The Upper Quarter Pain Puzzle: Peripheral Neuropathic Syndromes in Orthopedic & Sports Medicine Patients

presented by Jack Stagge

Accreditation Check:

In this course, Jack Stagge will present the concepts - pioneered by Bob Elvey - of differential diagnosis and treatment of patients with upper quarter pain and dysfunction that can often be unrecognized as having a neuropathic causation. Adhesive Capsulitis, Chronic Tendonitis, Impingement Syndromes, Fibrocytis, and even Specific Joint Inflammations often times have a non-diagnosed neurogenic component and thereby fail treatment. Negative MRI's, Negative EMG's, and non-specific testing can often lead the therapist to incorrect assessment of these patients. The upper limb tension test, or ULTT, as pioneered by Bob Elvey, will be illustrated in this course. Beyond these tests - and crucial to correct diagnosis - Bob's four other well documented criteria for the assessment of these syndromes will be emphasized and clearly demonstrated. Well researched pathophysiological concepts such as "Antidromic Pain", Neurogenic Rheumatica, Pseudoneuromas, Central Sensitization, and others will be discussed. Specific treatment of these syndromes by orthopedic, sports, industrial, and hand therapists will be explained and demonstrated for immediate application. Case presentations and demonstrations will be used to further allow the participant to successfully apply this material into their daily practice.

Course Testimonials:
"I have the utmost respect and confidence in Jack Stagge's abilities to teach what I have spent most of my professional career developing. Jack and I will continue to research, teach, and report our findings as they develop. This is a great opportunity for all who are interested in this topic to attend a worthwhile workshop."
Robert L. Elvey, PT, GDMT

"I have found both of these courses to have provided me with a better understanding of the importance of neural structure assessment as part of a comprehensive orthopedic evaluation. Assessment and treatment techniques were well supported by extensive research and pathophysiological data."
Mike Rogers, PT, MOMT, OCS, FAAOMPT
Past President of the American Academy of Orthopedic Manual Physical Therapy

Meet Your Instructor

  • Jack Stagge, PT, OCS, FAAOMPT

    Jack Stagge received his bachelor’s degree in Physical Therapy from CSU Fresno in 1978 and a specialty certification in Adult Neurology from U.S.C. in 1979. His postgraduate training includes extensive manual therapy course work in Norwegian, Australian, McKenzie and Cyriax protocols. He was chosen as a subject matter expert by the American Physical Therapy Board of Specialties in 1988 and helped in writing the first O.C.S. exam. He was Board Certified as an Orthopedic Clinical Specialist in May 1990 and 1999, and became a Fellow of the A.A.O.M.P.T. in 2002. Mr. Stagge taught “Physical Evaluation and Treatment of Neural Tissues in Disorders of the Neuromusculoskeletal System” with Mr. Robert L. Elvey, P.T., G.D.M.T. of Curtin University, Perth, Australia for several years throughout the United States. Jack has also been a featured presenter at the World Confederation for Physical Therapy, the APTA’s National Scientific meeting, Combined Section Meetings, State Conferences, and the I.F.O.M.P.T. in Perth Australia. He has served as a visiting professor and lecturer at several graduate programs and is a member of the International Teachers’ Forum of I.F.O.M.P.T. Mr. Stagge has also served as a book reviewer for the Journal of Orthopedic and Sports P.T., and as a consultant on several articles published on orthopedic manual therapy. In the past Mr. Stagge served as a consultant to the San Diego Chargers, the San Diego Padres, and the U.S. Olympic Track and Field Association. Mr. Stagge is currently director of International Manual Therapy Seminars and continues to consult and teach in the area of neurogenic pain syndromes.

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Chapters & Learning Objectives

  1. Introduction

    1. Introduction

    Understand the subjective complaints and objective findings of patients with neuropathic pain and learn about the important aspects to remember during the physical examination of these patients.

  2. Neuropathology, Neurojargon & Peripheral Afferent Sensitization

    2. Neuropathology, Neurojargon & Peripheral Afferent Sensitization

    Gain an understanding of the neurological basis and mechanisms of pain, the different categories of neuropathic pain, and afferent sensitization in the human brain.

  3. Evaluation

    3. Evaluation

    Learn about the subjective and objective evaluation of neuropathic pain of the upper extremities. Become familiar with the various pain scales and as the areas that should be examined when evaluating neuropathic pain.

  4. Neuro Palpation, Tender Points, Signs of Local Dysfunction, & Arriving at Diagnosis

    4. Neuro Palpation, Tender Points, Signs of Local Dysfunction, & Arriving at Diagnosis

    Review the anatomy of nerve trunks of the upper extremities, their distributions and how they translate to clinical signs and symptoms. The common denominators of neuropathic pain will also be summarized to help the online learner remember what to look for in diagnosing neuropathic pain.

  5. Concepts of Treatment Technique

    5. Concepts of Treatment Technique

    Understand the basic concepts of compressive and inflammatory neuropathies and gain familiarity with the sequence of treatment protocol by physical therapists.

  6. Home Programs and Treatment Sequencing

    6. Home Programs and Treatment Sequencing

    Understand the specific roles of the therapist and the patient in conducting home programs, and describe active neural mobilization techniques and desensitization exercises.

  7. Postulations for Treatment Effect & Indications and Contraindications for Treatment

    7. Postulations for Treatment Effect & Indications and Contraindications for Treatment

    Review treatment effects including mechanical, neurophysiological and physiological, and understand the indications and contraindications to treatment.