Thoracic Outlet Syndrome: The Scalene Triangle
Presented by: Paul J. Bonzani, OTR/L, CHT, MHS
$39; 1.5 Contact Hours (See CEU provider info below)
ONLINE COURSE DESCRIPTION
Nonspecific pain syndromes of the upper limb present a challenge to the clinician entrusted with the care of these difficult cases. Success depends on a comprehensive understanding of the anatomy of this region. Further, the clinician must be able to apply anatomic knowledge to clinical presentation to derive effective treatment. In part one of this course the anatomy of the scalene triangle and its relationship to the first rib is explored. Assessment techniques specific to this region are reviewed and treatment strategies are presented. Relationships to scapulothoracic movement and posture are also presented. Mobilization techniques are blended with corrective exercise and relevant ergonomic education to present a comprehensive approach to treatment.
ONLINE COURSE OBJECTIVES
1. Identify the relevant anatomic structures of the scalene triangle and articulate their
relationship to thoracic outlet syndrome symptom presentation.
2. Identify and apply at least three clinical assessment techniques applicable to thoracic outlet syndrome assessment.
3. Identify and implement at least one mobilization and one exercise technique appropriate to
management of thoracic outlet syndrome through the scalene triangle or scapulothoracic region
4. Identify and implement 2 postural/ergonomic techniques to control thoracic outlet syndrome symptoms during return to work or activities of daily living.
Anterior and lateral neck anatomy relevant to TOS
Assessment of symptom presentation including:
Cervical Spine Screening
Supraclavicular fossa test
Scalene flexibility assessment
Ipsilateral/Contralateral Addison’s test
Elevation and stiffness of the first rib assessment
Scapula release test
Scalene flexibility exercises
Cervical retraction in the forward head presentation
Deep neck flexor activation
First/Second rib mobilization
Ergonomic interventions including workstation and sleeping positions
Q/A and review of demonstrated techniques per request
Paul J. Bonzani, OTR/L, CHT, M.H.S.
currently maintains a very busy clinical practice in Concord, NH. Throughout his career he has had the fortunate opportunity to work with some of the finest hand surgeons and therapists in the country having held management positions at both The University of Vermont—Fletcher Allen Medical Center and Duke University Medical Center. Additionally he has been an adjunct instructor in both the Duke University Physical Therapy Program and the Program in Occupational Science at the University of North Carolina-Chapel Hill. Mr. Bonzani brings 21 years of clinical experience in orthopedic and industrial rehabilitation. Paul has presented nationally in the areas of biomechanics and rehabilitation of the shoulder, nerve compression syndromes, RSI/CTD management and pain syndromes. He has published on the subjects of CTD/RSI management, thumb reconstruction and management of the rheumatoid elbow. Clinical specialties include rehabilitation of the elbow and hand, chronic pain syndromes, TOS, nerve compression syndromes and neural tension disorders of the upper limb. Current research interests include functional outcome measures following fractures and upper quadrant sensate deficits. Paul is a clinician, researcher and educator and considered to be one of the leading therapists in the care of shoulder, elbow and hand injuries in North America.
This is an intermediate level course designed for PTs, PTAs, OTs, OTAs, CHT’s and ATCs
CE Approval provided through Therapy Network Seminars:
PT CEU: *AK,AL,*AR,*AZ,CO,CT,*DC,*DE,GA,HI,IA,ID,*IN,*KS,*KY,MA,ME,MI,*MO,*MS,MT,*NC,ND,NE,NH,NY, OR,*RI,*SC,SD,TN,TX,*UT,VA,WA,*WI, VI,VT,WY;
*Approved “by virtue”
NY-NYSED Approved Provider for PT/PTAs 10/14/2014 – 10/14/2018
TX-TPTA Accredited Provider. This activity is provided by the TX Board of PT Examiners Accredited Provider and meets continuing competence requirements for PT and PTA licensure renewal in TX.
OT CE Approval provided through Therapy Network Seminars:
*Satisfies NBCOT Requirements only.
AOTA Approved Provider # 3073. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA.