranial faults.
• Relate the function of the cranial bones with the cervical spine.
• Utilize the structural and functional anatomy of the cervical spine for examination of soft tissues and pathology related to headaches.
• Determine which soft tissue structures when dysfunctional lead to headaches.
• Discern soft tissue pathology from examination for the differential diagnosis of causative factors headaches.
• Apply the functional anatomy of the TMJ and cervical spine to pathological conditions in these regions that can cause headaches.
• Explain the history and definitions of Craniopathy from 1596 - present.
• Explain the history and definition of Cranial Osteopathy and Craniosacral Therapy in Osteopathic Medicine.
• Determine pathology in the TMJ through thorough history using passive and active examination procedures and relate findings to headaches.
• Apply the VROM (vertical range of motion) scale to TMJ movement analysis.
• Treat the TMJ using a variety of methods.
• Perform Cranial Bone examination to find cranial faults using Sacro Occipital Technique (SOT) and relate findings to headaches.
• Apply Mind Language to cranial bone evaluation for SOT Category I and II.
• Perform Cranial Bone examination to find cranial faults using Applied Kinesiology (AK) and relate findings to headaches.
• Demonstrate effective muscle testing techniques when applying AK for cranial bone examination.
• Diagram the sequencing of Cranial Bone Examination using AK and its application during treatment.
• Differentially diagnose individual cranial faults and their relationship to one another during examination and treatment.
• Treat cranial bone faults using the methods discussed.
• Determine soft tissue and joint pathology in the cervical spine using active and passive examination procedures as well as functional testing to relate findings to headaches.
• Differentiate pain quality between the soft tissue structures (periosteum, joint, ligament, muscle, tendon, bursa, fascia, vascular and nerve).
• Utilize motion palpation as a tool to determine cervical spine joint fixation and dysfunction.
• Apply soft tissue palpation methods to evaluate the soft tissues of the cervical spine.
• Assess the cervical spine soft tissue structures using passive and active functional testing.
• Detect pathological conditions of the soft tissues of the TMJ as they relate to headaches.
• Relate the mechanics of Acceleration Deceleration Impact of the TMJ as a causative factor in injury and relationship to headaches.
• Assess pathological conditions of the soft tissue structures of the cervical spine (periosteum, joint, ligament, muscle, tendon, bursa, fascia, vascular and nerve) and relate the pertinent conditions to headaches.
• Detect bony defects, osseous and congenital that alter function in the cervical spine with the potential causative factor for headaches.
• Interpolate findings of scoliosis as a complicating factor in cervical spine dysfunction in relation to headaches.
• Relate the mechanics of Acceleration Deceleration Impact of the cervical spine as a causative factor in soft tissue injury and relationship to headaches.
• Apply treatment protocols for headaches using Craniopathy and Sacro-Occipital Technique (SOT) to address pathological conditions of the TMJ.
• Apply treatment protocols for headaches using soft tissue methods, modalities and manipulation for the pathological conditions of the TMJ.
• Apply treatment protocols for headaches using Craniopathy and SOT for the cranial bones and TMJ.
• Apply treatment protocols for headaches using Craniopathy and Applied Kinesiology (AK).
• Develop treatment sequencing practices and corrections for cranial faults in relationship to headaches.
• Integrate sinus congestion corrections into treatment protocols for cranial faults and headaches.
• Determine the effects of the rebound in the closed system of the cranium and apply the findings to cranial bone treatment.
• Apply treatment protocols for headaches using soft tissue methods, modalities and manipulation for the pathological conditions of the cervical spine.
• Determine pain radiation patterns of trigger points in the cervical spine in relation to head pain.
• Evaluate the most conducive manual methods to determine the most affective soft tissue treatments of the soft tissues of the cervical spine including Strain Counterstrain, postfacilitation stretch, somatic technique, postisometric relaxation, modalities, massage, manipulation and mobilization.
• Apply manual methods, modalities, mobilization and manipulation to pathological conditions cervical spine in relation to headaches.
• Apply treatment protocols to scoliosis in relation to cervical spine dysfunction and headaches.
• Relate treatment of the cervical spine after Acceleration Deceleration Impact to the treatment of headaches.
• Review a case study on the use of cranial fault correction, manipulation, manual methods and modalities in a patient with Cluster Headaches.
• Derive confidence in treating severe headache complexes using soft tissue treatments, Craniopathy, modalities and manual methods.

