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Intramuscular Stimulation (IMS) Trigger Point Dry Needling
"Dr. Steven Goodman is a knowledgeable and experienced practitioner of the IntraMuscular Stimulation technique for treating chronic myofascial pain. I have worked with him at international medical conferences where he has displayed not only his thorough understanding and skill in this valuable treatment model, but also a warm and empathetic approach to the patient. He is committed to maintaining and improving his skills in teaching the Gunn-IMS technique to his medical colleagues, and… is recognized by others in the field to be a dedicated and articulate proponent of IMS to the worldwide medical community. His extensive work in rehabilitation medicine and electrodiagnostic techniques have placed him in a unique position to assist both patients and practitioners in their understanding of this powerful treatment modality."
John Kent, M.D.
Maccabi Health Services
Maalot, Israell
LearnIMS Course Summary
It is Dr. Goodman's goal to have you return home and immediately begin offering IMS safely and effectively in your practice. During the LearnIMS course and workshops, you will have personal and continuous 1:1 observation and instruction directly from Dr. Goodman in learning this treatment model. You will get frequent practice in this technique during the course to help you build the confidence necessary to begin using it immediately. It will transform your practice by providing an effective non-drug, non-surgical solution for your patients.
LECTURES CONTENT SUMMARY
The Gunn Intramuscular Stimulation (IMS) - radiculo-neuropathic model of myofascial trigger point pain is taught. Students are provided with copies of lecture slides, patient education handouts, informed consent forms and supporting published scientific literature references.
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Neurophysiology of Pain: Anatomical, Pathophysiological, Temporal-Functional Models: Types 1, 2 & 3 Pain
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Cannon’s Law of Denervation Supersensitivity
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Muscle Contracture & Radiculo-Neuropathic-Myofascial Pain (RNMP) Syndromes
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Clinical Basis & Physical Examination of RNMP
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Epidemiology of Myofascial Pain Syndromes
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General Approach to the Treatment of the Patient with Neuropathic-Myofascial Pain: Reversing Neuropathic Supersensitivity through Counter-Irritation Reflex Stimulation: Manual Therapy, Therapeutic Aids, Gate Theory/TENS, Needle Effect, LTR-Local Twitch Response, Dry Needling vs. Trigger Point Injection, Gunn IMS vs. other TP DN Models
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Therapeutic Mechanisms of the IMS needle
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Published Basic Animal & Clinical Research on Dry Needling and IMS
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Indications, Contraindications, Potential Complications & Adverse Events Data
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Educating the Patient Properly @ IMS Prior to Rx, Patient Handouts on IMS for their Review; Ergonomic and Travel Precutions for IMS Patients
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Informed Consent Form Review
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Integration of Manual therapy, Electrotherapeutic Modalities (TENS/U/S) and Proper Functional Rehabilitation Exercise Regimens w/ IMS Rx
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Value and Limitations of MRI and EMG studies in the IMS patient
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Clinical Decision Making: Monitoring Progress Objectively, Adjusting Therapeutic Targets, Handling Unusual Responses, Discontinuing Rx, Seeking Advice, Followup Support from Dr. Goodman, Opportunities for Continued Education in IMS
DESCRIPTION OF THE CLINICAL, SAFETY & INFECTION CONTROL INSTRUCTION
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Based on the principles and physical exam findings taught in the lectures, physical examination of the patient is demonstrated, with particular emphasis on identification and selection of patients most likely to respond to treatment. Appropriate expectation of the length of treatment based on the physical findings is emphasized and identification of patients NOT appropriate for dry needling is taught and emphasized. Monitoring progress through objective measures, adjustment of therapeutic targets, handling uncommon clinical responses and decisions to seek advice and/or discontinue treatment are covered.
Use of the point finder device to optimize treatment is taught and practiced.
Axial spine and regional limb anatomy is reviewed, and surface anatomy with particular attention to DANGER ZONES that contain nerve, vascular, gland and organ structures to avoid/vulnerable to injury is emphasized.
The difference between sterile and ‘no-touch’ antiseptic technique is reviewed. Proper personal and patient precautions, including hand washing, cleansing of the skin and handling and disposal of needles are covered.
Proper positioning of the patient for safety and comfort, and direction of needling to minimize the chance of injury to underlying vulnerable structures is taught. Students are taught proper selection of needle size and monitoring for and management of potential complications (including pneumothorax) is reviewed. The College of Physical Therapists of Alberta ‘Dry Needling Competency Profile for Physical Therapists’ document is provided to all students and the sections titled ‘Clean Dry Needling Technique’ and ‘Safe Dry Needling Technique’ are reviewed in class.
ANATOMICAL REGIONS TAUGHT
The most commonly treated regions and muscles, that account for the large majority of the muscles that are routinely treated in practice, are demonstrated, taught and practiced extensively during the hands-on workshop with direct continuous observation and coaching 1:1 by Dr. Steven R. Goodman.
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Cervical Spine, Occipital Attachments, Mandible/Masseter/Pterygoid
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Shoulder Girdle: Anterior and Posterior
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Elbow/Forearm/Hand
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Thoracic Spine
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Lumbosacral Spine, Quadratus Lumborum
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Hip Girdle: Posterior and Lateral
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Thigh: Anterior, Medial and Posterior
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Leg: Anterior and Posterior
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Foot
Reminder: Required reading materials must be completed BEFORE Day 1 of the LearnIMS course.