North Dakota Chiropractic Continuing Education

• Construct a list of four specific compliance risk areas for physicians
• Establish internal control mechanisms
• Distinguish aspects of Quality Assurance
• Develop Documentation Principles
• Identify documentation warning signs and components of SNOCAMP

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to malpractice
• Minimize risks and failure in malpractice actions
• Encourage development and nurturing of skill sets in avoiding malpractice actions
• Identify action steps for minimizing risks of malpractice actions

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to informed consent
• Minimize risks and failure in malpractice actions
• Encourage development and nurturing of skill sets in avoiding malpractice actions by utilizing properly executed informed consent
• Identify action steps for minimizing risks of malpractice actions

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to malpractice actions from neural injury
• Minimize risks and failure in malpractice actions
• Encourage development and nurturing of skill sets in avoiding malpractice actions by utilizing proper manipulative procedures, recognizing post-operative complications and risks, and identifying and managing a complication.
• Identify action steps for minimizing risks of malpractice actions from neural injury

• Emphasize that each chiropractic provider must keep informed as to the laws and their interpretation in their particular state of practice
• Identify various ingredients found in a typical judicial opinion
• Discuss what each chiropractic provider should look for when they read an opinion
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to legal opinions
• Encourage development and nurturing of skill sets in reading legal opinions by utilizing case method

• Describe each of the four elements of malpractice
• Differentiate between a bad treatment result and malpractice
• Define Duty, Dereliction of Duty, Direct causation, and Damage
• Search out a case report on-line or in a law library by using the case citation

• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to fee splits and kickbacks
• Explain the development of current fee-splitting laws
• Distinguish the letter of the law regarding fee-splitting and anti-kickback legislation from unprofessional conduct and consequent harms the statutes were enacted to discourage
• Demonstrate a working knowledge regarding the roles played by the various state and federal enforcement agencies as they related to fee splits and kickbacks
• Assess ones working knowledge regarding the process by which anti-referral safe harbors developed and how they operate

• Evaluate sample healthcare employment agreement
• Explain the components of a well drafted healthcare employment agreement
• Relate likely enforcement of provisions included in healthcare employment contract
• Assess non-compete provisions through a judicial balancing test
• Distinguish the various methods by which a court will rehabilitate certain contract provisions and selectively enforce others
• Explain what kinds of contract provisions may run afoul of state and federal laws, including fee splitting and kickback prohibitions

• Evaluate a sample sale agreement and sample letter issued to patients upon dissolution of practice
• Explain components of any well drafted buy-sell agreement including non-competes
• Identify how to handle patient records vis-à-vis the sale
• Understanding forms and laws relating to the transfer of logos, trademarks and Internet Domain Names
• HIPAA Considerations
• Acquaint oneself with the tax consequences of particular types of practice sales
• Discuss valuation methods used for determining an appropriate practice sales price
• Identify legal concerns associated with the dissolution of a healthcare practice
• Recognize how sales can trigger violations: fee splitting, patient abandonment, kickback, and anti-trust

• Identify "high risk" patients
• Design protection strategies for telephone "advice."
• List the "4 D's" of malpractice
• Differentiate clinical from administrative malpractice risks
• Distinguish malpractice from an adverse patient outcome
• Describe how a non-office encounter can create a dr/patient relationship
• Give examples of statutory duties beyond clinical care
• Explain how you can be guilty of malpractice without being negligent
• Assess office equipment hazards
• Discuss malpractice cases where patient was never given an adjustment

• Discuss problems created by leaving blank spaces in records
• Create practice appropriate SOAP note format to reduce risk exposures
• Recognize Health Questionnaire “red flag” responses

• Integrate protective “rules for recordkeeping"
• Monitor records release authorizations
• Individualize pre-printed forms to conform with your practice and reduce risk exposures

• Identify and document significant patient non-compliance
• Generate appropriate X-ray warning labels
• Identify “bad” forms
• Incorporate protective letters-writing protocols

• Recognize “exposure events” in area's of potential risk management
• Discuss proper communication of a potential exposure event with a malpractice carrier
• Maintain a healthy practice while in litigation
• Prepare staff for dealing with the publicity of litigation

• Prepare for a deposition
• Identify “informed consent” compliance
• Analyze your website for potential risk management issues
• Recognize deposition “tricks & traps”

• Properly prepare for a trial
• Prepare for lawyers questioning techniques
• Avoid detrimental body language in front of a jury
• Prepare for the phases of trial and the "down time" associated with trial

• Find and Analyze Chiropractic Malpractice Court Opinions
• Justify referral protocols
• Plan staff training to avoid "vicarious liability"
• Interpret "lawyer-speak" like "vicarious liability"
• Assess equipment risk
• Differentiate between good PR & sexual harassment
• Generate HIPAA compliance strategies w/o paranoia
• Appraise partnership, independent contractor and doctor/associate risks
• Implement Table safety procedures
• Recognize "exposure events"

• Assess state, federal and board rulings regarding fee discounts, particularly time-of-service discounts and hardship discounts, and the extent to which they may be impacted by anti-kickback legislation, insurance regulations, self-referral laws, marketing restrictions, and the tenets of unprofessional conduct..
• Identify potential problems associated with routine approval of hardship discounts and the requirement for inquiry and documentation regarding qualifying for same.
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services.
• Demonstrate how these discounts are regarded by relevant professional boards, and state and federal enforcement agencies.
• Explain terms associated with time of service discounts and relevant factors associated in calculating an appropriate reduction in fees.
• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to pre-paid fee arrangements.
• Explain the development of current fee discounting legislation, rules and holdings.
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services.
• Demonstrate a working knowledge regarding the roles played by the various state and federal enforcement agencies as they related to fee splits and kickbacks.
• Assess one’s working knowledge regarding the process by which state and federal rulings regarding fees impact a healthcare provider’s practice in light of marketing, fee-splitting and anti-kickback legislation, insurance regulations, self-referrals, and the tenets of unprofessional conduct generally.
• Verify how certain discount practices may be legally actionable as “improper inducements.”
• Evaluate federal Stark legislation and the discouragement of corruption in sound professional healthcare decision-making.
• Identify distinctions between federal anti-kickback and the federal Stark legislation.
• Critique state anti-kickback laws.
• Recognize the role the FTC played, and continues to play, in discouraging the fraudulent marketing of discount health care programs.
• Draw associations between co-pay requirements, consumer habits and federal healthcare expenditures.
• Assess how "professional courtesy" discounts may raise enforcers' concerns under the federal anti-kickback statute.
• Diagram how prepaid fee arrangements often resemble health insurance to unwitting patients.
• Illustrate pitfalls that advertising discounts visit on the practitioner.