• Differentiate ossification from calcification
• Identify the categories of ossification
• Differentiate myositis ossificans progressiva from myositis ossificans traumatica
• Discuss imaging utilization with regards to ossification
• Review common and uncommon entities predisposed to ossification or calcification

• Recognize and identify important key factors for interpreting plain film x-rays of the spine and pelvis
• Recognize important medical/legal issues regarding interpreting plain films of the spine and pelvis and be able to apply appropriate radiographic documentation requirements when charting x-ray findings in the medical record
• Identify, analyze and interpret normal and abnormal anatomical osseous structures, common congenital and acquired pathologies, common normal radiographic variants and soft tissue calcifications/structures of the cervical, thoracic, lumbar, lumbosacral spine and pelvis

• Alert your clinical consciousness to prevent complacency
• Explain ways to identify the most common aneurysms clinically and on x-ray in the abdominal aorta, thoracic aorta, and splenic artery
• Differentiate aneurysm from dissection and pseudoaneurysm

• Identify the source of metastatic lesions
• Determine an advanced imaging protocol once a metastatic lesion is found
• Discuss how to identify on radiographs the two most common primary malignancies of bone - multiple myeloma and osteosarcoma

• Discuss the fundamental role of trauma in musculoskeletal disease and the various diagnostic imaging techniques used to evaluate it
• Identify, describe, and classify fractures by both direct & indirect radiographic signs
• Review fractures of specific etiologies based upon imaging findings
• Evaluate fracture alignment issues, complications, and healing
• Identify non-accidental injury of childhood, as well as normal structures that mimic fractures

• Understand Osteoporosis - (risk factors, incidence, prevalence, morbidity, etc.)
• Understand the fundamentals of DEXA (dual-energy x-ray absorptiometry), the gold standard in bone density testing
• Explain how to interpret the results
• Investigate the advantages and limitations of DEXA
• Investigate the indications and contraindications for utilization of DEXA

• This contains all courses with the educational objectives listed in Xray 119, and, Xray 123 through 127

• Use plain film to identify imaging findings of common diabetic foot fractures
• Discuss foot ulcers and using diagnostic imaging to rule out secondary osteomyelitis
• Identify diagnostic imaging findings of neuropathic osteoarthropathy (Charcot foot)

• Explain the clinical presentation, physical examination findings, orthopedic tests, laboratory findings, and radiographic findings associated with ankylosing spondylitis
• Discuss the extraskeletal manifestations of ankylosing spondylitis
• Explain the similarities and differences between the spondyloarthropathies
• Discuss the surgical and pharmacological management
• Discuss treatment that promotes spine mobility including the chiropractic adjustment

• This contains all courses with the educational objectives listed from Xray 124 through 146

• Explain the origin and pathophysiology of gout
• Understand how to prevent and monitor gout
• Examine gout on plain film
• Determine the clinical presentation of gout
• Describe the differences between the crystal arthritides on plain film

• Describe the patients that are at risk for developing osteoarthritis
• Summarize the pathophysiology behind the disease
• Discuss what osteoarthritis looks like on plain film and which joints are most likely affected
• Discuss the use of advanced imaging in osteoarthritis
• Present the research on many conservative treatment options including: physiotherapy, physical therapy/exercise, diet, and acupuncture

• Describe the anatomy of the disc and what causes the disc herniation
• Discuss the clinical presentation and who is at risk for a disc herniation
• Explain the diagnostic imaging findings for the disc herniation patient
• Evaluate the treatment options for disc herniation patients

• Assess the clinical presentation and diagnostic imaging procedure for vertebral compression fractures
• Discuss the use of plain film, CT, MRI, and DEXA
• Discuss treatments for vertebral compression fractures
• Identify other causes of vertebral fractures
• Identify other fractures besides vertebral fractures

• This contains all courses with the educational objectives listed from Xray 129 to Xray 134

