I Survived, Now What? Treating the Musculoskeletal Consequences of Maturing with a Chronic Health Condition

Course Description:

Children with medical problems and/or physical disabilities are surviving to adulthood. Adults with chronic health conditions are living longer.  As these patients “survive” their health conditions, atypical breathing patterns and atypical postural control strategies often develop and cause repetitive stress on the musculoskeletal system.  The consequences can be chronic pain, inefficient motor plans, and/or physical dysfunction, all which limit health and participation.  Current research supports this paradigm, showing a higher incidence of chronic pain and decreased quality of life among children and adults with long-term health conditions.  The focus of this course is on identifying, treating, anticipating/preventing common consequential spinal and rib cage restrictions: thoracic kyphosis, scoliosis, pectus deformities, rib flares, asymmetries, tightness, etc.  These musculoskeletal restrictions can limit breathing (health) and/or shoulder, trunk, and hip/pelvis mobility (participation).  Labs present manual therapy techniques (soft tissue techniques, joint mobilizations) and neuromotor re-education techniques.  While Dr. Massery’s primary focus is on pediatrics and young adults, the material is pertinent across the whole lifespan. 


Upon completion of this course, you will be able to:

  1. Describe the relationship between chronic health conditions (pediatric & adult), atypical motor plans for breathing and/or postural stability, and the development of secondary musculoskeletal deficits.
  2. Screen for musculoskeletal abnormalities, inadequate core stabilization strategies and compensatory breathing patterns that may contribute to the abnormal alignment of the rib cage, trunk and/or spine secondary to pediatric and adult chronic health conditions.
  3. Develop and demonstrate musculoskeletal mobilization and soft tissue techniques of the rib cage, trunk, and spine to correct or minimize these deformities.
  4. Develop subsequent treatment plans for neuromuscular retraining that is focused on simultaneously optimizing breathing, core stabilization and postural development across the lifespan in order to minimize long-term secondary postural impairments.


“Thank you for a simply AWESOME seminar.  We are planning a team seminar to share the highlights of what we learned.  Already we are looking at our patients more holistically, asking questions related to breathing style, cough productivity, voice production and target muscles needing to be toned and strengthened.  So much to learn from each other!  You are a master physical therapist and an inspiring presenter.  What a joy to experience your presence.”
C.F.  SLP, Minneapolis, MN

“Excellent problem solving and strategies to facilitate pulmonary, neuromuscular and musculoskeletal activity and function.  The speaker made the subject come alive.”
- M.P. PT, London, ONT Canada

“Mary looked at the body as a functional unit and gave such applicable information for any type of problem.  I felt like I can leave this course and apply (the concepts) immediately.  Loved her enthusiasm and lighthearted teaching style.  Her genuine care and concern and love for patients shows as she is mission-driven to get this information to therapists/healthcare providers.” 
- PT, Oklahoma City, OK 


Mary Massery