• Assess state, federal and board rulings regarding fee discounts, particularly time-of-service discounts and hardship discounts, and the extent to which they may be impacted by anti-kickback legislation, insurance regulations, self-referral laws, marketing restrictions, and the tenets of unprofessional conduct..
• Identify potential problems associated with routine approval of hardship discounts and the requirement for inquiry and documentation regarding qualifying for same.
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services.
• Demonstrate how these discounts are regarded by relevant professional boards, and state and federal enforcement agencies.
• Explain terms associated with time of service discounts and relevant factors associated in calculating an appropriate reduction in fees.
• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to pre-paid fee arrangements.
• Explain the development of current fee discounting legislation, rules and holdings.
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services.
• Demonstrate a working knowledge regarding the roles played by the various state and federal enforcement agencies as they related to fee splits and kickbacks.
• Assess one's working knowledge regarding the process by which state and federal rulings regarding fees impact a healthcare provider's practice in light of marketing, fee-splitting and anti-kickback legislation, insurance regulations, self-referrals, and the tenets of unprofessional conduct generally.

• Assess how state scopes of practice affect chiropractic treatment of nutrition-related health problems.
• Identify the roles the FDA and FTC play in the administration of nutritional healthcare.
• Distinguish between a "food" and a "drug" for purposes of nutritional supplementation.
• Demonstrate how the various states' ban against the practice of medicine affects other disciplines' approach to nutritional healthcare.
• Explain aspects of nutrition labeling.
• Identify issues associated with current performance-enhancing supplementation.
• Explain the significance of distinguishing "treatment" from "informing" as it relates to nutritional counseling.

• Assess the relationship between the implementation of efficient office systems, accurate record keeping, patient communication, and adherence to professional standards of conduct within the context of malpractice allegations by patients who engage in sports.
• Identify actions suggestive of malpractice negligence and conduct that fails to live up to the standard established by law for the protection of others.
• Demonstrate a professional relationship can spring into existence when the healthcare professional is hired by a third party to oversee the health of athletic participants.
• Distinguish the duties an examining physician has regarding informing those athletes he examines about abnormal test results.
• Explain the legal concept of “assumption of the risks” within the context of sports participation and how it affects a healthcare professional’s liability.
• Identify “therapeutic exceptions” to providing informed consent excusing the practitioner from fully disclosing matters where they might unfavorably affect the outcome of a patient’s treatment.
• Explain a healthcare professional’s duty to warn patients engaged in sports regarding injury prevention following treatment.
• Examine a practitioner’s duties regarding athletes’ return to play in instances when head injury and concussion may be a factor.

• Assess the role the doctor-patient relationship plays in allegations of Patient Abandonment
• Identify the components to any successful Patient Abandonment charge
• Discuss court cases evaluating whether the doctor-patient relationship had been terminated lawfully
• Distinguish between proper and improper considerations a doctor may rely upon to either refuse to undertake, or to terminate, a doctor-patient relationship
• Explain the role notice plays in lawfully terminating a doctor-patient relationship
• Evaluate the role consent plays in the establishment of the doctor-patient relationship, and in subsequent treatment

• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to fee splits and kickbacks
• Explain the development of current fee-splitting laws
• Distinguish the letter of the law regarding fee-splitting and anti-kickback legislation from unprofessional conduct and consequent harms the statutes were enacted to discourage
• Demonstrate a working knowledge regarding the roles played by the various state and federal enforcement agencies as they related to fee splits and kickbacks
• Assess ones working knowledge regarding the process by which anti-referral safe harbors developed and how they operate

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to the practice of forensic science
• Identify a new dimension of chiropractic practice that will minimize risks and failure in court appearances as a practitioner
• Construct skill sets in forensic examination and document review

• Acquire a current knowledge base relating to medicolegal issues
• Identify risks and liabilities that may be encountered by examiners with electronic communications
• Develop a level of understanding of the medicolegal system as it relates to Junk Science

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to the ethical expert witness
• Introduce a new dimension of chiropractic practice that will minimize risks and failure in court appearances as an ethical expert witness.
• Encourage development and nurturing of skill sets in forensic examination and appearing as an expert witness through certification.
• Develop a level of understanding of the medicolegal system as it relates to the ethical expert witness.

• Emphasize that each chiropractic provider must keep informed as to the laws and their interpretation in their particular state of practice
• Identify Daubert criteria
• Discuss what each chiropractic expert should look for when preparing for the opposing attorney
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to Daubert challenges
• Encourage development and nurturing of skill sets in proving expert opinions

• Emphasize that each chiropractic provider must keep informed as to the laws and their interpretation in their particular state of practice
• Identify the basics of a deposition
• Discusses the tricky question types and suggested responses
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to the deposition process
• Encourage development and nurturing of skill sets in responding to questions posed in a deposition

• Perform professional advertising and marketing that passes state and federal legal restriction.
• Comprehend requirements for advertising testimonials, press releases, television, radio, Internet, personal solicitation and other marketing initiatives.
• Comprehend the limits of commercial speech (advertising) within the arena of professional healthcare marketing and dissemination of information.
• Train staff and implement policies associated with marketing initiatives and materials vis-a-vis state rules, regulations and statutes.
• Comprehend issues associated with signage, listings, letterhead, and other matters of ostensible agency that may lead to liability.
• Administer professional marketing such that it neither misleads, confuses nor exploits members of the public.
• Discuss how nutritional supplementation labeling and HIPAA affects professional healthcare marketing efforts.
• Undertake a review of marketing materials and initiatives so as to ensure compliance with relevant state rules, regulations and statutes.
• Administer coverage decisions, professional referrals, and communicate same in a manner that limits professional liability.

• Identify common risky mistakes providers make when navigating patient financial matters
• Recognize the providers financial obligation when treating Medicare & Medicare Advantage patients
• Review both federal and payer guidelines on managing patient financial obligations
• Identify practical ways to manage non-covered services and uninsured patients

• Analyze charges and documentation on a daily or per visit basis to ensure accuracy and compliance
• Compile accurate and comprehensive responses to documentation or record requests
• Recognize and avoid confusing HIPAA privacy issues that can cost you time and money
• Identify key areas that lack written policies causing increased risk in the practice
• Evaluate your current written procedures and appraise the need for additional content

Hour 1

• Identify various types of billing irregularities and impact on healthcare expenditures.
• Distinguish upcoding from bundling within the context of irregular billing schemes.
• Demonstrate how and when exceeding a state’s scope of practice becomes “the unauthorized practice of medicine.”
• Explain the restrictions states’ scopes of practice place on healthcare providers’ authority to treat and diagnose patients.
• Discuss how invoicing unrendered medical services impacts third-party payers.
• Interpret chiropractic boards’ positions on testimonial advertising and how best to comply.

Hour 2

• Identify what constitute a false claim under the False Claims Act.
• Discriminate a kickback from a self-referral.
• Trace how anti-kickback legislation arose and examine its prohibitions.
• Explain the enactment of Stark legislation arising on the heels of anti-kickback bans.
• Assess providing nutritional counsel within the context of “the practice of medicine.”
• Evaluate identity theft and its impact on patients, providers and the cost of healthcare.
• Discriminate between illegal copayment waivers from proper hardship waivers.
• Discuss court cases instancing successful prosecution of healthcare fraud.

• Identify the 18 PHI Identifiers
• Awareness of other HIPAA related documentation and the appropriate retention period
• How to confirm retention period for healthcare records
• Recognize required security measures and their value to practice risk management
• Implement policy and protocol for compliant and secure disposal of records

• Be able to identify the definitions of Fraud, Waste and Abuse and how they may show up in day-to-day practice
• Become aware of the source of overpayments, including not-medically necessary care, maintenance care, and active treatment
• Apply the guidance from the OIG to your state and carrier regulations since they are a resource to these groups
• Recognize insufficient documentation and incorrect coding before the billing takes place
• Implement the action steps recommended by the OIG to eliminate incorrect documentation, billing and coding practices to reduce compliance risk

• Distinguish between fraud, waste and abuse
• Review and properly utilize your Medicare Local Coverage Articles (LCA)
• Integrate critical compliance requirements for minimum, mandatory, annual self-audits  
• Detect common billing protocols that are red-flags for third-party auditors and chiropractic boards of examiners

• Identify the expected standards of a compliant and complete patient medical record
• Audit documentation to ensure the most important details are present
• Analyze and correct for the four most commonly missed components of appropriate documentation
• Apply the federal requirements for Medicare documentation and use this knowledge to initial and routine patient visit documentation

• Assess limits of state, federal and board authority regarding the prohibition of solicitation of patients by, and on behalf of, chiropractors. 
• Explain distinctions between general marketing and intrusive solicitation, and the reasons for the regulation of each
• Demonstrate how the courts protect businesses’ right to advertise and how they discourage deceptive practices. 
• Distinguish between appropriate and inappropriate/illegal marketing relating to fees and professional services. 
• Examine criminal and civil laws associated with overly aggressive chiropractic advertising.

• Classify circumstances that trigger Good Samaritan laws for chiropractors.
• Restate duties imposed upon people in the United States to render aid to others in dire circumstances.
• Compare a doctor’s versus a lay person’s duty to render aid to someone in distress.
• Explain principles and philosophical underpinning Good Samaritan laws.
• Discuss the Bystander Effect.and scientific studies that unearth reasons why people are reluctant to render aid/assistance to others in emergency situations.
• Summarize the role compensation, expecting to get paid, plays in the operation of Good Samaritan laws.
• Locate states that impose a duty to render assistance, and those states that remove Good Samaritan law protection from hospitals.
• Identify protections offered under various states’ Good Samaritan Laws.
• Express the relaxation of professional standards, and what behaviors are shielded from liability, under Good Samaritan laws.

• Recognize and execute the rules to avoid inducement violations
• Define what you CAN give away for a first visit that will not break the rules. 
• Implement compliant initial visit screening services as part of a new patient offer
• Apply risk management rules to avoid offering free services to some and not others
• Modify your current marketing strategy to attract new patients while being compliant

• Identify ethical and legal prohibitions against patient deception, misinformation, exaggerating healthcare cures, guaranteeing treatment results, and dishonesty.
• Distinguish between appropriate and inappropriate communications and medical file entries describing patients' healthcare prognoses and progress.
• Explain scientific literature linking patients' attitude and mental states to healthcare outcomes.
• Illustrate placebo-enhancing doctor-patient interactions that comply with states' prohibitions against deception and misinformation.
• Give examples where ethical patient encouragement authentically fosters positive mental states that promote desired patient outcomes.
• Express why patient communications must be consistent with medical file entries regarding prognoses and patient progress.
• Explain office procedures and staff training likely to optimize health-promoting ethical patient communication and the documentation thereof.

• Identify which portion of the complex regulation applies to their practice
• Recognize proper use of a Good Faith Estimate vs Balance Billing Protection form
• Formulate customized forms and training tools to meet regulatory guidelines
• Adopt best practices and regulation standards during the patient intake process

• Discuss the public’s increased use of health data-gathering devices and its effect on dispensing healthcare by professional healthcare providers.
• Identify sources for state authority to regulate the practice of healthcare in the various states.
• Explain states’ prohibition against the unauthorized practice of medicine and identify points where data collection and subsequent evaluation may encounter this prohibition.
• Compare courts’ interpretations of state scopes of practice laws as they relate to the various stages of a doctor-patient encounter.
• Distinguish data collection from activities that may include preliminary evaluation, diagnosis, and treatment - while identifying their relevance to state scopes of practice.
• Analyze how courts interpret activities that may constitute the unauthorized practice of medicine, as distinguished from those that do not.
• Discuss obligations to refer people to other healthcare providers based upon determinations and/or diagnoses related to observation, examination, and evaluation of collected data.
• Distinguish boundaries regarding data collection versus the unauthorized practice of medicine.
• Recognize the public's rights to information and free speech protections.

 Part 1

• Discuss the costs of fraud and financial crime
• Review the technology trajectory and how this affects fraud
• Quote Honesty studies
• Identify behaviors related to cheating

Part 2

• Review the criminological and behavioral theories of fraud in healthcare
• Explain key aspects of the psychological of fraud
• Identify aspects of sociology related to fraud
• Examine: Biological school of criminology

Part 3

•  Examine victimology and victim behavior
• Discuss internal fraud and trends
• Examine opportunity reduction
• Be aware of red flag and fraud indicators

 Part 4

• Apply human based preventative and detection strategies to avoid fraud
• Use technology based preventative and detection strategies to avoid fraud
• Use vulnerability assessment preventative and detection strategies

• Compare the various Responsibilities that patients owe to the doctor-patient relationship
• Describe the doctor-patient relationship as a dynamic one that relies on the active participation of patient and doctor alike, and enlists aspects of trust in order for the interaction to render optimal benefits.
• Recognize how the Hippocratic Oath contributed significantly to the development of chiropractic patient rights
• Discuss the historical evolution of Patients' Rights in the United States and their application to chiropractic
• Explain the various Patients’ Rights
• Present case studies to illustrate how patient rights and responsibilities can be applied in practice.
• Analyze how Patient Obligations contribute to the success of the doctor-patient interaction and can favorably impact patient outcomes.
• Explain how chiropractors’ efforts to enhance profitability could negatively impact both public perception and the bottom line.

• Appreciate the significance of Artificial Intelligence (AI) in transforming the healthcare industry.
• Recognize the potential benefits of AI in improving diagnosis accuracy and treatment outcomes.
• Identify how AI can streamline administrative processes, such as scheduling appointments, billing, forms, and managing patient records.
• Explore compliance with laws and regulations when using AI and chatbots in advertising, including rules around data collection and use
• Understand the challenges of determining who owns the copyright for content generated by AI systems
• Evaluate the importance of keeping up-to-date with technological advancements in healthcare for quality patient care and practice management
• Comprehend the challenges regarding patient data privacy and security associated with AI.

• Recognize different forms of social media and how clinics can benefit from using social media
• Appreciate the risks of using social media and how to avoid any pitfalls
• Develop policy and procedures to protect patient information when using social media
• Ability to identify commonly overlooked risks when communicating to patients on third-party software platforms

• Distinguish Constitutionally-protected expression contributing to a healthy marketplace, from defamatory reviews that damage doctors and impede intelligent consumer activity.
• Explain what triggers patient complaints and discuss how their constructive information improves healthcare services.
• Identify how patient complaints can compromise doctors’ health, devastate their businesses, impede professional performance, and compromise patient outcomes.
• Express how doctors may shape doctor-patient relationships so as to reduce the likelihood and frequency of patient complaints.
• Illustrate how a doctor's proactive remedial behavior can mitigate the incidence and severity of formal disciplinary actions and litigation generally.
• Explain the power traditionally ascribed to word-of-mouth recommendations and how current social media review systems leverage this power.
• Discuss how the Consumer Review Fairness Act restricts prohibitions against posting negative reviews.
• Describe how a complaint navigates a state Board disciplinary process and factors regarding appeal.
• Illustrate the financial and reputational costs that attend doctors responding to negative complaints and/or initiating litigation against patients.

• Evaluate sample forms including contract, informed consent, treatment plan and intake - and draft forms that clearly distinguish between standard care and potential contractual guarantees.
• Identify the key elements that can transform a doctor's statement into a contractual guarantee (e.g., specific results, use of positive language like "cure" or "fix").
• Define the concept of a doctor-patient contract and distinguish it from the standard of care in medical malpractice.
• Describe the legal ramifications of a doctor breaching a contract with a patient (e.g., damages, potential for longer statute of limitations compared to malpractice).
• Analyze case studies to identify instances where a doctor's communication with a patient may have created a contractual obligation.
• Effectively communicate treatment options and limitations to patients, avoiding language that could be misconstrued as a contractual guarantee.
• Apply your knowledge of doctor-patient contracts to real-world scenarios, such as consultations, advertising materials, and treatment plans.
• Critically assess the advantages and disadvantages of relying on formal contracts in the doctor-patient relationship.

• Define HIPAA and identify fundamental components of the HIPAA law.
• Explain the concept of Protected Health Information and provide examples.
• Describe the key provisions of the HIPAA Privacy Rule, including patient rights and provider responsibilities.
• Summarize the HIPAA Security Rule and its requirements for safeguarding electronic Protected Health Information.
• Identify common HIPAA violations and their potential consequences.
• Explain the importance of Business Associate Agreements and their role in HIPAA compliance.
• Describe the steps involved in developing a HIPAA compliance plan.
• Discuss the impact of emerging technologies (e.g., telehealth, AI) on HIPAA compliance.

• Explain the anatomy of the spine, cranium and spinal cord components
• Discuss the development of the theory of Sacro-occipital Technique
• Explain the categories of Sacro-occipital Technique
• Explain the physiology of the Cranio-sacral respiratory mechanism
• Define the physical anomalies associated within each category system
• Explain the diagnostic evaluations specific to Sacro-occipital Technique
• Discuss Category I with regards to diagnosis and application
• Discuss Category II with regards to diagnosis and application
• Discuss Category III with regards to diagnosis and application
• Demonstrate the adjustments for each of the categories
• Demonstrate auxiliary treatment methods within the category systems
• Describe rehabilitation methods within the category systems

• 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.

• Identify the goals, indications and contraindications of spinal traction and decompression
• Predict responsive patient selection for spinal traction and decompression
• Plot phases of traction and calculate the appropriate force, traction and hold times
• Evaluate the validity of logarithmic pulls and disc targeting
• Define ethical behavior for billing and marketing of non-surgical spinal decompression device

• Develop and overview of Adult Golf Injury Assessment and Rehab
• Identify the nature of balance and applying balance assessment to golfers
• Review and Understand the concepts of coordination as applied to golf

• Identify which trunk muscles are used in the golf swing
• Review the Chiropractic influence on the golf swing
• Construct practical swing suggestions for golf patients
• Discuss fundamental conditioning concepts
• Prepare physical conditioning to improve club speed

• Differentiate the basic fundamentals of the golf swing and ball flight
• Understand the epidemiology of golf injuries in both professionals and amateurs
• Discuss the factors that influence injury formation and prevention
• Learn the shoulder muscles involved in the various phases of the golf swing and apply this knowledge to examination and rehabilitation
• Learn about the relationship between back pain and elite golf mechanics
• Determine the spinal and metabolic loading characteristics associated with golf

• Illustrate basic principles of cardiorespiratory exercise
• Outline health screening and physical fitness testing
• Create cardiorespiratory and strength training exercise prescriptions

• Describe the biomechanical fundamentals of grip, posture and swing
• Identify golf injuries and golfers’ problems
• Develop protocols of rehab, strength training and adjusting for golfers

• This contains all courses with the educational objectives listed from Sports Medicine 109 through Sports Medicine 113

• Investigate the anatomical structures strained during the Ober and Modified Ober tests for iliotibial band concerns
• Evaluate the utility of screening tests for predicting injury risk in athletes
• Describe the biomechanics associated with the extensor carpi ulnaris and recognize the variety of pathologies that can affect this structure
• Summarize recommendations for the assessment, diagnosis and management of Femoroacetabular Impingement (FAI)
• Assess whether expert and novice Functional Movement Screen raters can report the same scores

• Determine appropriate exercise recommendations
• Design a proper fitness program for patients
• Identify proper exercises for the osteoporotic patient
• Review exercise guidelines with patients and encourage compliance

Hour 1

• Review basic concepts of exercise physiology
• Understand the fitness training model
• Identify various communication strategies
• Determine appropriate behavior change techniques

Hour 2

• Identify the components of the client investigation stage
• Review the various tests to determine functional ability of a client
• Discuss the tests necessary to determine a clients physiological sport abilities
• Analyze proper movement patterns through testing

Hour 3

• Design an appropriate resistance exercise program
• Understand the components of an appropriate cardiovascular program
• Determine various ways to progress in training
• Review basic concepts of sport nutrition

• Summarize the current body of literature surrounding the anatomy and biomechanics of the iliotibial band (ITB), to better understand the etiology, clinical examination and treatment of ITB syndrome 
• Explore and integrate connections between tissue structures, function, environmental and personal factors for the management of patients with lateral epicondylosis 
• Outline our contemporary understanding of possible musculoskeletal causes of inguinal-related groin pain in athletes
• Determine whether the Ottawa Ankle Rules accurately rule out ankle fractures in adults 
• Compare non-operative treatment, open surgical repair, and minimally invasive surgery for acute Achilles tendon ruptures

• Illustrate the pathogenesis of CADs ­dissection mechanisms
• Identify putative causes and triggers of CAD
• Estimate the purported incidence of cerebrovascular syndromes following cervical manipulation
• Distinguish between the neurological syndromes
• Identify stroke risk factors in general
• Assess the value of pre-manipulation testing: to screen or not to screen?
• Outline the warning signs/symptoms of CAD
• Indicate what to include in the patient history and examination
• Describe what to do if you suspect CAD
• Point out how to communicate risk to patients as well as implementing strategies to prevent CAD
• Assess the current literature on the relationship between stroke and manipulation
• Describe the anatomy of the blood supply to the brain
• Summarize the clinical biomechanics of vertebral arteries
• Outline the epidemiology and classification of cervicocerebral (vertebral and internal carotid) arterial dissections (CAD) or strokes
• Recognize the diseases affecting cervicocerebral arteries

• This contains all courses with the educational objectives listed from Stroke and Manipulation 101 through Stroke and Manipulation 104

• Compare the associations of chiropractic care and stroke with primary care physician (PCP) care and stroke in the Medicare population
• Quantify risk of stroke after chiropractic spinal manipulation, as compared to evaluation by a primary care physician, for Medicare beneficiaries aged 66 to 99 years with neck pain
• Determine the hemodynamics in the Circle of Willis with Internal Carotid Artery Stenosis under cervical rotatory manipulation: a finite element analysis
• Review compensation claims for chiropractic in Denmark and Norway 2004-2012
• Examine the risk of traumatic injury associated with chiropractic SMT in the Medicare population

• Compare the risk of injury (via Medicare data) between two cohorts of patients treated by chiropractic spinal manipulation versus treatment by a primary care physician
• Investigate the association between chiropractic manipulative treatment and vertebrobasilar artery stroke
• Assess the level and quality of evidence regarding the potential association between cervical manipulation and cervical artery dissection/stroke
• Evaluate the diagnostic accuracy of premanipulative vertebrobasilar tests in terms of sensitivity, specificity, predictive values and likelihood ratios in adults
• Observe vertebral artery blood-flow after cervical manipulation and various head positions

• Outline methods used and estimations as to the incidence of cervical spinal manipulative therapy and subsequent vertebrobasilar ischemia.
• Review and describe cerebrovascular anatomy and hemodynamics.
• Discuss proposed patho-physiological mechanisms believed responsible for subsequent vertebrobasilar ischemia.
• Review and discuss past and present scientific literature to explore the evolution of what we think we know about the process of cervical spinal manipulative therapy and subsequent vertebrobasilar ischemia.
• Identify radiographic signs of a vertebral artery dissection.
• List and discuss the uses, pros and cons of current examination tools as they apply to vertebral artery dissection.
• Explore issues and examination procedures related to patient assessment as well as vertebrobasilar ischemia recognition and proper diagnosis.
• Define and contrast currently suggested procedures and develop a vertebrobasilar ischemia plan of action.
• Explore various perspectives and reveal bias in both public media and biomedical journals.
• Identify and define new theoretical concepts and prophylactic therapies.
• Give multiple examples of anti-chiropractic bias in the biomedical literature
• List and describe the most common red flags for a patient “at risk” for suffering Vertebrobasilar Ischemia following cervical manipulation.
• Recite list of scientific studies relating to laboratory testing of plasma Homocystine levels and its relationship to Vertebrobasilar Ischemia from vertebral artery dissection.
• List examples of bias against chiropractic cited in both the popular media as well as in biomedical journals.
• Critically review landmark articles regarding the issue of cervical manipulation and vertebrobasilar distribution ischemia.
• List studies suggesting that a high plasma homocystine level may be associated with vertebrobasilar dissection.
• Cite studies suggesting that increasing folic acid intake can reduce plasma Homocystine levels.
• Identify laboratory tests that may be useful in helping calculate an individual’s risk of suffering vertebrobasilar stroke following cervical manipulation.

