Advanced Self-Paced Online Training
Course Overview
In this Advanced Training you will learn three-dimensional clinical “neuromyofascial” applications using a unique approach developed by Graston Technique, LLC. Skills demonstrated in this course are applied along the kinetic chains of the trunk and extremities for modulation of pain and to eliminate movement dysfunction. They reflect the most current evidence regarding manual therapy.
At the end of this course you will have:
Extended interest and commitment to personal development using Graston Technique® therapy
Advanced knowledge of Graston Technique® therapy and examination procedures for assessing musculoskeletal dysfunction
Introductory exposure to principles of regional interdependence and 3-D kinetic chain neuromyofascial applications
Course Instructors

Jacqueline Shakar DPT, PT, GTS
Jackie has maintained a clinical practice in musculoskeletal physical therapy for more than 30 years, specializing in manual therapy and lower extremity biomechanics, including custom foot orthotics. She is a professor at Mount Wachusett Community College, where she has taught anatomy, kinesiology, clinical orthopedics and evidence-based practice/clinical research for more than 20 years. Jackie is an avid runner and works with a number of elite and recreational runners and triathletes. She also works with high school and college athletes. She has been a GT instructor since 2007. Jackie is also the clinical advisor for Graston Technique®. She completed a transitional Doctoral Degree at Massachusetts General Hospital Institute of Health Professions in 2010. Jackie became board-certified as a clinical specialist in orthopedic physical therapy by the American Board of Physical Therapy Specialties in 2011. She earned a master's degree in physical therapy from Boston University in 1983. She has been an Athletic Trainer since 1984, and she received a certificate in massage therapy from the Bancroft School of Massage Therapy in 2001.

Mike Ploski ATC, PT, GTS
Mike maintains a clinical practice at a rehabilitation company with four sites in the Indianapolis area and is a guest instructor in orthopedic manual therapy at the University of Indianapolis. He was a clinic director in Indianapolis for 12 years for a national rehabilitation company. Prior to that, he was a Physical Therapist/Athletic Trainer for the PGA Tour and the CART racing league. Mike has been a GT-trained clinician since 1996 and a GT instructor since 1998. He joined Graston Technique, LLC in 2013 and now serves as Clinical Advisor. He works in close collaboration with the faculty members who teach Graston Technique in the curriculum of advanced degree programs in physical therapy and athletic training and represents GT at national conferences. Mike received a Bachelor of Arts degree from Wabash College in 1984 and a Master of Education degree with a major in exercise physiology from Temple University in 1986. He earned a Master of Science degree from the Krannert School of Physical Therapy at the University of Indianapolis in 1988. He has been a certified Athletic Trainer since 1985 and board certified in orthopedics since 1998.
Course Content
Chapter 1: Introduction
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Advanced Applications
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Social Media
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Short Questionnaire
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Meet Your Instructors
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Conflict of Interest
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Disclaimer
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Disclaimer (cont.)
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Graston Technique, LLC
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Prohibited During Training
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More Than Just a Name
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Please Be Careful
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The Graston Technique® Training Series
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GTS Credential
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Non-Completion Policy
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Advanced Course Materials
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Preferred Provider Program (i)
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Preferred Provider Program (ii)
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Preferred Provider Program (iii)
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Advanced Course Topics
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Administrative
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GT Therapy is Multidisciplinary
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GT Therapy
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Advanced Course Description
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Advanced Course Objectives
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Advanced Course Objectives (cont.)
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Advanced GT Therapy Algorithm
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GT Therapy Modes of Application: Dictated by Stage of Healing
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GT Therapy Modes of Application (i)
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GT Therapy Modes of Application (ii)
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GT Therapy Modes of Application (iii)
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GT Therapy During Therapeutic Exercise/Neuromuscular Re-Education
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Essential GT Treatment Algorithm
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Review of GT Instruments & Essential Strokes
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GT Instruments
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Shape of the GT Instruments
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Bevel Edges of the GT Instruments
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Factors to Consider When Selecting GT Instruments for a Treatment Session
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Essential Instrument and Handhold Review
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Overview: Clinical Applications for Each Instrument
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Review of Essential Strokes and Handholds
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GT Treatment Preparation
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To Glove Up or Not?
