Comprehensive Evaluation & Treatment of the Sub-Occipital, Craniofacial & Temporomandibular Complex.

A progressive course series of 3 separate two-day modules within a 3-month period which allows for clinical practice of the evaluation and treatment techniques that are supported by videos between each module

Does Your Patient Only Have a Temporomandibular Disorder (TMD)?

OR

Could the Pain and Dysfunction Also Be Due to or Comorbid with Any of the Following?

Cervicogenic myofascial pain, cluster, migraine or tension-type headache, ear infection or toothache, C2 – C4 discal bulging, temporal arteritis, TMD, cranial nerve neuralgia or a combination of one or more?

Without a comprehensive evaluation and individualized treatment program, which is the foundation of this course, chronicity is likely to develop.

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.

Objectives:

Upon successful completion of this course, each participant should be able to delineate the major types of headaches, craniofacial and temporomandibular pain-dysfunction syndromes and initiate appropriate and logically sequenced comprehensive therapeutic management.  All concepts and techniques will be supported by evidence-based, peer-reviewed publications.  Completion of the course will allow the student to achieve the following goals and competencies, which will be determined/measured by participant interaction during case presentations.

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.Demonstrate knowledge of the anatomy and arthrokinematics of the TMJ as well as related dental terminology.
2. 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.
7. Assess the need for adaptive devices and ergonomic changes for correction of improper driving, sitting, sleeping and working postures.
8. Understand the role of dental/oral appliances and techniques utilized in the management of TMD and OFP.
9. Instruct patients in self-management and non-medicinal techniques to prevent a recurrence of pain and/or dysfunction.
   

JEFFREY S. MANNHEIMER, PT, Ph.D, CODN, CCTT

Dr. Mannheimer received a BS degree in Biology from Bradley University, MA degree and Certificate in Physical Therapy from New York University and a Ph.D in Health Science from Seton Hall University. He is now in his 56th year of clinical practice, which over the past 37 has been limited to the evaluation and treatment of cervical spine disorders, temporo-mandibular disorders, cervicogenic headaches and orofacial pain (CSD, TMD, CGH & OFP) respectively.  He is a certified Cervical and Temporo-mandibular Therapist (CCTT) by the Physical Therapy Board of Craniofacial & Cervical Therapeutics (PTBCCT) and certified in Orofacial Dry Needling (CODN) by Myopain seminars.

He has many publications pertaining to the evaluation and management of pain by postural and ergonomic correction, manual techniques, therapeutic exercise and non-medicinal pain control in dental, medical and physical therapy texts and journals. He coordinated the chapter on “Cervicogenic Mechanisms of Headaches and Orofacial Pain” for the 4th edition of “Orofacial Pain: Guidelines for Assessment, Diagnosis & Management” of the American Academy of Orofacial Pain (AAOP).  He is also the co-author of the first medical textbook on Transcutaneous Electrical Nerve Stimulation, “Clinical TENS” published by F.A. Davis in 1984.  His most recent clinical contribution “Dry needling for management of pain in the upper quarter and craniofacial region” by Kietrys DM, Palombaro KM & Mannheimer JS, was published in Current Pain & Headache Reports. 18(8): 437- 446, 2014 and “International consensus of the most useful assessments by physical therapists to evaluate patients with temporomandibular disorders: A Delphi study”. Journal of Oral Rehabilitation. 47(6): 685-702, 2020.

In addition to private clinical practice, Dr. Mannheimer is currently an Adjunct Clinical Professor in the Department of Rehabilitation & Regenerative Medicine (Program in Physical Therapy) at Columbia University. He was previously a Clinical Assistant Professor in the Dental School of the University of Medicine and Dentistry of New Jersey (UMDNJ) and director of the physical therapy tract for their continuing education program in the Diagnosis and Management of Temporomandibular Disorders and Orofacial Pain for 13 years until the program was discontinued.

Current professional memberships are held in the American Physical Therapy Association, American Academy of Orofacial Pain (AAOP) and the International Association for the Study of Pain (IASP). He has also served on the examination committee of the American Board of Orofacial Pain (ABOP), which certifies dentists in this specialty field, is a member of the AAOP education committee and previously served as an AAOP council member. Dr. Mannheimer is the founder and current president of the PTBCCT (ptbcct.org), which consists of an international group of physical therapists who desire to promote education and specialty certification in the field of CSD, CGH, TMD and OFP.  Dr. Mannheimer is a frequent invited speaker at national and international seminars and scientific meetings as well as a manuscript reviewer for Quintessence and Pain Medicine and previously for the Journal of Craniomandibular and Sleep Practice.

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

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.

