Courses - Cervico-Cranio-Mandibular Academy

CCMA training program

1. Comprehensive Cervico-Cranio-Mandibuar (CCM) – 64 Hours

Course title	Comprehensive CCM therapeutics
Instructor	Tzvika Greenbaum, BPT MaPT (Manip & Sports) PhD
Participants	Physiotherapists, Osteopaths, Chiropractors
Description	The main role of the neck is to carry the head and to serve its main functions as vision, hearing, mastication (including taste) and position in space (proprioception). This major role connects the neck-head-face & jaw into one major functional complex in which its components are inter-related and affects each other. Additionally, the modern neuroanatomy research points out the tight neural sensory connection between the complex parts so that noxious stimuli in one part (right side of upper neck) can easily lead to pain presentation in other part (around the right eye) and vice versa. Therefore, the ideal management for us as Physiotherapists in this region requires understanding of the whole Cervical-Cranio-Mandibular complex. In this comprehensive course, participants will learn the evidence informed effective assessment & practical management of people with musculoskeletal pain and dysfunction in their CCM complex. The course consists of 3 equal parts: Cranio-Cervical (CC) therapeutics Cervico-Brachial (CB) therapeutics Cranio-Mandibular (CM) therapeutics
Contact hours	This is a 64 hour course (8 full days)
Course objectives	After completing to course participant will be able to: Know the up to date scientific background of musculoskeletal pain & dysfunction in the CCM complex Recognize signs & symptoms of serious medical problem (none musculoskeletal) in people with CCM complex pain (red flags) and will know to response accordingly Practically know to assess, evaluate & recognize common clinical patterns in people with musculoskeletal pain & dysfunction in the CCM complex Practically use a relevant clinical reasoning model of management in people with pain & dysfunction in the CCM complex Effectively & safely treat people with musculoskeletal pain and dysfunction in the CCM complex using hands on & exercise modalities
Course format	Instructor led course: lectures (40%) & practical (60%) sessions

Upcoming Courses

2. Cranio-Mandibular (CM) – 24 Hours

Course title	CM therapeutics
Instructor	Tzvika Greenbaum, BPT MaPT (Manip & Sports) PhD
Participants	Physiotherapists, Osteopaths, Chiropractors
Description	Temporomandibular Disorders (TMD) refer to several highly common clinical disorders that involve the masticatory muscles, the temporomandibular joint (TMJ) and the adjacent structures. TMD is one of the most frequent causes of orofacial pain & headache and is associated with basic functional limitations such as difficulties in chewing, talking and yawning. Additionally TMD patients tends to suffer from other disabling pain syndromes such as Migraine, tension type HA and neck pain – therefore introducing a challenge to clinicians. In this course, participants will learn effective evidence informed assessment & practical management of people with TMDs and associated disorders.
Contact hours	This is a 24 hour course (3 full days)
Course objectives	After completing to course participant will be able to: Know the up-to-date scientific background of musculoskeletal pain & dysfunction in Cranio- Mandibular region. Recognize signs & symptoms of serious medical problems (not musculoskeletal) in people with Cranio- Mandibular pain ( i.e. red flags) and will know how to respond accordingly. Practically know how to assess, evaluate & recognize common clinical patterns in people with TMDs. Practical use of the relevant clinical reasoning for management of people with TMD and associated disorders. Effectively & safely treat people with TMD using hands on & exercise modalities.
Course format	Instructor led course: lectures (40%) & practical (60%) sessions

Course Schedule:

Day 1

8:30-9:00	Registration
9:00-11:00	Clinical oriented scientific background: Historical background of TMDs and OFP Epidemiology of TMD Etiology of TMD Psychosocial factors in TMD Common comorbidities of TMDs
11:00-11:30	Morning coffee
11:30-13:00	Clinical oriented scientific background (continuance): Clinical anatomy of masticatory system kinesiology, mechanics & patho-mechanics of the TMJ Upper neck & orofacial pain – neuroanatomical mechanism Practical palpation of the masticatory system
13:00-14:00	Lunch
14:00-15:30	Neck-Jaw evidence informed connections: Functional connections Pain system connections Postural connections Clinical connections Practical assessment of neck involvement in TMDs
15:30-15:45	Afternoon break
15:45-17:00	Clinical reasoning of differentiating temporomandibular disorders: Pain related TMD (myogenic TMD, arthralgia) Intra-articular TMD (different disc dysfunctions) Degenerative TMD (mainly osteoarthritis of TMJ)

Day 2

09:00-9:30	Summary of day 1
9:30-11:00	Intra-oral palpation: Coronoid process Masseter Temporalis Medial pterygoid Mandibular neck
11:00-11:15	Coffee break
11:15-13:00	Physical assessment and diagnostics of TMDs according to the Diagnostic Criteria for TMDs (DC-TMDs): Diagnostic Criteria Decision trees Assessment forms Documentation
13:00-14:00	Lunch
14:00-15:30	Assessment & therapeutics of pain related TMD: myogenic components (Mouth Closers): Masseter (Trigger Points and self-stretches) Temporalis (Trigger Points and self-stretches) Medial Pterygoid (Trigger Points and self-stretches) Specific exercise prescription
15:30-15:45	Coffee break
15:45-17:00	Assessment & therapeutics of pain related TMD: myogenic components (Mouth openers) Lateral pterygoid (Stretches and friction) Hyoid location and mobility Supra Hyoids (Trigger Points and self-stretches) Infra Hyoids (Trigger Points and self-stretches)

Day 3

9:00-9:30	Summary of day 2
9:30-11:00	Assessment & therapeutics of Joint related TMDs: Intra-Oral Accessory techniques in 3Ds Intra-Oral Accessory techniques in 3Ds Choosing the right techniques to: Arthralgia Degenerative TMJ Disc Displacement (DD) without Reduction with Limited Opening
11:00-11:15	Coffee break
11:15-13:00	Assessment and management Intra-Articular TMDs: DD with Reduction with/without Psychosocial component DD with Reduction with Intermittent Locking DD without Reduction with Limited Opening
13:00-14:00	Lunch
14:00-15:30	Bruxism and Oral Appliances: Myths and Facts Awake Bruxism Sleep Bruxism Diagnosing and managing Sleep and Awake Bruxism Oral appliances background Oran appliances indications
15:30-15:45	Coffee break
15:45-17:00	Real case study demonstration & brainstorming. Course summary End of course

Upcoming Courses

3. Cranio-Cervical (CC) – 24 Hours

Course title	CC therapeutics
Instructor	Tzvika Greenbaum, BPT MaPT (Manip & Sports) PhD
Participants	Physiotherapists, Osteopaths, Chiropractors, MDs, Dentists, Speech-Therapists
Description	The upper neck is a distinct spinal region that requires a unique clinical rehabilitation approach. It is highly mobile and possesses accurate and sensitive motor skills. Furthermore, it has significant neurological connections to the vestibular, ocular, and trigeminal nervous systems. Any noxious stimuli or dysfunction in this area can easily result in craniofacial pain (Cervicogenic Headache) and sensory-motor complaints such as Dizziness. This region responds well to manual therapy techniques combined with specific therapeutic exercises. In this course, participants will learn effective evidence-based assessment and practical management of people with musculoskeletal pain, dysfunction, and sensory- motor impairments related to the Cranio-Cervical region.
Contact hours	This is a 24-hour course (3 full days)
Course objectives	After completing the course, participants will be able to: Understand the current scientific background of musculoskeletal pain, dysfunction, and sensory-motor impairments related to the CC region. Learn to recognize signs and symptoms of serious medical problems (excluding musculoskeletal issues) in individuals who experience headaches and Dizziness. Know the appropriate course of action to take. Know how to assess, evaluate, and recognize the involvement of the upper neck in patients with the main complaints of HA and Dizziness. Practically use a relevant clinical reasoning model of management in people with HA and sensorimotor complaints. Effectively and safely manage patients with upper neck-related HA and sensorimotor complaints.
Course format	Instructor led course: lectures (40%) & practical (60%) sessions

Course Schedule:

Day 1

8:30-9:00	Registration
9:00-11:00	Clinical-oriented scientific background: Cervical versus Lumbar spines Epidemiology of neck pain Etiology of neck pain Modern Classification of neck pain Revision of pain mechanisms The Psychosocial factor in people with neck pain
11:00-11:30	Morning coffee
11:30-13:00	Clinical-oriented scientific background: Clinical anatomy of the cervical spine (upper neck emphasis) Upper neck disorders and the motor system Upper neck disorders and the sensorimotor system Topographical anatomy and palpation of the upper neck
13:00-14:00	Lunch
14:00-15:30	The traffic-light approach: Clinical reasoning of common upper neck-related clinical patterns: Cervicogenic Headache versus potential involvement of upper neck in primary headaches (tension-type & migraine)
15:30-15:45	Coffee break
15:45-17:00	Assessment and rehabilitation of Deep neck flexors

