+ Course Overview

Physical therapy education relative to an understanding of the various types of headaches, orofacial pain and temporo-mandibular disorders (TMD), as well as their inherent patho-physiological mechanisms, are commonly not covered sufficiently within the entry-level or graduate physical therapy curriculum. This specialty course has been designed to fill the void, which exists beyond the evaluation of the cervical spine and provide knowledge as well as training in definitive evaluative and therapeutic skills unique to this specialty area.

+ Description

One of the most overlooked causes of headache and orofacial pain are those of a cervicogenic and/or temporo-mandibular etiology. Many general practice physicians, neurologists and dentists commonly disregard the cervical spine as a causative craniofacial pain factor or are unaware of temporomandibular dysfunction focusing instead on a vascular, vestibular or neurological etiology. Physical therapists who receive referrals relative to the evaluation and treatment of patients with headaches, orofacial pain and temporomandibular dysfunction in children and adults, therefore need to understand that there are mechanisms other than vascular or neurologic that represent significant etiological factors and require a multi-disciplinary approach.

This course is designed to provide the information and necessary evaluative skill to delineate the major types of headaches, orofacial pain, temporomandibular joint (TMJ) movement disorders and associated symptoms that originate from the craniofacial and temporomandibular regions from those of a cervicogenic and/or comorbid origin. An in-depth understanding of the anatomical and neurophysiological factors relative to the trigeminocervical, sub-occipital and temporomandibular complex, as well as the cranium in relation to headaches and orofacial pain will be presented. Sub-occipital, orofacial, temporomandibular and cranial pain/dysfunction syndromes will be analyzed with emphasis placed upon their delineation and subsequent development of comprehensive therapeutic paradigms. Workshop sessions will follow the lectures and focus upon case study analysis, proper sequencing and use of manual upper ¼ and craniofacial (intra & extraoral) soft tissue and joint mobilization techniques, therapeutic exercise, adjunctive modalities, dry needling as well as postural and ergonomic intervention for the reduction of pain and inflammation, restoration of function and prevention of recurrence. A constantly evolving 6-page evaluation form provides the foundation for the course.

+ Course Learning Objectives

Goals:

1. Identify the components of the trigemino-cervical complex.
2. Understand how cervicogenic mechanisms can impact the craniofacial region.
3. Delineate between the general headache categories.
4. Delineate between the various types and causes of cervicogenic headaches (CGH), prime headache disorders (tension-type, vascular/migraine, neuralgic and autonomic), temporo-mandibular disorders (TMD) and orofacial pain (OFP) in order to direct treatment to the causative structures and eliminate perpetuating factors.
5. Understand the significant impact of myofascial pain upon the cervical, shoulder girdle and craniofacial regions.

Competencies:

1. Understand new evaluative concepts relative to the cervical/shoulder girdle, sub-occipital, craniofacial and temporomandibular regions, as well as their inherent interaction that frequently gives rise to co-morbidity.
2. Demonstrate knowledge of the anatomy and arthrokinematics of the TMJ as well as related dental terminology.Identify occlusal abnormalities, intrinsic and extrinsic etiological factors that contribute to TMD, masticatory muscle hyperactivity or imbalance and the need for dental and/or physical therapy intervention.
3. Properly interpret the findings of the evaluation and present it in verbal and written form to the referring physician (medical and dental) along with appropriate therapeutic goals and treatment plans for comprehensive management.
4. Perform specific manual therapeutic procedures relative to joint and soft tissue mobilization, of the cervical, shoulder girdle, sub-occipital, craniofacial, masticatory and temporomandibular regions.
5. Instruct patients in therapeutic exercise techniques for postural correction, functional restoration, muscle imbalance, strengthening and relaxation.
6. Understand the different TMJ surgical techniques and proper post-operative management.Assess the need for adaptive devices and ergonomic changes for correction of improper driving, sitting, sleeping and working postures.
7. Understand the role of dental/oral appliances and techniques utilized in the management of TMD and OFP.
8. Instruct patients in self-management and non-medicinal techniques to prevent a recurrence of pain and/or dysfunction.

+ Overview of Each Two-Day Module

Module I:
Cervicogenic Causes of Headaches and Orofacial Pain of Non-TMD Origin
The Sub-Occipital Connection – Comprehensive Evaluation & Treatment of the Cervical-Shoulder Girdle & Cranium

Module II:
Comprehensive Evaluation of the Temporomandibular Complex
Comprehensive Treatment of the Non-Surgical TMD Patient

Module III:
Advanced Delineation of Disc Displacements, Subluxation/Luxation
Comprehensive Evaluation & Treatment of the Pre & Post-Surgical TMD Patient
Adjunctive Therapeutic Techniques for Vagus Nerve Stimulation, Tinnitus, and Eustachian Tube Dysfunction
Class performance of a complete comprehensive evaluation of an actual patient with cervicogenic and TMD symptomatology that was previously treated by Dr. Mannheimer utilizing the 6-page course evaluation template.

Case study presentations with class interaction are presented specific to the topics of each module. The complete hour by hour agenda for day one and day two of each module are available by clicking the following links:
Module I - Day One / Module I - Day Two
Module II - Day One / Module II - Day Two
Module III - Day One / Module III - Day Two

+ 2025 Course Schedule

+ Logistics

1. Each course is held at my office on the grounds of the Princeton Yoga Center in Skillman, NJ which is 5 miles from Nassau Street in Princeton, NJ.