The course is structured as a Mini-Residency consisting of 3 progressive weekend modules over a consecutive 3-month period that allows for practice and review of the evaluation and manual therapeutic techniques prior to the start of the next module. Manual technique videos are sent after each module for review & practice. Each module is geared to a specific area that can create local and/or referred pain with or without dysfunction and are all crucial components of the trigemino-cervical complex.

Each mini-residency is limited to no more than 6 PT’s/course due to space, the necessity of closely observing everyone performing the evaluative and manual techniques as well as to have sufficient time for me to perform them on everyone.  This requirement is also necessary to maintain the intensive nature of teaching and demonstrating numerous manual soft tissue, joint mobilization techniques in association with therapeutic exercise paradigms specific to the shoulder girdle, cervical, sub-occipital, cranial and orofacial regions (intra & extra-oral).  As the course proceeds everyone will learn how to integrate combinations of the above techniques into specific therapeutic paradigms with adjunctive modalities as needed. 

The evaluation section (cervical-orofacial-temporomandibular-headache) of the course follows my specific 6-page template which is needed to obtain all of the required subjective and objective data to develop the proper ICD-10 diagnostic and CPT treatment codes (your diagnostic impression and therapeutic treatment paradigm). 

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 PDF 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

2024 Course Schedule

Course XX (COMPLETED):
Module I: January 20-21, 2024
Module II: February 24-25, 2024
Module III: March 23-24, 2024

Course XXI (COMPLETED):
Module I: April 27-28, 2024
Module II: May 18-19, 2024
Module III: June 22-23, 2024

Course XXII (FILLED & IN PROGRESS):
Module I: September 21-22, 2024
Module II: October 19-20, 2024
Module III: November 16-17, 2024
Note: There are 7 PTs and one MD registered for Course 22, which is limited to 8 participants. Therefore, registration for Course 22 is closed.

Course XXIII (2 SPOTS OPEN):
Module I: January 18-19, 2024
Module II: February 22-23, 2024
Module III: March 22-23, 2024
Note: There are 3 dentists and 3 PT’s registered for Course 23, therefore only 2 spots remain.

If you are interested in attending my first 2025 course (Course 23), PLEASE NOTE: Registration is on a first-come, first-serve basis and MUST be made in advance with your immediate email confirmation and is guaranteed only upon receipt of your deposit VIA CHECK in order to ensure your spot in the course.

Each module of every course must be taken in succession & switching modules between courses is not permitted. The nature of this series allows for 23 hands-on workshop sessions and lectures, maximized by limiting each course to a combination of no more than 8 of the following licensed medical professionals: PT/DPT, DDS/DMD, MD/DO.

The 40 CEU’s obtained from this course can be applied towards the required 100 that are needed to sit for the 2025 examination leading to CCTT status as a PT.

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

Lodging: 

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 qualify you for the discounted rate of $129.00.

The hotel is adjacent to the Princeton Market Fair Mall which has a movie theater, Barnes & Noble bookstore, Starbucks, many interesting stores and a choice of restaurants within and outside the mall.

Tuition: Tuition for the 2024 courses is $2400.00 ($800.00/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 $400.00 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:

Jeffrey S. Mannheimer, PT, PHD, PC

Mail to: Jeffrey S. Mannheimer, PT, PHD, PC
88 Orchard Road Suite 11 in the Carriage House
Skillman, NJ 08558 

What you will learn:

Course Name and Dates

Evaluation and Treatment of Temporomandibular Disorders and Craniofacial Pain

This two-day TMJ course provides a basic understanding of Temporomandibular Disorder (TMD) and Craniofacial Pain (CFP). Participants will learn anatomy and biomechanics of the normal Temporomandibular Joint (TMJ), as well as abnormal mechanics or pathophysiological mechanics that will require a comprehensive evaluation and treatment approach. Additional info and agenda can be found at: https://www.treatingtmj.com/tmd-course-schedule/

CRAFTA, the Craniofacial Therapy Academy, is globally recognized as a leading institution in more than 16 countries in the field of education in the assessment and treatment  for cranio-orofacial dysfunctions and pain for physical therapists, dentists, and other healthcare providers interested in this field.

The courses are taught by world-renowned experts if the field of orofacial pain.   CRAFTA is founded by Dutch physiotherapist Dr. Harry von Piekartz, PT, PhD, MSc, OMT.

For the CCFT exam ,the CRAFTA 1 Foundation course is required.

Course schedules see  www.crafta.org and or www.myopainseminars.com/courses/134-cranio-facial-therapy-academy-1/region-US/

The CRAFTA-1 Foundations course consists of three parts: CRAFTA-1a,  CRAFTA-OM (Online Module), and CRAFTA-1b.

The course focuses on the assessment and management of the craniomandibular-facial region and its functional relations. Students will learn about pain mechanisms of the relevant temporomandibular structures, the function of the temporomandibular joint (TMJ) and the neurophysiological, biomechanical, and functional relationships with the cervical spine.