• Summarize the current literature on fracture prevention
• Discuss diagnostic imaging and treatment of hip fractures
• Evaluate common lower extremity fractures, including stress fractures
• Discuss common upper extremity fractures, including the Colle's fracture and stress fractures
• Demonstrate knowledge of fractures in special populations, including adolescents and the developmentally disabled

• Evaluate the plain film images of upper and lower extremity dislocations
• Determine the mechanism of action and clinical presentation for upper and lower extremity dislocations
• Summarize the treatment options for the different upper and lower extremity dislocation
• Use assessment tools to determine treatment outcomes for extremity dislocations

• Determine the risk of MRI procedures and gadolinium contrast agents with respect to children
• Discuss the consequences of ionizing radiation in plain film, computed tomography, nuclear medicine, and fluoroscopy
• Demonstrate procedures to lessen the consequences of diagnostic imaging and discuss alternatives to the riskier modalities

• Determine the risks of ionizing radiation on the fetus
• Demonstrate the usefulness and limitations of ultrasound with regards to the pregnant woman
• Analyze the appropriate usage of magnetic resonance imaging in fetal diagnoses

• This contains all courses with the educational objectives listed from Xray 133 through Xray 144

• Demonstrating the differences between pediatric fractures and adult fractures
• Looking at the red flags for reporting non-accidental trauma (child abuse)
• Identifying fractures in children with osteopenia
• Discussing common upper extremity and lower extremity fractures
• Assessing proper protocol in imaging pediatric fractures, namely the use of plain film, ultrasound, MRI and CT

• Identifying bone and joint uses for PET
• Discussing neurological uses of PET, focusing on Parkinson’s disease and Alzheimer’s disease diagnosis
• Demonstrating the oncology use of PET
• Comparing PET with other diagnostic imaging modalities

• Determine the skeletal manifestations of neurofibromatosis and Paget’s disease
• Assess the diagnostic features of someone with neurofibromatosis or Paget’s disease
• Identify benign and malignant tumors commonly associated with neurofibromatosis and Paget’s disease
• Discuss the pathophysiology of neurofibromatosis and Paget’s disease

• Order proper diagnostic imaging for the lumbar spine
• Determine appropriate imaging for various pediatric musculoskeletal complaints
• Use plain film imaging for extremity complaints
• Determine what advanced imaging is appropriate for different extremity pathology

• Recognize normal bony and soft tissue anatomy of the upper cervical spine.
• Describe the direct and indirect signs of cervical trauma.
• Identify the more common mimics to cervical spine trauma.
• Summarize specific traumatic conditions affecting the upper cervical spine and their imaging findings.
• Assess which traumatic conditions of the upper cervical spine are stable, which are unstable, and how to manage each.

• Determine the diagnostic imaging findings consistent with a diagnosis of emphysema
• Discuss the plain film findings of congestive heart failure and conservative treatment options for these patients
• Determine the stage of sarcoidosis on plain film
• Identify the most common mediastinal masses of the chest
• Analyze different diagnostic imaging manifestations of pneumonia

• Analyze the debate between ALARA and AHARS with respect to the allowable amount of artificial radiation
• Express the cost vs. benefit of using CT, the imaging modality with the highest radiation risk
• Understand the added risk of radiation consequences in children
• Identify the different types of ionizing radiation

• Assess cervical radiographs to identify the radiographic signs of lower cervical spine trauma, recognizing which views are most diagnostic.
• Recognize, differentiate, and classify cervical hyperflexion and hyperextension injuries with respect to spinal stability.
• Identify and describe the imaging findings of neural arch trauma in the lower cervical spine.
• Discuss and categorize the complications of lower cervical spine trauma.
• Summarize the gravity as well as the evolving imaging and management protocols of penetrating neck injury.

• Summarize the radiographic findings of simple compression fractures and discuss how spinal biomechanics predispose to their occurrence.
• Describe the radiographic signs and sequelae of burst fractures and differentiate them from simple compression fractures.
• Identify the imaging findings of Chance type fractures and discuss their most common complications.
• Recognize the common radiographic manifestations of posterior arch trauma.
• Categorize the different types of intervertebral disc lesions and summarize their imaging findings.