• Cite the strength of evidence about whether chiropractic neck manipulation causes cervical artery dissection (CAD) based on a systematic review, meta-analysis, and evaluation of the body of evidence as a whole
• Summarize our current state of knowledge on cervical artery dissection and how it impacts the practice of cervical spinal manipulation
• Outline the state of knowledge regarding bedside diagnosis and management of an acute vestibular syndrome, with the suspicion for stroke 
• Describe the demographics, past health care utilization, and comorbidities of vertebrobasilar artery stroke patients in Ontario, Canada who consulted a chiropractor within one year prior to their stroke
• Analyze the nature of internal carotid artery biomechanics and associated risk of injury during cervical spinal manipulation

• Outline methods used and estimations as to the incidence of vertebrobasilar ischemia.
• Review and describe cerebrovascular anatomy and hemodynamics
• Discuss proposed patho-physiological mechanisms believed responsible for subsequent vertebrobasilar ischemia.
• Review and discuss past and present scientific literature to explore the evolution of what we think we know about the process of cervical spinal manipulative therapy and potential vertebrobasilar ischemia.
• Identify radiographic signs of a vertebral artery dissection.
• List and discuss the uses, pros and cons of current examination tools as they apply to vertebral artery dissection.
• Explore issues and examination procedures related to patient assessment as well as vertebrobasilar ischemia recognition
• Define and contrast currently suggested procedures
• List and describe the most common red flags for a patient “at risk” for suffering Vertebrobasilar Ischemia
• Recite list of scientific studies relating to laboratory testing of plasma Homocystine levels and its relationship to Vertebrobasilar Ischemia from vertebral artery dissection.
• List examples of bias against chiropractic cited in both the popular media as well as in biomedical journals.
• Critically review landmark articles regarding the issue of cervical manipulation and vertebrobasilar distribution ischemia.
• List studies suggesting that a high plasma homocystine level may be associated with vertebrobasilar dissection.
• Cite studies suggesting that increasing folic acid intake can reduce plasma Homocystine levels.
• Identify laboratory tests that may be useful in helping calculate an individual’s risk of suffering vertebrobasilar stroke

• Assess the association between cervical spinal manipulation and cervical artery dissection among adults in the United States using insurance claims data 
• Evaluate the relationship between cervical spinal manipulation and cervical artery dissection among Medicare beneficiaries aged 65–99 
• Describe the effects of cervical spine manipulation on the vertebral artery concerning length changes and associated tensile forces 
• Quantify the effects cervical spinal manipulation on angular displacements of the head relative to the sternum as well as associated vertebral artery length changes 
• Compare the total vertebral artery elongations during cervical spinal manipulation and range of motion procedures

• Explain the relationship between posture and subluxations
• Describe different types of posture
• Explain the benefits of locating subluxations in different postures
• Explain the difference between the concept of the hologram and posture
• Disucss the differences between Empirical Healthcare and Mechanistic Healthcare
• Define the three Cs - challenge, check and correct

• Summarize the concept of a subluxation as recognized by other Doctors of Chiropractic.
• List and discuss the various definitions of the term subluxation.
• Outline the basic premise of the effects of aging, subluxation and the adjustment.
• List and discuss terms used by other health professions for a similar clinical syndrome.
• Define pain, nociception and antalgia.
• Draw the basic nociceptive pathway to consciousness.
• Describe and differentiate antalgic scoliosis.
• List and discuss the various definitions of spinal adjustment, manipulation, and mobilization.
• List the deep paraspinal muscles responsible for subluxation maintenance.
• Compare and contrast paraspinal muscle response to the acute abdomen.
• List and discuss therapies used by other health professions for similar clinical syndromes.
• Describe and summarize the Maintland manipulation classifications.
• Itemize scientific evidence regarding physiologic studies regarding subluxations.
• Explain how and why documentation of a subluxation is so important for Medicare patients in chiropractic practice.
• Define requirements for chiropractic services to be covered by Medicare.
• List and discuss how a subluxation may be properly documented in the medical record for Medicare patients.

• Determine the epidemiology, etiology and background on obesity
• Assess the theories of obesity development and pathophysiology
• Outline the risks and morbidities related to obesity

• Outline the management of obesity
• Summarize the assessment of obesity for the busy clinician
• Synthesize the literature on the dietary management of obesity
• Discuss the role of exercise and physical fitness in the management of obesity and overweight

• Outline the principles of body composition assessment
• Review the anthropometic measures of body composition
• Discuss the circumference measurements of body composition
• Assess the laboratory and field assessments of body composition

• Outline the definition and components of health and wellness
• Review the dimensions of wellness
• Discuss various models of health and the need for wellness lifestyles
• Outline the publication and goals of Healthy People

• Identify the differences between the holistic and allopathic models for health and wellness
• Show how the Web of Well-Being can be used to assess and educate clients about the various factors impacting their wellness.
• Describe the conclusions of research into the benefits of meditation for human health.
• Explain the basic principles and practice of a simple mindfulness meditation technique.

• Emphasize the unique anatomy of the cervical spine as related to spinal trauma.
• Point put the importance of the uncinate process joints as related do disc herniation, the nerve root, the vertebral artery, and the spinal cord.
• Explain how cervical spine injury may manifest clinically as low back and leg pain.
• Explain the role for sleep and sleep’s influence on the ability to safely operate a motor vehicle.
• Summarize the influence of sleep on brain neurochemistry.
• Explain the influence of awareness on an impending collision and the muscles ability to protect joints.
• Explain how being “caught by surprise” by a collision is related to a poor prognosis for full recovery.
• Summarize the history of whiplash injuries, including mechanical mechanisms, biological mechanisms, pathology, diagnostics and management.
• Define the issues that the early whiplash literature got wrong.
• Emphasize the issues that early whiplash literature got correct.
• Summarize recent advances in the understanding of whiplash injuries, emphasizing anatomy, diagnostics, pain production and pain suppression.
• Integrate whiplash trauma, chronic pain, and chiropractic care.
• Point out the mathematics of how a low speed vehicle to vehicle collision can result in passenger injury.
• Explain why vehicle damage should not be used as a proxy for passenger injury.
• Integrate the concepts of awareness, rotation, and pre-accident spondylosis in injury magnitude and prognosis.
• Define the three phases of soft tissue healing and point out the time sequence for each phase.
• Justify the clinical interventions that have a positive therapeutic influence on each phase of soft tissue injury healing.
• Emphasize the concept of motion in the healing of injured soft tissues, especially spinal adjusting (specific manipulation) motion.
• Quantify acute injury and ultimate recovery(prognosis) by using measurement outcomes.
• Summarize the biology and published data on treatment frequency and duration for whiplash spinal trauma.
• Point out published studies relating to recovery and prognosis.
• Reference the incidence of acceleration of spondylosis in long-term studies following a whiplash injury.

Hour 1:    Anatomy Review 

• Emphasize the unique anatomy of the cervical spine as related to spinal trauma.
• Point out the importance of the uncinate process joints as related to disc herniation, the nerve root, the vertebral artery, and the spinal cord.
• Explain how cervical spine injury may manifest clinically as low back and leg pain.

Hour 2:    Define Sleep Hygiene

• Explain the role for sleep and sleep’s influence on the ability to safely operate a motor vehicle.
• Summarize the influence of sleep on brain neurochemistry.

Hour 3:    Awareness and Soft Tissue Injury

• Explain the influence of awareness on an impending collision and the muscles ability to protect joints.
• Explain how being “caught by surprise” by a collision is related to a poor prognosis for full recovery.

Hour 4:    Whiplash History

• Summarize the history of whiplash injuries, including mechanical mechanisms, biological mechanisms, pathology, diagnostics and management.
• Define the issues that the early whiplash literature got wrong.
• Emphasize the issues that early whiplash literature got correct.

Hour 5:    Whiplash Today

• Summarize recent advances in the understanding of whiplash injuries, emphasizing anatomy, diagnostics, pain production and pain suppression.
• Integrate whiplash trauma, chronic pain, and chiropractic care.

Hour 6:    Low Speed Collisions and Minor Vehicle Damage

• Point out the mathematics of how a low speed vehicle to vehicle collision can result in passenger injury.
• Explain why vehicle damage should not be used as a proxy for passenger injury.
• Integrate the concepts of awareness, rotation, and pre-accident spondylosis in injury magnitude and prognosis.

Hour 7:    Soft Tissue Injury and Repair

• Define the three phases of soft tissue healing and point out the time sequence for each phase.
• Justify the clinical interventions that have a positive therapeutic influence on each phase of soft tissue injury healing.
• Emphasize the concept of motion in the healing of injured soft tissues, especially spinal adjusting (specific manipulation) motion.
• Quantify acute injury and ultimate recovery(prognosis) by using measurement outcomes.

Hour 8:    Treatment Duration, Frequency, and Prognosis

• Summarize the biology and published data on treatment frequency and duration for whiplash spinal trauma.
• Point out published studies relating to recovery and prognosis.
• Reference the incidence of acceleration of spondylosis in long-term studies following a whiplash injury.

Hour 1:     Low Back and Leg Pain Following Whiplash Injury

• Point out the probable mechanisms for direct injury to the lower back during motor vehicle collisions.
• Distinguish between radiculopathy, neuropathy, and sclerogenic referral of extremity pain.

Hour 2:     Whiplash Injury and the Vertebral Artery

• Review the anatomy of the vertebral-basilar vascular systems.
• Distinguish between the anterior and posterior circulation.
• Summarize the signs and symptoms of a cervical spine vascular injury.
• Solidify the knowledge as to when the suspected vascular injury patient should be referred to diagnostic imaging or emergency services.

Hour 3:     Whiplash Injury and Traumatic Brain Injury

• Explain the differences between a blow brain injury and an inertial brain injury.
• Define the pathoanatomic and patho-biochemistry of traumatic brain injury.
• Justify clinical interventions that have a positive therapeutic influence on traumatic brain injury.

Hour 4:     Cervical Disc Herniation

• Point out the anatomical differences between lumbar and cervical discs.
• Explore the pathoanatomical and therapeutic differences between lumbar and cervical discs lesions.

Hour 5:     Examinations and Evaluations

• Explain the minimum examinations that should be performed.
• Explain the minimum requirements for charting the daily patient contact.

Hour 6:     Informed Consent

• Define the legal requirements for informed consent for chiropractic care.
• Review common entities for an informed consent and the rational for each.

Hour 7:     Reports

• Make recommendations for re-evaluations.
• Make recommendations for interim reports contents.
• Explore common academic terminology and concepts in effective report writing.

Hour 8:     Testimony

• Distinguish between a percipient witness and an expert witness.
• Explain what a subpoena is and what it means to the treating chiropractor.
• Explain what a deposition is for the treating chiropractor. Summarize the basic rules of a treating expert deposition.
• Summarize the mechanics of a personal injury trial from the perspective of the treating chiropractor.

Hour 1 

• Point out the probable mechanisms for direct injury to the lower back during motor vehicle collisions.
• Distinguish between radiculopathy, neuropathy, and sclerogenic referral of extremity pain.

Hour 2 

• Define the parameters for cervical and lumber spine central canal stenosis.
• Utilize both the Torg/Pavlov and the ratio radiographic methods for assessing cervical spine central canal stenosis.
• Explain the critical relationship between central canal stenosis and hyperextension spinal injuries.
• Demonstrate a practical method for the clinical assessment of cervical spine central canal stenosis.