CRAFTA-1a

Primary topics include the subjective and physical examination and various treatment techniques of the TMJ. The course includes an up-to-date review of the current neurobiological and anatomical knowledge of the function of the TMJ.

The course includes theoretical and practical sessions. Theoretical presentations include pertinent aspects of dentistry, including brace/splint therapy and an introduction to various clinical syndromes, such as bruxism, bracing, (cervical) headaches, neuralgias, and otomandibular syndrome.

For the craniofacial region, students will learn to identify and recognize clinical patterns and develop clinical skills for the assessment and management of the craniofacial region within a defined clinical reasoning model. This course includes a thorough review of the function, anatomy, biomechanical properties, pathology, examination, and treatment of the craniofacial region.

CRAFTA-OM

Immediately following part 1a of the CRAFTA-1 course, students will get access to a 24-hour CRAFTA-OM (Online Module).

CRAFTA-1b

The CRAFTA-1b Foundations course is a continuation of the CRAFTA-1a  and  OM courses. During the CRAFTA-1b course, students will expand their knowledge in the assessment and treatment of patients with craniofacial pain and dysfunction. Much attention will be paid to pain mechanisms, neuroanatomy, neurodynamics, and the examination and treatment of the cranial nervous system.

In addition, the course will highlight specific assessment and management strategies of the neuro- and viscerocranium, and review neuropathic and neurogenic pain, specific testing, clinical pattern recognition, and pathologies of all cranial nerves. A clinical mechano-sensitivity classification model will be included with specific cranial nerve tests and  further management

Prerequisite: Successful completion of the CRAFTA-1a and CRAFTA-OM

CRAFTA -1 (Including 1a, Online Module, and CRAFTA 1b has been approved by:

Maryland Board of Physical Therapy for 8.8 CEUs.

NOTE: Many states, such as Connecticut, Georgia, New Hampshire, North Carolina, Kansas, Kentucky, South Carolina, Virginia, and Wisconsin, among many others, accept the CEUs approved by the Maryland Board of Physical Therapy Examiners.

If you are not sure about another state, check out your state board’s website and look for language like (from South Carolina – https://www.llr.sc.gov/pt/ce.aspx):

At least fifteen (15) of the required thirty (30) contact hours shall be from Certified Activities. Certified Activities include […] attendance at conferences and completion of continuing competency activities provided by the American Physical Therapy Association (APTA), South Carolina Chapter of the American Physical Therapy Association (SCAPTA), other chapters and sections of the APTA, as well as other state boards of physical therapy.

CRAFTA 1a

– Demonstrate knowledge and skills for the assessment of the TMJ

– Demonstrate differentiation tests of the TMJ and the craniocervical region

– Identify 6 dominant joint and 3 dominant muscle clinical patterns related to the

temporomandibular region

– Know the international classifications of TMD and orofacial pain

– Have specific knowledge and neuromuscular management skills of the TMD

– Understand craniofacial growth and dysfunction related to the assessment principals of the craniofacial region

– Know a minimum of 5 clinical reasoning strategies as a basis for advanced-level assessment and management

CRAFTA 1b

– Gain knowledge and skills for the manual assessment of 12 different specific bone regions of craniofacial tissues (neuro-cranium and viscero-cranium)

– Identify a minimum of 12 clinical patterns related to craniofacial dysfunction and

pain

– Demonstrate an understanding and practical skills for the treatment and management of patients with craniofacial dysfunction and pain

– Understand the current knowledge about the neuroanatomy, neurodynamics, and        pathobiology of the cranial region in relation to pain mechanisms

– Apply manual skills (conduction, palpation and neurodynamics) for the assessment and treatment of cranial nerve tissue

– Plan 4 long-term treatment and management strategies for patients with craniofacial tissue dysfunction

– Present an outline of minimal 5 advanced clinical reasoning skills as a basis for management

CRAFTA-1 Schedules (a & b)

CRAFTA-1a Schedule

Note: The actual times may vary with each program at the discretion of the instructors. Refreshments are provided; meals are on your own.