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Avoid Snow Plowing
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GT Dosage Parameters
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Intensity of GT Session
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Intensity of GT Session (cont.)
- Advanced Applications
- Social Media
- Short Questionnaire
- Meet Your Instructors
- Conflict of Interest
- Disclaimer
- Disclaimer (cont.)
- Graston Technique, LLC
- Prohibited During Training
- More Than Just a Name
- Please Be Careful
- The Graston Technique® Training Series
- GTS Credential
- Non-Completion Policy
- Advanced Course Materials
- Preferred Provider Program (i)
- Preferred Provider Program (ii)
- Preferred Provider Program (iii)
- Advanced Course Topics
- Administrative
- GT Therapy is Multidisciplinary
- GT Therapy
- Advanced Course Description
- Advanced Course Objectives
- Advanced Course Objectives (cont.)
- Advanced GT Therapy Algorithm
- GT Therapy Modes of Application: Dictated by Stage of Healing
- GT Therapy Modes of Application (i)
- GT Therapy Modes of Application (ii)
- GT Therapy Modes of Application (iii)
- GT Therapy During Therapeutic Exercise/Neuromuscular Re-Education
- Essential GT Treatment Algorithm
- Review of GT Instruments & Essential Strokes
- GT Instruments
- Shape of the GT Instruments
- Bevel Edges of the GT Instruments
- Factors to Consider When Selecting GT Instruments for a Treatment Session
- Essential Instrument and Handhold Review
- Overview: Clinical Applications for Each Instrument
- Review of Essential Strokes and Handholds
- GT Treatment Preparation
- To Glove Up or Not?
- Avoid Snow Plowing
- GT Dosage Parameters
- Intensity of GT Session
- Intensity of GT Session (cont.)
Chapter 2: Fascial Physiology and Additional Advanced Considerations
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Fascia: Physiological, Structural & Functional Considerations
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Lecture Topics
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Relevant Connective Tissue Physiology
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Fascial Physiology
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Fibroblasts
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Fibroblast Responses to Pressure
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Extracellular Matrix (ECM): Function
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Fascial Physiology: Mechanotherapy
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Neurophysiological Effects: Altered Neural Activity Increased
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Structural Considerations
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Structural Considerations: Superficial and Deep Fascia
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Structural Considerations: Superficial Fascia
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Superficial Fascia: Advanced Stroke Selection
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Structural Considerations: Deep Fascia
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Structural Considerations: Deep Fascia (cont.)
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Structural Considerations: Lumbo-Pelvic Region: T-L andAbdominal Fascia
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T-L Fascia: Force Transmission
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Structural Considerations: Aponeuroses
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Structural Considerations: What Is A Tissue Interface?
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Graston Technique Therapy to Tissue Interfaces
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Structural Considerations: Retinaculum
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Retinaculum: Innervated with Free and Encapsulated NerveEndings (Stecco, Langevin)
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Dynamic Graston Technique® Therapy to Retinacular Tissues
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Structural Considerations: Musculotendinous Junctions
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Deep Fascia, Tissue Interfaces & Retinacula: Advanced Stroke Selection
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Functional Considerations: Dynaments
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Fascial Expansions/Load Transfer
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Functional Considerations: Fascial Linking
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Functional Considerations: Fascial Strain
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Functional Considerations: Fascia and The Kinetic Chain
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Functional Considerations: Biotensegrity & Regional Interdependence
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Functional Considerations: Anatomy Trains or Fascial Line Concept
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Evidence Supporting Myofascial Chains
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Posterior Chain
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Untitled - #378813
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Anterior Chain
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Anterior Chain Therapeutic Exercise
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Lateral Chain
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Lateral Chain Therapeutic Exercise
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Functional / Performance Chain
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UE Fascial Chain
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Dynamic Therapeutic Exercise Multiple Chains
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Functional/Pathological Considerations: At any level of function the lines are in use and abuse over time.