• Examine common orthopedic hardware on plain film and what needs to be reported
• Explain Xray findings which require Orthopedic referral and the various options
• Determine when advanced imaging is appropriate and what modality to use
• Discuss possible complications when finding orthopedic hardware

Hour 1

• Examine common orthopedic hardware on plain film and what needs to be reported
• Explain Xray findings which require Orthopedic referral and the various options
• Determine when advanced imaging is appropriate and what modality to use
• Discuss possible complications when finding orthopedic hardware

Hour 2

• Discuss congestive heart failure: diagnosis, imaging, and treatment
• Understand the imaging and treatment of multiple myeloma
• Understand the nature of chronic obstructive pulmonary disease, specifically emphysema
• Evaluate the use of DXA in the diagnosis of osteoporosis
• Determining appropriate care for patients with osteoarthritis

Hour 3

• Determining common geriatric conditions that need special consideration in a patient assessment
• Identifying diabetic foot complications, specifically Charcot's foot
• Analyzing bone metastasis in the elderly, specifically carcinomas
• Understanding thoracic and abdominal aorta aneurysms and aorta dissections
• Explaining pneumonia, specifically community acquired pneumonia, from a clinical perspective

Hour 4

• Determining the risk factors, diagnostic imaging and pathophysiology of atherosclerosis
• Assessing patient risk for developing hip fractures
• Understanding prevention and diagnosis of lung cancer
• Identifying normal anatomy of the disc and what goes wrong in degenerative disc disease
• Reviewing common orthopedic hardware found in elderly patients

• Discuss congestive heart failure: diagnosis, imaging, and treatment
• Understand the imaging and treatment of multiple myeloma
• Understand the nature of chronic obstructive pulmonary disease, specifically emphysema
• Evaluate the use of DXA in the diagnosis of osteoporosis
• Determining appropriate care for patients with osteoarthritis

• Determining common geriatric conditions that need special consideration in a patient assessment
• Identifying diabetic foot complications, specifically Charcot's foot
• Analyzing bone metastasis in the elderly, specifically carcinomas
• Understanding thoracic and abdominal aorta aneurysms and aorta dissections
• Explaining pneumonia, specifically community acquired pneumonia, from a clinical perspective

• Determining the risk factors, diagnostic imaging and pathophysiology of atherosclerosis
• Assessing patient risk for developing hip fractures
• Understanding prevention and diagnosis of lung cancer
• Identifying normal anatomy of the disc and what goes wrong in degenerative disc disease
• Reviewing common orthopedic hardware found in elderly patients

• Explaining in layman’s terms the basics of cancer
• Determining prognosis when skeletal metastasis is found on plain film
• Identifying osteolytic versus osteoblastic metastasis on plain film and specifying what advanced imaging is appropriate based on the cancer’s radiographic appearance
• Exploring current literature on emerging treatment options
• Discussing pathophysiology of bone metastasis

• This contains all courses with the educational objectives listed from Xray 154 to Xray 158

Hour 1

• Describing common conditions affecting the middle aged adult, including the following: osteoarthritis, rheumatoid arthritis, disc herniations, Type 2 diabetes mellitus, and abdominal aortic aneurysms
• Observing diagnostic imaging related to each of the above conditions and determining the best imaging modality to use for the various conditions
• Determining appropriate prevention and ancillary treatments for the discussed conditions

Hour 2

• Analyzing obesity through assessment and intervention
• Discussing breast cancer diagnostic imaging and disease management
• Diagnosing and treating congestive heart failure
• Evaluating diagnosis and treatment options for the osteoporosis patient

• Outline the utility of bone scintigraphy in the pediatric population
• Summarize basic bone physiology & radiopharmaceutical dosing
• Discuss image acquisition and analyze scans for signs of pathology
• Identify common clinical indications for pediatric bone scintigraphy
• Recognize the various imaging phases of bone scintigraphy and their clinical utility

• Identify the risk factors for breast cancer – preventable and non-preventable.
• Determine appropriate diagnostic imaging for screening and breast cancer assessment.
• Investigate different CAM approaches to breast cancer prevention and symptom management.