Day 2

9:00-9:30	Summary of day 1
9:30-11:00	Continue assessment therapeutics of the upper neck: Deep neck flexors assessment and rehabilitation in 3 phases
11:00-11:30	Morning coffee
11:30-13:00	Assessment & therapeutics of the upper neck: Occ-C1 segmental assessment and treatment
13:00-14:00	Lunch
14:00-15:30	Assessment & therapeutics of the upper neck: C1-C2 segmental assessment and treatment
15:30-15:45	Coffee break
15:45-17:00	Assessment & therapeutics of the upper neck: C2-C3 segmental assessment and treatment

Day 3

9:00-9:30	Summary of Day 2
9:30-11:00	Assessment & therapeutics of the upper neck: soft tissue assessment and treatment (sub-occipitals, Upper trap, splenius capitis, SCM)
11:00-11:30	Morning coffee
11:30-13:00	Putting it all together: Comprehensive assessment of the upper neck in patients with HA
13:00-14:00	Lunch
14:00-15:30	Whiplash Associated Disorders: Background Clinical challenge Symptoms Mechanism of injury and classifications Sensory-motor aspects in Whiplash Sensory-motor assessment and management of patients with post- traumatic upper neck
15:30-15:45	Last coffee break
15:45-17:00	Actual case study demonstration and brainstorming. End of course

Upcoming Courses

4. Cervico-Brachial (CB) – 16 Hours

Course title	CB therapeutics
Instructor	Tzvika Greenbaum, BPT MaPT (Manip & Sports) PhD
Participants	Physiotherapists, Osteopaths, Chiropractors
Description	Neck pain in one of the most common musculoskeletal disorders. Both up to date research findings and current experts opinions suggest good response of people with neck pain to modern musculoskeletal rehabilitation (better than people with LBP). In order to achieve good responses a thorough clinical assessment which reveal specific impairments is required. The effective rehabilitative approach is based on the recognition of specific neck related clinical pattern. In this course, participants will learn an effective evidence informed assessment & practical management of people with musculoskeletal pain and dysfunction in their CB region
Contact hours	This is a 16 hour course (2 full days)
Course objectives	After completing to course participant will be able to: Know the up to date scientific background of musculoskeletal pain & dysfunction in the CB region Practically know how to assess, evaluate & recognize common clinical patterns in people with musculoskeletal pain & dysfunction in the CB region (Discogenic pain, Facet joint disorder, TOS, Myofascial pain, Nerve root irritation) Practically use a relevant clinical reasoning model of management in people with lower neck related musculoskeletal disorders Effectively & safely treat people with lower neck related musculoskeletal disorders
Course format	Instructor led course: lectures (40%) & practical (60%) sessions

Course Schedule:

Day 1

8:30-9:00	Registration
9:00-11:00	Clinical oriented scientific background: Clinical anatomy of the cervical spine (lower neck emphasis) Epidemiology of neck pain Neck disorders and the sensory system Neck disorders and the motor system Contributing factors to neck disorders Psychosocial factor in people with neck pain
11:00-11:30	Morning coffee
11:30-13:00	Clinical reasoning of common lower neck related clinical patterns: Discogenic disorder Facet joint disorder Nerve root irritation Thoracic outlet syndrome Myofascial neck pain
13:00-13:45	Lunch
13:45-15:15	Assessment & therapeutics of the lower neck: topographical anatomy, common contributing factors: posture & breathing pattern
15:15-15:30	Coffee break
15:30-17:00	Assessment & therapeutics of the lower neck: Disc/Nerve root irritation

Day 2

8:30-9:00	Summary of day 1
9:00-11:00	Assessment & therapeutics of the lower neck: Thoracic outlet syndrome & Myofascial pain syndrome
11:00-11:30	Morning coffee
11:30-13:00	Assessment & therapeutics of the lower neck: Facet joint irritation
13:00-13:45	Lunch
13:45-15:15	Assessment & therapeutics of the lower neck: Neck on trunk + scapula on thorax dysfunctions
15:15-15:30	Coffee break
15:30-16:30	Real case study demonstration & brain storming. End of course