2. The recommended hotel is the Residence Inn by Marriott Princeton at Carnegie Center: 3563 US Route 1, Princeton, NJ 08540: Call 609-799-0550 and ask to speak with Debbie or Dawn and state that you are taking Dr. Mannheimer's course which will let you get the discounted rate of $129.00. It is imperative for everyone who will not be driving to my office from home each day to stay at this hotel to coordinate transportation to and from my office. Please make your reservations ASAP as the hotel is frequently fully booked.

3. The hotel is within walking distance of my condo and adjacent to the Princeton Market Fair Mall which is one block from the hotel. It has a movie theater, Barnes & Noble bookstore, Starbucks, many other interesting stores and a choice of restaurants within and outside the mall.

4. I need to know who will be staying at the hotel on Friday and Saturday night and/or driving to the course each day from home as well as who will be traveling by airplane: If you are traveling by airplane let me know the state and airport from which you will be traveling). Please remember to fly into Newark Airport (NOT NEW YORK) and arrive mid-afternoon on Friday for each module. When you disembark from your flight, please note the following directions:

• Take the airport monorail (Airtrain) to the NJTransit Rail Link.
• Purchase a roundtrip NJ Transit (NOT AMTRAK) train ticket from Newark airport to Princeton Junction. Travel time is usually 30-45 minutes.
• Send me your airline flight information ASAP so I can coordinate picking you up at the Princeton Junction station and taking you to the Hotel. I can only do this if you plan on arriving at the Princeton Junction Train Station between 5:00-6:30 pm or you will need to take Uber or Lyft to the hotel which is only a 5 minute ride.
• I will also pick you up each morning and take you to the office unless one or more PTs are staying at the hotel who have a car. (Please let me know who will have a car at the hotel and can help with driving).
• Following the above travel directions from the airport eliminates the extra cost of renting a car at the airport.
• Let me know before you make the airline reservations if you need to take a flight back leaving in the early evening on Sunday as I will need to start and end the class earlier on Sunday to accommodate anyone that needs to fly out at that time as further delineated below:

5. Otherwise, the course will commence on Saturday and Sunday at 8:00 am, ending between 6-6:30 pm on Saturday but by 4:00-4:30 pm on Sunday. However, whenever one or more PT’s from a western state enrolls, which occurs with almost every course, the course will commence on Sunday at 7:00 and end at 3:30 to allow for those from the west coast to make a Sunday evening flight home from Newark Airport so that they do not have to stay at the hotel on Sunday night and miss a day of work on Monday.

6. Continental breakfast and break items will be available each day of the course on Saturday and Sunday from 7:00-8:00 am at my office and will include juice, coffee, tea, bagels, cream cheese/jelly/peanut butter, hot cereal packets, bananas, nutrition bars, nut mix, etc.

7. In order to save time from having to go out for lunch I recommend that everyone bring lunch items each day. I have a refrigerator, microwave and toaster oven in the office. If the weather is acceptable, you can eat lunch outside the office or on the grounds of the Yoga Center.

8. I will provide driving directions from the hotel to my office. Please park directly in-front of my office and diagonally alongside my metallic grey Subaru facing the pond (see picture on my website which shows my previous blue Subaru). My office is only 8.5 miles from the Marriott. Driving time on the weekend is only 15 minutes.

9. My office is on the ground floor of a two-story free standing white building on the grounds of the Yoga Center. The entrance is directly into my office without any hallway.

10. Regarding COVID-19 Guidelines: I assume that everyone has been fully vaccinated & boosted by now, but I will still be taking everyone’s temperature upon arriving at the office each day and you will need to complete a brief questionnaire that is required in New Jersey. Everyone will need to bring masks and at least one face shield. Masks will be worn during the course except when you are a subject for extra and intra-oral evaluation and manual therapeutic techniques. However, if everyone is fully vaccinated we may agree not to wear masks during the lectures.

11. I will provide examination gloves, disinfectant wipes, hand lotion and all other items that are necessary to fully evaluate and treat the cervical and temporomandibular complex.

12. Everyone will receive their own course booklet for each Module and video’s of all the manual techniques. Each booklet will contain the slides of every lecture presentation, evaluation forms, illustrations and/or explanations of each manual technique, patient home exercise programs, recommended adjunctive devices, supportive publications, etc.

13. Please submit your cell phone numbers to me ASAP to allow for coordination.

14. Course Certificate: Cannot be granted unless all 3 modules are completed in succession.

Let me know if you have any questions. During each module of the course you will learn, laugh, enhance your mental and manual skills and develop new collegial friendships. I will look forward to meeting everyone.

Jeff

+ Course Tuition and Registration

Tuition: Tuition for the 2025 courses is $2700.00 ($900.00/module) and can be paid in three installments as the course series progresses. Tuition includes all course material, lecture slides, evaluation and home exercise instruction forms, adjunctive postural corrective and pain reduction options as well as illustrations of all manual techniques printed in a separate booklet/module. Separate videos of all manual cervical/shoulder girdle, craniofacial and masticatory extra and intra-oral myofascial, joint mobilization and tractional techniques/module are included along with continental breakfast and refreshments.

To ensure your registration, a $450.00 deposit is due ASAP prior to the start of each course that counts as 50% of the tuition for Module I. Payment can be made by personal, business, or bank check as well as money orders. PAYABLE TO: