Assessment and Exercise Options for the Disc-Injured Low Back - Course Notes
Assessment and Exercise Part 1 of 3 (46:42)FREE PREVIEW
Assessment and Exercise Part 2 of 3 (54:07)
Assessment and Exercise Part 3 of 3 (53:10)
Assessment and Exercise Options for the Disc-Injured Low Back Quiz
Lumbar Spine Pain Biology Part 1 of 4 (15:16)
Lumbar Spine Pain Biology Part 2 of 4 (20:22)
Lumbar Spine Pain Biology Part 3 of 4 (49:14)
Lumbar Spine Pain Biology Part 4 of 4 (34:00)
Pain Biology Education Quiz
Nutritional Considerations - Low Back Pain - Course Notes
Nutritional Considerations Part 1 of 3 (45:57)
Nutritional Considerations Part 2 of 3 (43:59)
Nutritional Considerations Part 3 of 3 (35:55)
Nutritional Considerations Quiz
Strength & Conditioning Lab Part 1
Strength & Conditioning Lab Part 2
Strength & Conditioning Lab Part 3
S & C Flexion Intolerant Back Quiz
Epigenetics of Low Back Pain - Course Notes
Epigenetics and LBP Part 1 of 5 (21:38)
Epigenetics and LBP Part 2 of 5 (22:57)
Epigenetics and LBP Part 3 of 5 (21:16)
Epigenetics and LBP Part 4 of 5 (21:50)
Epigenetics and LBP Part 5 of 5 (20:30)
Epigenetics Recap Interview
Epigenetics and LBP Quiz
Ethics Discussion Part 1 of 3 (37:01)
Ethics Discussion Part 2 of 3 (38:54)
Ethics Discussion Part 3 of 3 (52:29)
Affiliated Ethics PDF
The most notable industry leaders and researchers have a keen appreciation for functional contributors to disc injury in the lumbar spine. While multiple structures may be involved in back pain, the most commonly seen functional pattern of low back pain in the clinic is the so-called flexion intolerant pattern. In this 12 hour video-based program, multiple experts on this topic explore the structural, functional, cognitive and histochemical contributors to the development of the lumbar spine sensitized to flexion. Building on current evidence, graded exposure to loaded movement offers an opportunity to change central sensitization and improve
By the end of this 12 hour course the registrant should be able to:
- Possess a working knowledge of the basic epidemiological aspects of low back pain
- Better understand how to frame imaging results within the diagnostic framework for cLBP
- Understand the importance of language in patient care in regards to nocebo
- Integrate pain neuroscience into the patient education
- Appreciate the importance of systemic inflammation in the phenomenon of chronic pain
- Identify key lab measures to understand glycemic balance in the patient
- Feel confident in applying loaded movement in the disc injured patient
- Understand the concept of graded exposure to feared stimulus in back pain patients
- Have a clear understanding of ethical, evidence-based use of imaging in the chiropractic practice
- Appreciate how to determine appropriate referral habits for patients not responding to care
SUPPORT: How do I get help if I need it?
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Please contact your state/national board for your reporting requirements. On request, we will provide you with a digital certificate of completion for your course after you have completed all proficiency tests with an 80% passing grade. If your state or province requires third party accreditation, our CE broker will provide that to your state.
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ELIGIBILITY: Who is this course for?
This course is for licensed chiropractic physicians (DCs) and offers CEUs to doctors in most states and provinces. While other licensed healthcare professionals (PT, LAc, MD, DO, ND, ATC, LMT, personal trainers) will find this material helpful in care of their patients and clients, those professionals should contact their state organizations to determine eligibility of this material for CEUs.
Dr. Snell is the creator and curator of ProChiropracticOnlineCE.com, a resource for chiropractic physicians to obtain accredited continuing education via video delivery of online lectures.
MyRehabExercise.com is a library of functional corrective exercise videos available to clinicians to share with patients via email to help with patient education on proper exercise form.
FixYourOwnBack.com is a self-guided online tool for those suffering from lumbar disc herniation. Subscribers receive education and exercise recommendation to help them reduce risk of injury and improve long term healing of lumbar disc herniation.
DermalTractionMethod is a neurocentric manual therapy technique developed by Dr. Snell and Dr. Justin Dean. The method focuses on easy to learn and easy to teach manual techniques to assess and correct mechanical interface dysfunction of the superficial cutaneous neurology.
NeuroCentricApproach.com is the first comprehensive physical medicine and rehabilitation method combining unique assessment, manual therapy and exercise interventions. With Dr. Justin Dean, Dr. Snell offers coursework in this innovative approach to an old problem...chronic pain.