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Pathological Considerations: Fascial Pain and Joint Dysfunction
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Pathological Considerations: Fascial Pain and Joint Dysfunction (cont.)
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Summary: Structural & Functional Considerations of Fascia
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Summary: Structural, Functional & Pathological Considerations of Fascia
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Making the Case for Additional Advanced Strokes & Treating in 3D & Under Load
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Why Address Connective Tissue in 3D?
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Why Treat Under Load?: Impact of Tension and Stress
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Why Treat Under Load?: The Physical Stress Theory
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Why Treat Under Load?: Davis’ Law
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New Advanced Strokes
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Connective Tissue Assessment: Finger Glide and Clock, Skin Roll
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I-A Skin Rolling
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IA-C Bowing
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IA Skin Rolling & C-Bowing Applications
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Fascial Spiral
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Fascial Spiral Applications
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Pin & Stretch (Stationary Instrument/Bevel Down)
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Pin & Glide GT4
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Pin & Stretch/Glide Applications
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GT4 Interface Rock/Scoop
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Interface Rock/Scoop Applications
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Lab 2: New Advanced Strokes
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Advanced Additional Treatment Considerations
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Advanced Graston Technique® Therapy Algorithm
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Additional Considerations: Treating Under Load, Weightbearing & With Motion
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Additional Considerations: Treating Under Load, Weightbearing & With Motion (cont.)
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Potential Treatment Response
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General Treatment Guidelines
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General Treatment Guidelines (cont.)
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Advanced Treatment Parameters
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Other Important Points…
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Documentation of Graston Technique® Therapy Intervention
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Coding and Billing
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Clinical Indications
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Clinical Indications (cont.)
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Relative Contraindications
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Relative Contraindications (cont.)
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Injections
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Post-Surgical Graston Technique® Therapy Considerations
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ABSOLUTE CONTRAINDICATIONS
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ABSOLUTE CONTRAINDICATIONS (cont.)
- Fascia: Physiological, Structural & Functional Considerations
- Lecture Topics
- Relevant Connective Tissue Physiology
- Fascial Physiology
- Fibroblasts
- Fibroblast Responses to Pressure
- Extracellular Matrix (ECM): Function
- Fascial Physiology: Mechanotherapy
- Neurophysiological Effects: Altered Neural Activity Increased
- Structural Considerations
- Structural Considerations: Superficial and Deep Fascia
- Structural Considerations: Superficial Fascia
- Superficial Fascia: Advanced Stroke Selection
- Structural Considerations: Deep Fascia
- Structural Considerations: Deep Fascia (cont.)
- Structural Considerations: Lumbo-Pelvic Region: T-L andAbdominal Fascia
- T-L Fascia: Force Transmission
- Structural Considerations: Aponeuroses
- Structural Considerations: What Is A Tissue Interface?
- Graston Technique Therapy to Tissue Interfaces
- Structural Considerations: Retinaculum
- Retinaculum: Innervated with Free and Encapsulated NerveEndings (Stecco, Langevin)
- Dynamic Graston Technique® Therapy to Retinacular Tissues
- Structural Considerations: Musculotendinous Junctions
- Deep Fascia, Tissue Interfaces & Retinacula: Advanced Stroke Selection
- Functional Considerations: Dynaments
- Fascial Expansions/Load Transfer
- Functional Considerations: Fascial Linking
- Functional Considerations: Fascial Strain
- Functional Considerations: Fascia and The Kinetic Chain
- Functional Considerations: Biotensegrity & Regional Interdependence
- Functional Considerations: Anatomy Trains or Fascial Line Concept
- Evidence Supporting Myofascial Chains
- Posterior Chain
- Untitled - #378813
- Anterior Chain
- Anterior Chain Therapeutic Exercise
- Lateral Chain
- Lateral Chain Therapeutic Exercise
- Functional / Performance Chain
- UE Fascial Chain
- Dynamic Therapeutic Exercise Multiple Chains
- Functional/Pathological Considerations: At any level of function the lines are in use and abuse over time.
- Pathological Considerations: Fascial Pain and Joint Dysfunction
- Pathological Considerations: Fascial Pain and Joint Dysfunction (cont.)