Day 1

08:00 – 08:30 Registration
08:30 – 09:30 Lecture: Introduction
09:30 – 10:15 Lecture: Functional anatomy of the craniomandibular region
10:15 – 11:00 Practicum: Palpation of the of the craniomandibular region and surroundings
11:00 – 11:15 Questions & Answers
11:15 – 11:45 Lecture: Clinical reasoning related to the craniomandibular region
11:45 – 12:30 Lecture: Pathobiological mechanisms clinical patterns of the craniomandibular region
12:30 – 01:00 Lecture: Subjective examination and planning the physical examination
01:00 – 02:00 Lunch
02:00 – 4:15 Practicum: Functional analysis of the craniomandibular region. Physical examination (Part 1)
04:15 – 04:30 Questions & Answers
04:30 – 05:30 Lecture: Relationship between the craniomandibular region and other structures

Day 2

08:30 – 09:30 Lecture: Differential diagnosis of craniomandibular dysfunction
09:30 – 11:00 Practicum: The physical examination (Part 3)
11:00 – 11:15 Questions & Answers
11:15 – 01:00 Practicum: The physical examination (Part 4)
01:00 – 02:00 Lunch
02:00 – 04:15 Practicum: The physical examination (Part 5)
04:15 – 04:30 Questions & Answers
04:30 – 05:30 Demonstration: Patient examination and treatment

Day 3

08:30 – 09:30 Lecture: Management of craniomandibular dysfunctions (General)
09:30 – 10:30 Practicum: Neuromuscular Rehabilitation
10:30 – 11:00 Practicum: Palpation of articular structures
11:00 – 11:30 Questions & Answers
11:30 – 01:00 Lecture and practicum: Management of articular craniomandibular dysfunctions
01:00 – 02:00 Lunch
02:00 – 03:15 Practicum: Muscular craniomandibular dysfunctions (Part 1)
03:15 – 04:00 Lecture: Para-functions and the otomandibular syndrome
04:00 – 04:15 Questions & Answers
04:15 – 06:30 Practicum: Functional analysis of the craniomandibular region. Physical examination (Part 1)

Day 4

08:30 – 09:30 Lecture: Activities of Daily Living
09:30 – 10:15 Practicum: Follow up Patient
10:15 – 11:00 Practicum: Clinical reasoning exercise
11:00 – 11:15 Questions & Answers
11:15 – 12:00 Lecture: Craniofacial dysfunctions and functional relations
12:00 – 01:00 Lecture: General definitions and the dynamic skull
01:00 – 02:00 Lunch
02:00 – 02:30 Lecture: Cranial dynamics, which structures do we influence

CRAFTA 1b Schedule

Note: The actual times may vary with each program at the discretion of the instructors. Refreshments are provided; meals are on your own.

Day 1

08:00 – 08:30 Registration
08:30 – 10:30 Practicum: Specific techniques—neurocranium (Part 1)
10:30 – 10:45 Questions & Answers
10:45 – 12:30 Practicum: Specific techniques—neurocranium (Part 2)
10:45 – 12:30 Practicum: Specific techniques—neurocranium (Part 2)
12:30 – 01:30 Lunch
01:30 – 03:45 Lecture: Viscerocranium
03:45 – 04:00 Questions & Answers
04:00 – 05:30 Practicum: Viscerocranium (Part 2)

Day 2

08:00 – 08:30 Registration
08:30 – 09:00 Lecture: Management cranial treatment
09:00 – 10:30 Lecture: Introduction “update” on craniofacial dysfunctions and pain
10:30 – 10:45 Questions & Answers
10:45 – 11:30 Lecture: Classifying neuropathic and neurogenic pain
11:30 – 12:30 Practicum: Examination of the mechanosensitivity of the nervous system: first category
12:30 – 01:30 Lunch
01:30 – 02:15 Lecture: Neuroanatomy of the cranial nervous tissue
02:15 – 02:45 Lecture: Cranio-neurodynamics
02:45 – 03:45 Practicum: Examination of cranial nerves: second category (Part 1)
03:45 – 04:00 Questions & Answers
04:00 – 05:30 Practicum: Examination of cranial nerves: second category (Part 2)

Day 3

08:00 – 08:30 Registration
08:30 – 10:30 Practicum: Examination of cranial nerves: second category (Part 3)
10:30 – 10:45 Questions & Answers
10:45 – 12:30 Practicum: Examination of cranial nerves: second category (Part 4)
12:30 – 01:30 Lunch
01:30 – 02:45 Patient Demo: Examination and management of a patient with chronic craniofacial pain
02:45 – 03:30 Practicum: Examination of cranial nerves: third category (Part 1)
03:30 – 03:45 Questions & Answers
03:45 – 05:30 Practicum: Examination of cranial nerves: third category (Part 2)

Day 4

08:00 – 08:30 Registration
08:30 – 08:45 Lecture: Clinical reasoning
08:45 – 11:15 Practicum: Examination of cranial nerves: second category (Part 3)
11:15 – 11:30 Questions & Answers
11:30 – 12:30 Practicum: Examination of cranial nerves: third category (Part 4)
12:30 – 13:30 Lunch
13:30 – 14:30 Lecture: Treatment concepts related to peripheral neurogenic dysfunctions
14:30 – 15:15 Practicum: Treatment of the nervous tissue by palpation
15:15 – 15:45 Practicum: Revision techniques
15:45 – 16:00 Adjourn