Dr. Snell also lectures internationally at professional conventions and in-person continuing education presentations on exercise interventions, manual therapy and integrated pain science in the treatment of chronic pain and neuromusculoskeletal injury.
My success in university resulted in being awarded a graduate scholarship (NSERC) toWaterloo University to be 1 of only 2 Masters students studying with Dr Stu McGill, a world leader in Spine Biomechanics, exercise prescription and athletic performance.
As a faculty member at the Canadian Memorial Chiropractic College I developed a research program that produced more than 20 publications on exercise biomechanics, golf fitness and the science of manual therapy. I taught more than 25 graduate students in Spine Biomechanics and Research Instrumentation and supervised more than 50 students and 20 undergraduate research theses. I was subsequently awarded a Researcher of the Year award by the Ontario Chiropractic Association.
1.Recipient: Ontario Chiropractic Association Professional Service Award (2006): Research
2. National Sciences and Engineering Research Council (NSERC) Graduate Scholarship (1996-98) $33,800
3. CMCC Internal Research competition: Spine Biomechanics Infrastructure Funding (2001) $20,000
4. Canadian Society for Exercise Physiology Gold Medal for highest academic performance in Kinesiology (1996)
2000 – 2008 Research Associate/Assistant Professor, Graduate Studies and Research, Canadian Memorial Chiropractic College (CMCC) This appointment involved the designing, conducting and publishing of biomechanical research projects, equipment acquisition and training of students in conducting biomechanical research.
1998-1999 Clinic Scientist, University of Waterloo-Canadian Memorial Chiropractic College Research Clinic, WaterlooON
Chapters in Books
Colloca CJ, Keller TS, Lehman, GJ, Harrison DD, Harrison DE. The use of spine measurement instruments in clinical practice. In: Haldeman, S, ed. Principles and Practice of Chiropractic, 3rd Edition. Norwalk, CT: Appleton & Lange, 2004
Refereed Journal Articles
Lehman GJ: Kinesiological Research: The influence of spinal manipulation on surface EMG: Invited Review. Journal of Electromyograph and Kinesiology. In press
Lehman GJ: An unstable surface is not a sufficient condition for increases in muscle activation. Journal of the Canadian Chiropractic Association.
Lehman GJ, Brandon MacMillan, Ian MacIntyre, Michael Chivers, Mark Fluter , Shoulder muscle EMG activity during push up variations on and off a Swiss ball. Dynamic Medicine 2006, 5:7 (9 June 2006)
Lehman GJ: Resistance training for performance and injury prevention in golf. Journal ofCanadian Chiropractic Association 2006; 50(1) 27-42
Lehman GJ. Trunk and hip muscle recruitment patterns during prone leg extension following a lateral ankle sprain: A prospective case study pre and post injury. Chiropr Osteopat. 2006Feb 27: 14:4
Lehman GJ, Story S, Mabee R. Influence of static lumbar flexion on the trunk muscle’s response to sudden arm movements. Chiropr Osteopat. 2005 Nov 23;13(1):23
Lehman GJ. The influence of grip width and forearm pronation/supination on upper-body myoelectric activity during the flat bench press. J Strength Cond Res. 2005 Aug;19(3):587-91.
Lehman GJ, Hoda W, Oliver S.Trunk muscle activity during bridging exercises on and off a Swissball. Chiropr Osteopat. 2005 Jul 30;13:14.
Lehman GJ, Trish Gordon, Jo Langley, Patricia Pemrose, Sarah Tregaskis. Replacing a Swiss ball for an exercise bench causes variable changes in trunk muscle activity during the performance of upper limb strength exercises. Dynamic Medicine 2005, 4:6 (3Jun2005)
Lehman GJ. The use of non-amplitude components of the myoelectric signal in identifying differences in function between the low back injured and controls. J Can Chiropr Assoc. 2004; 48(3) 225-234.
Lehman GJ, Buchan DD, Lundy A, Myers N, Nalborczyk A.Variations in muscle activation levels during traditional latissimus dorsi weight training exercises: An experimental study. Dyn Med. 2004 Jun 30;3(1):4.
Lehman GJ , Lennon D, Rayfield B, Poschar M, Tressider B. Muscle recruitment patterns during the prone leg extension test. BMC Musculoskeletal Disorders 2004, 5:3 (10Feb2004)
Lehman GJ. Biomechanical assessments of lumbar spinal function. How low back pain sufferers differ from normals. Implications for outcome measures research. Part I: Kinematic assessments of lumbar function.J Manipulative Physiol Ther. 2004 Jan;27(1):57-62.
Lehman GJ. Clinical considerations in the use of surface electromyography: Three experimental studies. J Manipulative Physiol Ther. 2002 Jun;25(5):293-9..
Lehman GJ, Vernon H & McGill SM: The effects of a mechanical pain stimulus on erector spine activity before and after a spinal manipulation in chronic low back pain patients: A preliminary investigation. J Manipulative Physiol Ther. 2001 Jul-Aug;24(6):402-6.
Lehman GJ & McGill SM: Spinal manipulation causes variable changes in trunk kinematics and associated EMG. Clinical Biomechanics 2001 May: 16(4): 293-9.
Lehman GJ & McGill SM: Quantification of the differences in EMG magnitude between the upper and lower rectus abdominis during selected trunk exercises. Physical Therapy 2001May;81(5):1096-101.
Lehman GJ & McGill SM: Proof of Principle: The Importance of Normalization in Surface EMG. JMPT 1999: 22(7): 444-446.
Lehman GJ & McGill SM: The influence of a spinal manipulation on lumbar kinematics and EMG during simple and complex tasks: A Case Study. JMPT 1999; 22(9):576-81
Master of Science thesis: “The influence of a lumbar spinal manipulation on trunk kinematics and associated trunk EMG”, 1998
Bachelor of Kinesiology thesis: “Occupational Biomechanics & Ergonomics Handbook”, 1996
Previously he attended the State University of New York at Oneonta, where he earned his B.S. in biology and minored in chemistry. Additionally he has spent over a decade learning and training in human nutrition, sports nutrition, kinesiology, strength and conditioning and rehabilitative techniques.
Currently he is the ONLY Certified Primary Spine Practitioner (PSP) in Central Florida, as well as the only PSP with a certification in Functional Medicine in the country.
∙ Certified Mechanical Diagnosis and Therapy (MDT) - 2019
∙ Primary Spine Practitioner Certification through University of Pittsburgh - 2017-2019 (http://www.psp.pitt.edu/)
∙The McKenzie Method of Mechanical Diagnosis and Therapy (MDT) PART D: Advanced Cervical Spine and Extremities – Upper Limb - 2016
∙ The McKenzie Method of Mechanical Diagnosis and Therapy (MDT) PART C: Advanced Lumbar Spine and Extremities – Lower Limb – 2016
∙ The McKenzie Method of Mechanical Diagnosis and Therapy (MDT) Part B: The Cervical and Thoracic Spine - 2016
∙ The McKenzie Method of Mechanical Diagnosis and Therapy (MDT) PART A: The Lumbar Spine – 2016 (http://www.mckenzieinstitute.org/)
∙ Functional Medicine University, Certified Functional Medicine Practitioner - 2015 (www.functionalmedicineuniversity.com)
∙ Integrative Blood Chemistry Analysis & Treatment - 2015
∙ Mastering the Clinical Audit Process (CAP) - 2015
∙ Titleist Performance Institute (TPI): Level One - 2015 (http://www.mytpi.com/)
∙ RockTape Performance Movement Taping (PMT) - 2015
∙ A New Perspective: Renal Detoxification & Often Over-looked, Related Musculoskeletal & Autoimmune Disorders - 2014
∙ Gastrointestinal Functionality & Health Workshop II - 2014
∙ Comprehensive Treatment Plans for Chronic Conditions - 2014
∙ Selective Functional Movement Assessment (SFMA) - 2014 (https://www.functionalmovement.com/)
∙ Cox Flexion-Distraction Technique - 2013 (http://www.coxtechnic.com/)
∙ Graston Technique - 2013
∙ Systems Approach to Nutrition - 2013
∙ The Cutting Edge: Lumbar Spine Rehabilitation - 2013
∙ Dynamic Neuromuscular Stabilization (DNS) Sport - 2013
∙ Dynamic Neuromuscular Stabilization (DNS) Course B - 2012
∙ Dynamic Neuromuscular Stabilization (DNS) Course A - 2012 (www.rehabps.com)
∙ Motion Palpation Institute (MPI) Full Spine Assessment and Adjusting - 2013
∙ Motion Palpation Institute (MPI) Upper Quadrant Functional Assessment & Treatment - 2012
∙ Motion Palpation Institute (MPI) Extremities Analysis & Adjustive Technique - 2012
∙ Motion Palpation Institute (MPI) Lower Quadrant Functional Assessment and Treatment - 2011 (http://www.motionpalpation.org/)
Dr. Dimak attended Nicholls State University in Thibodaux, LA on a football and academic scholarship, and he earned a BS in Biology/Pre-Physical Therapy.
Wanting to apply his passion and knowledge of sports medicine, he attended Logan College of Chiropractic in St. Louis, MO, where he acquired training in many different techniques that have allowed him diversity in his treatment options.