- Summary: Structural & Functional Considerations of Fascia
- Summary: Structural, Functional & Pathological Considerations of Fascia
- Making the Case for Additional Advanced Strokes & Treating in 3D & Under Load
- Why Address Connective Tissue in 3D?
- Why Treat Under Load?: Impact of Tension and Stress
- Why Treat Under Load?: The Physical Stress Theory
- Why Treat Under Load?: Davis’ Law
- New Advanced Strokes
- Connective Tissue Assessment: Finger Glide and Clock, Skin Roll
- I-A Skin Rolling
- IA-C Bowing
- IA Skin Rolling & C-Bowing Applications
- Fascial Spiral
- Fascial Spiral Applications
- Pin & Stretch (Stationary Instrument/Bevel Down)
- Pin & Glide GT4
- Pin & Stretch/Glide Applications
- GT4 Interface Rock/Scoop
- Interface Rock/Scoop Applications
- Lab 2: New Advanced Strokes
- Advanced Additional Treatment Considerations
- Advanced Graston Technique® Therapy Algorithm
- Additional Considerations: Treating Under Load, Weightbearing & With Motion
- Additional Considerations: Treating Under Load, Weightbearing & With Motion (cont.)
- Potential Treatment Response
- General Treatment Guidelines
- General Treatment Guidelines (cont.)
- Advanced Treatment Parameters
- Other Important Points…
- Documentation of Graston Technique® Therapy Intervention
- Coding and Billing
- Clinical Indications
- Clinical Indications (cont.)
- Relative Contraindications
- Relative Contraindications (cont.)
- Injections
- Post-Surgical Graston Technique® Therapy Considerations
- ABSOLUTE CONTRAINDICATIONS
- ABSOLUTE CONTRAINDICATIONS (cont.)
Chapter 3: Functional Testing
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Functional Testing and Exercise Prescription
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Functional Testing and Exercise Prescription (cont.)
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Considerations for Neuromyofascial Interventions
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What Does This Mean for our Treatments?
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Do You Incorporate Functional Testing Into Your Clinical Examinations?
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Do Not Be Intimidated By Jargon!
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Common Functional Testing Systems
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Functional Tests Examine Movements vs. Muscles
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Pain Site vs Pain Source
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Pain Alters Motor Control
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Time Spent In Assessment
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The Test Determines The Treatment
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Goal of the Advanced System of Functional Testing
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Principles of the Advanced Functional Testing System
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Advanced System of Functional Testing (SFMA Top Tier Tests)
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Functional Testing
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Tight Hamstrings vs. Stability/Motor Control Deficit
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Lab 3: Advanced Functional Testing System
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Cervical Patterns
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Cervical Movement Patterns (i)
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Cervical Movement Patterns (ii)
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Cervical Movement Patterns (iii)
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Upper Extremity: MREP & LRFP
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Upper Extremity: MREP & LRFP (cont.)
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Multi-Segmental Flexion
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Multi-Segmental Flexion (cont.)
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Multi-Segmental Extension
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Multi-Segmental Extension (cont.)
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Multi-Segmental Rotation
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Multi-Segmental Rotation (cont.)
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Single Leg Stance
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Single Leg Stance (cont.)
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Overhead Deep Squat
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Squatting Pattern
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Therapeutic Exercise Prescription Progression
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Functional Exercise Positions
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Functional Exercise Positions (cont.)
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Functional Exercise Progression
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What Do You Give Your Patients For “Homework”?
- Functional Testing and Exercise Prescription
- Functional Testing and Exercise Prescription (cont.)
- Considerations for Neuromyofascial Interventions
- What Does This Mean for our Treatments?
- Do You Incorporate Functional Testing Into Your Clinical Examinations?
- Do Not Be Intimidated By Jargon!