Upcoming Courses

5. Dry Needling for Orofacial Pain and Headaches- 9 Hours

Course title		Dry Needling for Orofacial Pain and Headaches
Instructor		Dr Tzvika Greenbaum, BPT, MaPT (Manip & Sports), PhD
Participants		Physiotherapists and dentists with previous qualification in dry needling and training in temporomandibular disorders rehabilitation.
Description		Orofacial Pain and Headache are highly common complaints seen in physiotherapy practice. In most cases, the musculoskeletal system plays the main role in the clinical presentation of orofacial pain and headaches (primary or secondary role). Dry needling of specific facial and cervical myofascial structures which have been shown to be relevant in orofacial pain and headaches have been proven to be highly effective both clinically and by research. In this one-day workshop participants will learn and practice safe and effective dry needling approaches for the most commonly involved myofascial structures in patients with orofacial pain (mainly TMD) and headaches (cervicogenic, tension type and migraine).
Contact hours		This is a 9 hour course (1 full days)
Course objectives		After completing to course participant will be able to: 1. Clinically assess, evaluate and identify common myofascial structures that can be source of pain in people orofacial pain and headache. 2. Clinically apply the clinical reasoning model of management in people with orofacial pain and headaches. 3. Effectively and safely apply dry needling techniques to several myofascial structures that are relevant to patients with orofacial pain and headache.
Course format		· Theoretical lessons (20%) · Practical workshop (80%)

Course Schedule:

Day 1

8:30-9:00	Registration
9:00-10:30	1. Scientific background of headache & orofacial pain in the musculoskeletal practice 2. Dry Needling safety
10:30-11:00	Coffee break
11:00-12:00	Clinical anatomy of the upper neck & masticatory system
12:00-13:30	DN for the upper neck muscles: SCM, Upper trapezius, Sub occipitals and Splenius capitis
13:30-14:15	Lunch break
14:15-15:45	DN for the mouth closers: Masseter, Temporalis, Medial pterygoid
15:45-16:00	Coffee break
16:00-17:30	DN for the mouth closers: Lateral pterygoid, Supra-Hyoids (Digastric, Mylohyoid), Infra-Hyoids (Sterno & Omohyoids)
17:30-18:00	Clinical points and day summary

Upcoming Courses

6. Advanced Cranio-Mandibular (ACM) – 8 Hours

Course title		TMD & OFP – Advanced Skills
Instructor		Dr Tzvika Greenbaum, BPT, MaPT (Manip & Sports), PhD
Participants		Physiotherapists with previous relevant training of Temporomandibular Disorders rehabilitation
Description		Orofacial Pain (OFP) is a frequent form of pain perceived in the face and/or oral cavity. Temporomandibular Disorders (TMD), the most common cause for OFP, refer to several highly common clinical disorders that involve the masticatory muscles, the temporomandibular joint (TMJ) and the adjacent structures. Although the majority of patients with TMDs response very well to manual and exercise therapies some patients are presented with chronic and persistent disorders that requires a very skilled and accurate management. In this one-day practical workshop, four real and complicated case-studies will be presented to participants and will be brain-stormed in small groups in a Problem-Based-Learning approach. For each case study several important and relevant techniques will be demonstrated and practiced under supervision.
Contact hours		This is a 8 hour course (1 full days)
Course objectives		After completing to course participant will be able to: 1. Practically use a relevant clinical reasoning model of management in people with TMDs & OFP. 2. Practically choose and apply a relevant advanced manual technique for several complicated clinical presentations of TMDs and OFP. 3. Suspect and recognize dangerous medical conditions that may mimic TMDs and OFP.
Course format		Instructor led & PBL course: lectures (20%)/PBL (40%)/practical (40%)

Course Schedule:

Day 1

8:30-9:00	Registration
9:00-10:30	1. Scientific background of headache & orofacial pain in the musculoskeletal practice 2. Dry Needling safety
10:30-11:00	Coffee break
11:00-12:00	Clinical anatomy of the upper neck & masticatory system
12:00-13:30	DN for the upper neck muscles: SCM, Upper trapezius, Sub occipitals and Splenius capitis
13:30-14:15	Lunch break
14:15-15:45	DN for the mouth closers: Masseter, Temporalis, Medial pterygoid
15:45-16:00	Coffee break
16:00-17:30	DN for the mouth closers: Lateral pterygoid, Supra-Hyoids (Digastric, Mylohyoid), Infra-Hyoids (Sterno & Omohyoids)
17:30-18:00	Clinical points and day summary

Upcoming Courses

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