Exam and Treatment of the Upper Extremity – Mennell/Travell Approaches to Joint Dysfunction & Trigger Points

Exam and Treatment of the Upper Extremity – Mennell/Travell Approaches to Joint Dysfunction & Trigger Points



This hands-on course will be held in-person at our school. It is intended for NJ Chiropractors (16 CEUs), NJ Physical Therapists and Physical Therapy Assistants (15 CEUs). It would also be very appropriate for Certified Hand Therapists (OT or PT).*

Regular Tuition: $495.  Early Bird Discount through November 27: $470.

Please dress comfortably for class.


This course draws attention to certain frequently overlooked diagnosable conditions which are readily treatable by the chiropractor or physical therapist. Essentially the course provides a new appreciation of the musculoskeletal system in medicine.


At the conclusion of this seminar-workshop, the participants should appreciate and accept the responsibility for making a structural diagnosis/assessment of the musculoskeletal system of the upper quarter. Evidence based outcomes will be stressed as it is both beneficial to the patient’s well being but also cost effective for the patient as well.

  • The participants will be able to differentiate which upper extremity is affected by joint complex dysfunction as per Dr. John Mennell’s model.
  • The participants will be able to differentiate which muscles are affected by myofascial trigger points as Dr. Janet G. Travell’s Model for the upper extremity.
  • The participants should be able to identify as to whether their choice of treatment, they are promoting healing as opposed to the promotion of the restoration of function which can only be undertaken when healing has taken place.
  • The participants should be able to demonstrate and explain the useful properties of any physical therapy technique they elect to use in their treatment program.
  • The participants will be able to identify the principles which guide them in their choice of said treatment, especially when treating the patient during the healing phase.
  • The participants should be able to design a treatment program based on a realistic diagnosis.
  • The participants will be able to teach their patients how to self manage the condition with an appropriate home program.
  • The participant should identify the concepts of orthopedic medicine in soft tissue treatment and the diagnosis of referred pain from the joints as well as associated musculature.
  • They should appreciate the integrated approach to evaluation and treatment and the skills learned should be immediately utilized in the clinical setting.
  • The participant should demonstrate all the techniques taught and pass a practical and written test given at the conclusion of the seminar.
  • The participant should be able to identify the prognosis for the patient and give measurable time frames for their outcome.


Day One

7:30-8:ooam            Registration/Continental Breakfast and Pre-Test

8:00-10:00am         Overview of the musculoskeletal system, structural examination of the system concept of mechanical pain from synovial joints: Clinical importance of the case history; Joint play-joint dysfunction-joint manipulation; Demonstration: Practice; Concepts of “Acute” and “Chronic” in patient analysis; Recognition of “healing” and “healed”; Rules for manipulative examining techniques; Three “NEVERS”.

10:00-10:15am         Break

10:15am-12:00pm   Workshop: Examining mobilization techniques – joints of the wrist complex

12:00-1:00pm           Lunch

1:00-2:30pm             Continue Workshop: Examining techniques wrist and hand

2:30-2:45pm              Break

2:45-3:30pm              Workshop – Joints of the fingers and elbow complex

3:30-5:00pm              Workshop – Joints of the shoulder complex

5:00pm                        Adjourn

Day Two

7:30-8:00am             Sign in/Continental Breakfast

8:00-10:00am           Workshop: Joints of the should complex continued

10:00-10:15am           Break

10:15am-12:00pm      Clinical overview of myofascial trigger points upper quarter

12:00-1:00pm             Lunch

1:00-2:15pm               Alternate treatment techniques for treating myofascial trigger points

2:15-3:30pm                Myofascial Trigger Points of the upper quarter workshop: palpation assessment and practice utilizing the spray and stretch technique and other alternative techniques

3:30-3:45                      Break

3:45-4:45pm                Rehabilitation exercises i.e. strength, stabilization, flexibility for the upper quarter

4:30-5:00pm                Questions and answers

5:00pm                          Adjourn

*CE APPROVALS: The Institute for Continuing Education is an Approved Sponsor/Provider with the NJ Board of Chiropractic Examiners. The Institute for Continuing Education is also recognized by the PACE Program of the Federation of Chiropractic Licensing Boards; the course is approved for chiropractors in any state that recognizes PACE. This course is approved by the NJ Board of Physical Therapy under CESI Continuing Education, approval code #2001-111.  Occupational Therapists can determine whether the course is appropriate to their professions under the National Board for Certification in Occupational Therapy (NBCOT); the course is not approved by the AOTA.

Founder and President of CESI Continuing Education Seminars Incorporated, owner/ director of A T.E.A.M. Approach Physical Therapy Center in Bloomfield, NJ, which he established in 1990.

Dr. Ruffalo is a physical therapist (PT), doctor of chiropractic (DC), certified chiropractic sports physician (CCSP), and is also a certified golf fitness instructor/medical professional, Level 3 by the Titleist Performance Institute (TPI CGFI-MP3), and a TPI Junior Level 2 Coach (JR2). At A T.E.A.M. Approach Physical Therapy Center, he brings together his diverse expertise, vast experience, and personal interests to deliver a unique multi-disciplinary health care practice. Dr. Ruffalo specializes in manual therapy of the cervical spine and extremities and is trained in a variety of treatment approaches and techniques.

In addition to his work as a physical therapist and chiropractor (one of only few dual licensed practitioners in NJ), Dr. Ruffalo has a passion for educating his peers by providing continuing education courses to physical therapists, chiropractors, physical therapy assistants, athletic trainers and insurance industry professionals. Many of the seminars are based on the advanced work of two medical pioneers: the late Dr. John Mennell, an orthopedist and founder of the joint dysfunction model for diagnosis and treatment, and the late Dr. Janet Travell, who founded the trigger point (myofascial pain) model of diagnosis and treatment. Dr. Ruffalo was fortunate to have lectured and taught with these practitioners and researchers.


Saturday, December 11 and Sunday, December 12, 2021 8:00am-5:00pm each day