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I SURVIVED, NOW WHAT? Treating the Musculoskeletal Consequences of Maturing with a Chronic Pediatric
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I SURVIVED, NOW WHAT? Treating the Musculoskeletal Consequences of Maturing with a Chronic Pediatric

6/1/2018 to 6/3/2018
When: June 1-3, 2018
Where: West Coast University
590 N Vermont Avenue
Los Angeles, CA  90004
United States
Presenter: Mary Massery PT, DPT, DSc
Contact: Rita Pierson
(916) 929-2782 x105

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Course Description

Children with complex medical problems are surviving to adulthood. Unfortunately, many reach adulthood with adverse musculoskeletal consequences of survival such as spinal deformities (thoracic kyphosis, scoliosis, tightness), rib cage restrictions (pectus deformities, rib flares, asymmetry, tightness), which in turn, limits shoulder, trunk, and hip/pelvis mobility. Repetitive stresses due to atypical movements/compensations predispose these children to the development of chronic pain conditions. This 3-day course will look specifically at why these limitations tend to occur and what can be done to minimize their development. The goal is to improve therapists’ knowledge and confidence in using musculoskeletal techniques that affect both quality, and potentially quantity of life. Participants will spend most of the course in lab. The focus will be on the rib cage, trunk, and spine. The target audience is pediatric PTs and OTs. Adult therapists are encouraged to attend as well as they will be treating this population as adults. Other disciplines are invited to attend as they see the need.


**This course is ideal for physical therapists. PTAs are welcome to attend with their supervising PT to participate in the hands-on portion.


Course Objectives

At the conclusion of this course, participants should be able to:

  • Screen for musculoskeletal abnormalities, inadequate core stabilization strategies and compensatory breathing patterns that may contribute to the abnormal development of the rib cage, trunk, and/or spine across the lifespan secondary to pediatric chronic health conditions and/or survival of prematurity.
  • Develop and demonstrate musculoskeletal mobilization and soft tissue techniques to correct or minimize these deformities with a focus on the rib cage and spine.
  • 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 postural impairments that develop secondary to these chronic conditions.


Friday (7.5 Contact Hours)

Focus: Breathing and its relationship to postural development                                           


8:00 - 8:30 am

Registration and coffee

8:30 - 10:30

Lecture: Adverse postural development related to maturing around a chronic childhood health condition

10:30 - 10:45


10:45 - 12:00

Lecture & Lab: I don’ t have a clue how to evaluate breathing…Well, now you will! Part 1: Ribs and sternal support of posture and respiration

12:00 - 1:00


1:00  -2:00

Lecture & Lab: Part 2: Core muscles: Assessing mid trunk control: intercostals, abdominals & diaphragm

2:00 - 3:00

Lab: Part 3: Assessing breathing patterns. Posture. Relationships.

3:00 - 3:15


3:15 - 4:30  Lab: Part 3: continued   
4:30 - 5:30 pm

Lab: Rib cage, shoulders, trunk, pelvis: musculoskeletal assessment and interventions (Trunk): Part 1: Screening functional trunk mobility in stance (ribs, spine, shoulders, fascia)


Saturday (7.5 Contact Hours)

Focus:  The rib cage: assessment and treatment of consequential problems                                      


8:00 - 8:30 am


8:30 - 10:30

Lab: Trunk - Part 2: Lateral trunk assessment: Rib cage, quadratus lumborum, shoulders (side-lying)

10:30 - 10:45


10:45 - 12:00

Lecture & Lab: Trunk - Part 3: Therapeutic exercises: Increasing trunk mobility

12:00 - 1:00


1:00 - 2:30

Lab: Trunk - Part 4: Soft tissue techniques: quadratus lumborum, intercostals, fascia, others

2:30 - 2:45


2:45 - 3:15 Lecture: Case studies: Scars and restricted fascia
3:15 - 4:30

Lab: Trunk – Part 5: Rib mobilization techniques

4:30 - 5:30 pm

Patient demonstration (if available)


Sunday (5.5 Contact Hours)

Focus:  The thoracic spine: assessment and treatment of consequential problems                                        


8:00 - 8:30 am


8:30 - 9:30

Lecture: The Spine

9:30 - 10:15

Lab: Spine treatment techniques: Mobs, releases, stretches, soft tissue releases, neuromotor retraining, and home exercise programs

10:15 - 10:30


10:30 - 12:00 Lab: Spine treatment techniques; continued
12:00 - 12:45


12:45 - 2:00 Lab: Dynamic postural control: Neuromotor re-education exercises incorporating newfound mobility into dynamic core stabilization strategies
2:00 - 2:45   Lecture: Case study “Kristy:” Long term consequences of survival
2:45 - 3:00 pm

Discussion: Planning ahead to avoid/minimize musculoskeletal consequences in your practice setting



Mary Massery, PT, DPT, DSc received her BS in Physical Therapy from Northwestern University in 1977, her DPT from the University of the Pacific in 2004 and her DSc from Rocky Mountain University in 2011. Her publications and interests focus on linking motor behaviors to breathing and/or postural mechanics in both pediatric and adult patient populations.

Dr. Massery has been invited to give over 800 professional presentations in 49 US states, 9 Canadian provinces, and 15 countries worldwide, including more than 100 presentations for the American Physical Therapy Association, and a full-day post-conference program at the World Congress of Physical Therapy in Singapore. Mary has delivered keynote and major addresses on topics such as cystic fibrosis and posture, neuropulmonary deficits, pectus excavatum (chest deformities), and connections between posture & breathing.

Mary has received national awards from the APTA, including its highest clinical award, The Florence Kendall Practice Award, honoring “one’s outstanding and enduring contributions to the practice of physical therapy." She has been honored as Outstanding Alumnus of the Year by each of her 3 alma maters. And in 2016, she was awarded Northwestern University’s Alumnae Research Achievement Award. Mary continues to maintain a private practice in Chicago, specializing in breathing and postural dysfunction.



20.5 contact hours or 2.5 CEUs

Instruction Level: Intermediate to Advanced
Format: Lecture and hands-on lab (student to faculty ratio 16:1)
Target Audience: Physical Therapists



West Coast University
590 N Vermont Avenue
Los Angeles, CA 90004


Registration received by May 17, 2018


$800 APTA PT members
$1,200 Non-members

Add $100 for late registration.


All cancellation requests must be received in writing – no exceptions. A full refund, less 20% service fee, if cancellation is received 14 days prior to the start of the course. No refunds after May 17, 2018.

Course Requirements

Required attire for labs: ladies - tank tops, sports bras, etc. Everyone - loose, comfortable pants such as yoga pants, sweat pants, etc. Please consider dressing in layers as each person has a different comfort level when the air conditioning is on.

Anatomy books: Participants are encouraged to bring their favorite anatomy book to help visualize the presentations.

Suggested pre-readings for the course: A variety of pre-readings are available. See Mary’s publications on her website: you have time for only one article, Mary suggests you read this one: Massery M. Musculoskeletal and neuromuscular interventions: a physical approach to cystic fibrosis.

Long hair: Hair clips or pony tail bands are needed for long hair in labs.

Linens: All registrants are asked to bring 1 pillow, 1 bath towel,1 beach towel, and a yoga or exercise mat for labs.



Free surface parking.


Hotel Normandie
605 Normandie Avenue
Los Angeles, CA 90005
(213) 388-8138
Request the West Coast University preferred rate of $149 single/double

Embassy Suites
800 North Central Avenue
Glendale, CA 91203
(818) 550-0828

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