- Common Functional Testing Systems
- Functional Tests Examine Movements vs. Muscles
- Pain Site vs Pain Source
- Pain Alters Motor Control
- Time Spent In Assessment
- The Test Determines The Treatment
- Goal of the Advanced System of Functional Testing
- Principles of the Advanced Functional Testing System
- Advanced System of Functional Testing (SFMA Top Tier Tests)
- Functional Testing
- Tight Hamstrings vs. Stability/Motor Control Deficit
- Lab 3: Advanced Functional Testing System
- Cervical Patterns
- Cervical Movement Patterns (i)
- Cervical Movement Patterns (ii)
- Cervical Movement Patterns (iii)
- Upper Extremity: MREP & LRFP
- Upper Extremity: MREP & LRFP (cont.)
- Multi-Segmental Flexion
- Multi-Segmental Flexion (cont.)
- Multi-Segmental Extension
- Multi-Segmental Extension (cont.)
- Multi-Segmental Rotation
- Multi-Segmental Rotation (cont.)
- Single Leg Stance
- Single Leg Stance (cont.)
- Overhead Deep Squat
- Squatting Pattern
- Therapeutic Exercise Prescription Progression
- Functional Exercise Positions
- Functional Exercise Positions (cont.)
- Functional Exercise Progression
- What Do You Give Your Patients For “Homework”?
Chapter 4: Breathing, the Diaphragm and the Abdominal Wall
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Breathing, Diaphragm, and Abdominal Wall
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Neuro-Development
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The Case for Breathing First
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Why Should We Assess Breathing?
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Pain & Breathing: What Does the Evidence Say?
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The Importance of Breathing
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Basic Breathing Retraining: Let’s Try!
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What Constitutes “Good” Breathing?
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Assessing Breathing: What is a Rib Flare and What Does it Mean???
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Abdomen, Diaphragm and Psoas/Iliacus Fascia Pre-Tests
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Abdomen/Diaphragm and Psoas/Iliacus
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Abdominal Wall/Diaphragm Exercises
- Breathing, Diaphragm, and Abdominal Wall
- Neuro-Development
- The Case for Breathing First
- Why Should We Assess Breathing?
- Pain & Breathing: What Does the Evidence Say?
- The Importance of Breathing
- Basic Breathing Retraining: Let’s Try!
- What Constitutes “Good” Breathing?
- Assessing Breathing: What is a Rib Flare and What Does it Mean???
- Abdomen, Diaphragm and Psoas/Iliacus Fascia Pre-Tests
- Abdomen/Diaphragm and Psoas/Iliacus
- Abdominal Wall/Diaphragm Exercises
Chapter 6: GT and Tendinosis
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GT for Tendinosis & Ligament Healing
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Acute Tendinitis
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Chronic Tendinosis
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Histopathology of Tendinosis
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Mechanical Loading Effects on Tendons
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Making a Case of Graston Technique® Therapy
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Graston Technique® Therapy Tendinosis Progression
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Graston Technique® Therapy Tendinosis Protocol UE (Supraspinatus Examples)
- GT for Tendinosis & Ligament Healing
- Acute Tendinitis
- Chronic Tendinosis
- Histopathology of Tendinosis
- Mechanical Loading Effects on Tendons
- Making a Case of Graston Technique® Therapy
- Graston Technique® Therapy Tendinosis Progression
- Graston Technique® Therapy Tendinosis Protocol UE (Supraspinatus Examples)
Chapter 9: GT to Improve Mobility of Motor Control of the Lower Body
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Lab 9 GT to Improve Mobility & Motor Control LE: Pre-Test
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Chris Johnson’s Table Test
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Lab 9A GT to Improve Hip Mobility & Motor Control
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Hip Exercises
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Lab 9B GT to Improve Knee Mobility & Motor Control
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Knee Exercises
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Lab 9C GT to Improve Ankle & Foot Mobility & Motor Control (Part 1)
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Lab 9C: Foot/Ankle Lab
- Lab 9 GT to Improve Mobility & Motor Control LE: Pre-Test
- Chris Johnson’s Table Test
- Lab 9A GT to Improve Hip Mobility & Motor Control
- Hip Exercises
- Lab 9B GT to Improve Knee Mobility & Motor Control
- Knee Exercises
- Lab 9C GT to Improve Ankle & Foot Mobility & Motor Control (Part 1)
- Lab 9C: Foot/Ankle Lab