With extensive training and knowledge in sports injuries and rehabilitation, Dr. Dimak’s clinical focus is on developing the resilience of his patients and athletes and getting them back in the gym or on the field as quickly as possible. By using cutting-edge, patient-focused progressions, he helps his patients not only achieve but also exceed their physical goals. He works with patients of all types who are interested in living pain-free lives and maintaining an active, healthy lifestyle.
He is certified in: Functional Movement Screen (FMS), Selective Functional Movement Assessment (SFMA), Functional Capacity Screen (FCS) and a member of the International Society of Clinical Rehab Specialists (ISCRS). He also serves as a regional faculty advisor for Rehab2Performance. He is also an associated faculty member at Southern California University of Health Sciences.
Dr. Dimak has experience working in Division I training facilities and has served as the team chiropractor for: Orange Coast College, Calvary Chapel High School, and Costa Mesa Pop Warner. He consults with many local gyms/strength facilities and hosts trainings at: Equinox, Southern California University of Health Sciences, Achieve Fitness, among other local venues.
In 2008, Dr. Gonzales graduated as salutatorian of his class at Southern California University of Health Sciences. Here he received an extensive education of human anatomy, the diagnosis of musculoskeletal injuries, and chiropractic manipulative care.
Since 2008, Dr. Gonzales has maintained a private chiropractic practice in Huntington Beach, CA. He is also the creator and content manager of the Performance Plus podcast, a respected resource for practicing clinicians highlighting the integration of active care in the clinical environment.
University of Western States Portland, OR Oct 2012 – 2015
Doctorate of Chiropractic – Cum Laude – Cumulative 3.69 GPA
Master of Science in Exercise and Sports Science – Sports Medicine Concentration – Cumulative 3.83 GPA
Bachelor of Science in Human Biology – Cumulative 3.86 GPA
Dean’s List Portland Community College Portland, OR Sep 2010 - 2012
Human Biology/Pre-Chiropractic Studies , Cumulative 4.0 GPA
Professional Licensure, Certifications and Affiliations:
California Board of Chiropractic Examiners – Licensed Chiropractor
American Chiropractic Association - Member
National Strength and Conditioning Association – Certified Strength and Conditioning Specialist
Rehab2Performance –Advisory Board Member
Rehab2Performance – Certified Clinician
Rehab2Performance – Certified Trainer
Dynamic Neuromuscular Stabilization – Certified Exercise Trainer
Certified Functional Strength Coach – Mike Boyle Strength and Conditioning
StrongFirst – Certified Kettlebell Instructor
Functional Movement Systems – Selective Functional Movement Assessment
Functional Movement Systems – Y Balance Test Administrator
RockTape – Functional Movement Taping
Academic Service Experience
University of Western States
Rehab2Performance National and International Student Program Coordinator, Oct 2014 – Dec 2015
Student ACA Sports Council National Executive Committee Past President and Advisor, Jan 2015– Dec 2015
Student ACA Sports Council National Executive Committee President, Jan 2014 – Dec 2014
Rehab2Performance UWS Chapter President, June 2014 – Oct 2014
Rehab2Performance UWS Chapter Vice President, Nov 2013 - June 2014
Student ACA Veterans Affairs Representative, March 2013 – Sep 2015
Student ACA Sports Council Chapter President, May 2013 – Nov 2013
Student ACA Sports Council Chapter Event Coordinator/Vice President, Nov 2012 – May 2013
Business Club Event Coordinator, Oct 2012 – Oct 2013
SACA Annual Leadership Conference, Milwaukee WI – Sep 2013
National Chiropractic Legislative Conference, Washington DC, Mar 2013, Feb 2015 Awards
UWS Winter 2015 Community Service Scholarship – Jan 2015
UWS Winter 2014 Community Service Scholarship – Jan 2014
3rd Place ACA Sports Council Annual Thomas Hyde Research Poster Contest – Sep 2013
Military Experience: Enlisted in the United States Navy Nov 2001 – Jul 2010
Fleet Replacement Center Southwest
San Diego, CA June 2008 - 2010
Aircraft Airframe Technician/Joint Aeronautical Screening Unit Shift Supervisor
Performed and supervised intermediate level airframe maintenance of U.S. Navy aircraft
Supervised Joint Aeronautical Screening Unit ensuring proper logistical flow of all incoming aircraft maintenance requirements
Awarded Navy and Marine Corp Achievement Medal for exemplary performance Helicopter Sea Combat Support Squadron 25 Yigo, GU June 2006 - 2008 MH-60S Helicopter Mechanic/Collateral Duty Inspector/Shift Supervisor
Deployed on board USNS Kiska and USNS Shasta in support of Operation Enduring Freedom and Pacific Fleet Operations