Hour 3

• Identify differences seen between a blow brain injury and an inertial brain injury.
• Define the pathoanatomic and patho-biochemistry of injury.
• Explore the relationship between cervical spine injury and TBI

Hour 4

• Discuss the concept of how the systemic inflammatory profile affects local injury.
• List 8 systemic inflammatory factors that should be considered and co-managed on whiplash-injured patients.

Hour 5 

• Discuss the anatomy of the thoracic outlet.
• Demonstrate a management protocol for thoracic outlet syndrome.
• Define cervical angina.
• Demonstrate the single most important test to distinguish cervical angina

Hour 6

• Draw the anatomical basis for cervicogenic headache.
• Integrate cervicogenic headache and the temporomandibular joint (TMJ).
• Define inertial injury and the TMJ articulation.
• Demonstrate a practical assessment and management of TMJ injury.

Hour 7

• Distinguish between a percipient witness and an expert witness.
• Explain what a subpoena is and what it means to the treating chiropractor.
• Explain what a deposition is for the treating chiropractor. Summarize the basic rules of a treating expert deposition.
• Summarize the mechanics of a personal injury trial from the perspective of the treating chiropractor.

Hour 8 

• Demonstrate a typical soft tissue direct examination.
• Show the two most common drawings to support chiropractic care for soft tissue injuries.

• Review anatomy and physiology of the female patient
• Perform Physical Examination procedures unique to the female patient
• Identify conditions unique to the female patient that require referral to a Medical Doctor
• Discuss the presentation, evaluation, and management of conditions affecting women’s health within the scope of Chiropractic practice
• Discuss risk factors, screening and prevention recommendations with female patients
• Review nutritional supplementations that can augment conditions affecting women’s health within the scope of Chiropractic practice

Hour 1

• Illustrate the patterns behind disordered eating in female athletes.
• Distinguish differences in the hormonal cycle, and menstrual disturbances in different kinds of female athletes.
• Contrast the differences of evaluation and management of female athletes.
• Compare and contrast the chemically and structural differences between male and female athletes.

.Hour 2:

• List common female athletic injuries.
• Explain how to evaluate knee and lower leg injuries.
• Apply knowledge of muscle strength and hormonal differences to provide suitable training recommendations for a strength athlete.
• Explain nutritional deficiencies in female athletes.

 Hour 3:

• List the detriments in health and/or sports performance from lack of proper nutrition.
• Provide recommendations for appropriate nutritional guidelines for female athletes.
• Consider body composition, increase muscle mass, and improve overall sports performance of female athletes.

• This contains all courses with the educational objectives listed from Xray 103 through Xray 118

• Discuss a common origin of lumbar disc pain
• Describe the orientation of lumbar facet joints
• Identify the effect of lordosis on the position of the nucleus pulposis
• Establish how injuries of the annulus fibrosus can cause nerve root changes
• Identify the dynamic stenosis of the lumbar spine

• Identify anatomical structures of the knee involved with anterior knee pain
• Diagnose fat pad and bursitis syndromes
• Establish pathologies of the patellar tendon in adults and children
• Differentiate different causes of patellofemoral pain
• Match clinical syndromes of knee pain with radiological appearances

• Identify the general anatomy of the knee joint
• Develop an intimate knowledge of the anatomy of the menisci and ligaments of the knee using gross dissection and cross-sectional imaging
• Understand the functional anatomy of the menisci of the knee and define the type and grade of meniscal tears
• Establish the conditions discoid lateral meniscus and meniscal cyst and understand the spectrum of treatment available
• Identify what type treatment is available for meniscal injuries and when it would be prudent to reevaluate a post-op patient with new knee pain

• Outline the physical basis of magnetic resonance imaging
• Identify patients that are candidates for an MRI
• Recognize categories of pathology in the spine that are imaged well with MRI
• Recognize cases that require contrast
• List contraindications for an MRI

• Identify and classify injuries to the anterior cruciate ligament
• Diagnose and develop treatment for injuries to the posterior cruciate ligament
• Diagnose and develop treatment for injuries to the medial collateral ligament
• Diagnose and develop treatment for injuries to the lateral collateral ligament
• Describe and classify ostochondritis dissecans of the knee

• 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

• Identify common causes of back pain
• Assess pro and con of different imaging modalities related to back pain
• Identify imaging features that may relate to back pain
• Develop imaging strategy for back pain

• 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

• Point out the anatomy of the upper cervical spine and associated regional anatomy as seen on the APOM
• Identify variants of anatomy on APOM, noting if they are clinically relevant in providing Chiropractic care
• Differentially Diagnosis pathology noted in the region
• Discuss the advantages and disadvantages of imaging modalities for the upper cervical spine and maxillofacial region

• Recognize the signs and symptoms of patients entering the chiropractic with flu and sinusitis that may mimic musculoskeletal conditions
• Identify radiographic features of sinusitis on standard chiropractic projections and differentially diagnose from other musculoskeletal conditions
• Identify radiographic features of flu on standard chiropractic projections  and differentially diagnose from other musculoskeletal conditions
• Examine basic treatment options within chiropractic scope of practice and when to refer

• 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.

• Identify plain film features of abdominal pathology that may present in the Chiropractic office, with an emphasis on calcifications
• Differentiate cystic from solid mass lesions
• Classify vascular calcifications
• Recognize when calcifications need immediate medical referral

• 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.

• Identify imaging modalities used in sports and musculoskeletal imaging
• List indications for advanced imaging in the athlete
• Explain why imaging of the weekend “athlete” could save your practice
• Integrate imaging into treatment plans
• Assess progress of care with imaging

• 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 Anatomy 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

• This contains all courses with the educational objectives listed from Xray 155 through Xray 165

• 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

• Review the pathophysiology of spondylolisthesis
• Evaluate the two classifications of spondylolisthesis
• Classify transitional segments
• Determine necessity and efficacy of imaging of spondylolisthesis and transitional segments

• Differential diagnosis osteopenia and its relevance towards Chiropractic practice
• Identify imaging features of osteopenia
• Recognize ominous features of osteopenia
• Select appropriate chiropractic treatments for the osteoporotic patient

• 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.