Graston Technique®: Evidence-Based Management for the Lower Quadrant
Presented by Jacqueline Shakar
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Lower-quadrant movement dysfunctions and pain can occur when the body is injured but also when repetitive strains from malalignments and muscle imbalances are present. These movement dysfunctions can be identified and treated by physical therapists and athletic trainers utilizing a top-down or a bottom-up approach. In a top-down approach, structures of the lumbopelvic and knee complexes are targeted. In this course, a bottom-up approach based on current evidence will be identified and demonstrated utilizing a unique system of evaluation, manual therapy, therapeutic exercise, and customizable orthotics to treat lower-quadrant pain and movement dysfunctions. Interventions, including soft-tissue and joint mobility techniques, highlighting the Graston Technique®, which is a system of instrument-assisted soft-tissue mobilization (IASTM), will be demonstrated. Evidence-based therapeutic exercise and neuromuscular reeducation strategies that target foot intrinsic muscles and complement manual therapy are included. An efficient, low-cost system of customizable orthotics, which has been found to be an effective adjunct to manual therapy, and exercise interventions will be discussed and shown via demonstration. The information and skills learned in this course can be immediately applied by physical therapists and athletic trainers in a variety of practice sessions, including sessions in outpatient clinics, in the athletic training room, and even in a patient’s home or school.
Meet your instructor
Jacqueline Shakar
Jackie has been a licensed physical therapist and athletic trainer for more than 38 years. She currently works in an outpatient facility, and her clinical focuses include a wide spectrum of patients, including those with pelvic pain, geriatrics, endurance athletes, and those experiencing persistent pain. She received her…
Chapters & learning objectives
1. Review of Relevant Anatomy and Gait Mechanics
In this chapter, clarification of terminology and identification of relevant osteology and myology as these topics relate to movement dysfunction of the lower quadrant will be covered. An overview of the kinematics of pronation and supination during normal and pathological gait will be discussed.
2. Evidence-Based Evaluation Techniques
In this chapter, an evidence-based series of unique tests that can efficiently and accurately assess foot and lower leg function will be discussed and demonstrated. A brief overview of the components of gait analysis utilizing a treadmill is included.
3. Evidence-Based Manual Therapy and Exercise Techniques
In this chapter, interventions that target potential mobility and/or strength/motor control deficits of the lower quadrant are covered. A brief review of the current evidence that supports manual therapy and its mechanisms of effectiveness is presented. Selected manual techniques utilizing instrument-assisted soft-tissue mobilization (IASTM) via the Graston Technique® and evidence-based therapeutic exercises that target foot intrinsic muscles are demonstrated.
4. Customizable Orthotics
In this chapter, a low-cost and efficient customizable orthotic system will be introduced as a vehicle to change the neurophysiology of the foot and ankle. Research supporting the efficacy of customizable orthotics is included. The evaluation techniques covered in Chapter 2 of this course will be demonstrated both prior to and then in conjunction with a customizable orthotic to illustrate the test/treat/retest philosophy of treatment.