• In plain film radiographs, identify the orthopedic hardware used to treat femur, humerus, tibia, and radius fractures.
• Discuss special situations for fracture repair, such as osteoporosis, metastasis, pediatrics, and obesity.
• Review various fracture risk assessment tools that can be used in clinical practice.
• Evaluate when various hardware such as screws, nails, and plates are utilized.

• Identifying vertebral characteristic features on plain film for the following diagnoses: Adolescent Idiopathic Scoliosis, Neurofibromatosis-1, Multiple myeloma, Paget's disease of bone, and vertebral compression fractures.
• Determining what advanced imaging might be warranted for each of the vertebral conditions.
• Describing general features of each condition such as incidence, clinical presentation and treatment options.

• Determine the incidence and the characteristics of different spine pathology.
• Demonstrate, with plain film radiographs and magnetic resonance imaging, characteristics of central nervous system tumors and metastasis, syringomyelia, disc herniation, and trauma.
• Identify clinical features and treatment for various spine pathologies.

• Understand the general features of the inflammatory arthritides
• Discuss the clinical presentation, radiographic features, and chiropractic treatments for Rheumatoid Arthritis
• Discuss the clinical presentation, radiographic features, and chiropractic treatments for Ankylosing Spondylitis
• Compare the two most common inflammatory arthritides – Rheumatoid Arthritis and Ankylosing Spondylitis – to the other diseases in this category
• Compare the inflammatory arthritides to the most common arthritide – osteoarthritis

• Differentiate Rheumatoid Arthritis from Ankylosing Spondylitis, the two most common inflammatory arthritides.
• Differentiate Rheumatoid Arthritis from Erosive Osteoarthritis, both hand arthritides.
• Differentiate Degenerative from Inflammatory arthritis.
• Differentiate Osteoarthritis from Gout, the most common arthritide and the most common metabolic arthritide respectively.

• Determine the safety of surgical clips with magnetic resonance imaging
• Examine the safety and usage of computed tomography and magnetic resonance imaging for patients with embedded bullets or shrapnel
• Assess the major types of hip arthroplasty and the usefulness of computed tomography and plain film x-ray
• Utilize different diagnostic imaging modalities for analysis of spinal fusion
• Identify external fixators on plain film and advanced imaging

• Assess the signs of non-accidental trauma in infants.
• Identify the unique childhood fracture known as the greenstick fracture.
• Evaluate a young adult for potential cervical spine fracture after trauma.
• Determine the work-up of a middle-aged patient with a Colles’ fracture.
• Examine the osteoporosis vertebral compression fracture, and consider diagnosis, treatment, and prevention.

• Develop and consistently use a complete search pattern for abdominal radiographs.
• Link the history and physical examination findings with the radiological abnormalities to arrive at a reasonable diagnosis or differential diagnosis.
• Identify the various soft tissue calcifications within the abdomen and state their clinical relevance.
• Know the indications for referral based on abnormal abdominal radiographic findings.
• Select appropriate imaging or other diagnostic procedures based on the history and physical examination.

Hour One:

• Identify normal/abnormal anatomical structures i.e.: osseous anatomy of the cervical spine
• Identify, analyze and interpret the importance of an increase ADI
• Identify normal/abnormal anatomical soft tissue structures (i.e.: calcifications of carotid/vertebral arteries and thyroid cartilage) of the cervical spine
• Recognize the importance of specific laboratory and diagnostic studies to aid in the differential diagnosis of common radiographic findings to rule out most often seen musculoskeletal disorders of the cervical spine

Hour Two:

• Identify normal/abnormal anatomical structures i.e.: osseous anatomy of the thoracic spine
• Identify normal/abnormal anatomical soft tissue structures (costal cartilage calcifications, trachea and bronchial air shadows, heart, diaphragm, hilar region, aortic knob etc.)
• Recognize the importance of specific diagnostic studies to aid in the differential diagnosis of common radiographic findings to rule out most often seen musculoskeletal disorders of the thoracic spine

Hour Three

• Identify normal/abnormal anatomical structures i.e.: osseous anatomy of the lumbar spine and pelvis
• Identify normal/abnormal anatomical soft tissue structures i.e.: vascular calcifications like abdominal aortic aneurysm, mesenteric lymph nodes etc
• Recognize the importance of specific laboratory and diagnostic studies to aid in the differential diagnosis of common radiographic findings to rule out most often seen musculoskeletal disorders of the lumbar, lumbosacral spine and sacroiliac joints

• Analyze the risk factors and causes of the distal radius fracture in teenagers.
• Utilize diagnostic imaging to assess the adolescent idiopathic scoliosis (AIS).
• Describe the risk factors leading to a poor outcome for patients with osteosarcoma.
• Evaluate the various ways Ewing sarcoma presents on x-ray.
• Differentiate ganglioneuroma from other neurogenic tumors.

• Develop and consistently use a complete search pattern for chest radiographs. 
• Recognize and describe the radiological features of a normal lung. 
• Recognize and describe the radiological features of pathology on chest radiographs 
• Link the history and physical examination findings with the radiological abnormalities to arrive at a reasonable diagnosis or differential diagnosis. 
• Discuss the indications for referral based on abnormal chest radiographic findings. 
• Select appropriate imaging or other diagnostic procedures based on the history and physical examination

• Develop and consistently use a complete search pattern for chest radiographs. 
• Recognize and describe the radiological features of a normal lung. 
• Recognize and describe the radiological features of pathology on chest radiographs 
• Compare, contrast and describe the radiographic signs of Atelectasis and Consolidation of the lungs.
• Recognize and describe the radiological features of Interstitial disease (Infiltrative disease) of the lungs.
• Identify the various diseases that can result in Atelectasis, Consolidation, Interstitial patterns
• Link the history and physical examination findings with the radiological abnormalities to arrive at a reasonable diagnosis or differential diagnosis. 
• Discuss the indications for referral based on abnormal chest radiographic findings. 
• Select appropriate imaging or other diagnostic procedures based on the history and physical examination

• Develop and consistently use a complete search pattern for chest radiographs.
• Recognize and describe the radiological features of Interstitial disease (Infiltrative disease) of the lungs.
• Identify the various diseases that can result in Atelectasis, Consolidation, Interstitial patterns.
• Link the history and physical examination findings with the radiological abnormalities to arrive at a reasonable diagnosis or differential diagnosis.
• Discuss the indications for referral based on abnormal chest  radiographic findings.Select appropriate imaging or other diagnostic procedures based on the history and physical examination.

• Develop and consistently use a complete search pattern for chest radiographs.
• Link the history and physical examination findings with the radiological abnormalities to arrive at a reasonable diagnosis or differential diagnosis.
• Recognize the presence of hilar enlargement.
• Know the conditions that can lead to hilar enlargement.
• Recognize the presence of mediastinal masses and know the disease that can cause mediastinal mass.
• Be able to identify diaphragmatic hernias on chest radiographs Know the indications for referral based on abnormal chest radiographic findings.
• Select appropriate imaging or other diagnostic procedures based on the history and physical examination.

• Develop and consistently use a complete search pattern for chest radiographs.
• Recognize and describe the radiological features of pleural fluid.
• Recognize and describe the radiological features of pleural calcification.
• Recognize and describe the radiological features of pleural-based tumors.
• Identify the various diseases that can result in Atelectasis, Consolidation, Interstitial patterns and pleural fluid.
• Link the history and physical examination findings with the radiological abnormalities to arrive at a reasonable diagnosis or differential diagnosis.
• Know the indications for referral based on abnormal chest radiographic findings.
• Select appropriate imaging or other diagnostic procedures based on the history and physical examination.

• Execute a complete search pattern for chest radiographs.
• Recognize and identify the different patterns of chest pathology.
• Recognize the radiological features of primary lung tumors.
• Recognize various radiological features of secondary tumors of the lungs.
• Link the patient’s clinical presentation with the chest radiograph to arrive at a reasonable diagnosis or differential diagnosis.
• Make a referral based on abnormal chest radiographic findings.
• Select appropriate imaging or other diagnostic procedures based on the history and physical examination

• Identify pathology on chest radiographs 
• Recognize the radiographic signs of different chest pathologies such as Atelectasis, Consolidation, infiltrative disease, and plural disease. 
• Recognize radiological features of Pneumoconiosis and Chronic Obstructive Pulmonary diseases. 
• Differentially diagnose based on the patient clinical presentation and chest radiographic findings. 
• Make referral based on abnormal chest radiographic findings. 
• Select appropriate imaging or other diagnostic procedures based on the history and physical examination.

• Apply a complete search pattern for chest radiographs.
• Identify the various diseases that can result in Consolidation, and Interstitial/Infiltrative disease.
• Link the history and physical examination findings with the radiological abnormalities to arrive at a reasonable diagnosis or differential diagnosis.
• Recognize and describe the radiographic signs of granulomatous disease on chest radiographs.
• Recognize and describe the abnormal radiographic signs of the common Cardiovascular diseases.
• Refer based on abnormal chest radiographic findings.

• Differentiate the presenting features of Ewing’s sarcoma, chondrosarcoma, osteosarcoma and metastasis in the extremities.
• Determine the appropriate diagnostic imaging and identify the characteristic features of Ewing’s sarcoma, chondrosarcoma, osteosarcoma, and metastasis on diagnostic imaging.
• Identify the treatment options and prognosis for patients with Ewing’s sarcoma, chondrosarcoma, osteosarcoma or metastasis in the extremities.

• Determine how a torus fracture looks on plain film radiographs and how to manage the fracture
• Utilize the scoring criteria in the diagnosis and denoting the disease progression in the gout foot on plain film radiographs
• Describe the most common primary tumors that result in foot metastasis
• Explain the typical appearance of the rheumatoid foot on radiographs and how to assess and manage the condition
• Evaluate how to diagnose and appropriate treatment methods for the Lisfranc fracture-dislocation.

• Evaluate hand chondrosarcoma by identifying the following: diagnostic imaging features and treatment options.
• Differentiate erosive osteoarthritis from other hand osteoarthritis cases and determine how to assess and treat them.
• Identify the appearance on radiographs and treatment of the various finger dislocations.
• Discuss how diagnostic imaging can help identify disease progression and symptoms in patients suffering from rheumatoid arthritis in the hand.
• Explain the most likely hand injuries in the child and athlete and the treatment options for each.

• Examine the appearance and use of plain film, computed tomography (CT), and magnetic resonance imaging (MRI) in the evaluation of bullets to the head.
• Identify Arnold-Chiari Type I malformation with magnetic resonance imaging.
• Review CT, positron emission tomography (PET), and MRI findings for cerebral bleeds.
• Evaluate stroke using different types of CT and MRI imaging.
• Discuss what to look for clinically and radiographically in cases of child abuse induced head trauma.

• Conduct and evidence-based assessment of the diagnostic, therapeutic and clinical utility of routine and repeat radiographs (without red flags) for the structural and functional assessment of the spine by chiropractors
• Summarize the current evidence for the use of spinal x-rays within chiropractic practice, with consideration to the related risks and benefits
• Determine if diagnostic imaging influences clinical outcomes in patients with low back pain presenting for chiropractic care
• Analyze whether an association between vertebral endplate structural defects and back pain exists
• Assess the relationship between movement-related pain in the shoulder and the number or severity of rotator cuff MRI findings

Hour 1

• Select the appropriate imaging modality for suspected foreign bodies
• Identify foreign bodies on radiographs
• Identify foreign bodies CT
• Identify foreign bodies MRI
• Identify foreign bodies Ultrasound

Hour 2

• List various indications for radiographic evaluation in relationship to specific clinical scenarios
• List various limitations for radiographic evaluation in relationship to specific clinical scenarios
• Identify fracture patterns on radiographic imaging
• Identify radiographic abnormalities within the soft tissues

 Hour 3

• List various indications for MRI and CT imaging evaluation in relationship to specific clinical scenarios
• List various limitations for MRI and CT imaging evaluation in relationship to specific clinical scenarios
• Identify osseous landmarks on MRI and CT imaging
• Identify abnormalities within the bones and soft tissues on MRI and CT imaging

 Hour 4

• List various indications for ultrasound imaging evaluation in relationship to specific clinical scenarios
• List various limitations for ultrasound imaging evaluation in relationship to specific clinical scenarios
• Identify osseous landmarks on ultrasound imaging
• Identify abnormalities within the bones and soft tissues on ultrasound imaging