Orthopaedic Physiotherapy Grand Rounds 21 - Rolling into Radiculopathy: A Jujitsu Grappling Trauma Case

Overview

This course explores a clinical presentation of acute upper extremity radiculopathy following a traumatic sports injury. Presented by the Orthopaedic Division of the Canadian Physiotherapy Association, the case study details the assessment and management of a 47 year old male who sustained a severe neck and shoulder injury during competitive jujitsu. Clinicians will review the subjective history, mechanism of injury, comprehensive objective findings, and the critical clinical reasoning required when evaluating competing differential diagnoses such as brachial plexus traction and cervical nerve root irritation.

You can find all Grand Rounds in this course track. 

Learning Objectives

1. Analyze the mechanism of injury in grappling sports and its potential impact o the cervical spine and brachial plexus.
2. Evaluate objective neurological findings, including specific dermatome and myotome deficits at the C5 and C6 levels.
3. Formulate a differential diagnosis distinguishing between brachial plexus traction injuries and cervical facet joint irritation.
4. Review the effectiveness of manual therapy interventions and specific exercise prescriptions for acute upper extremity pain.

Audience

Physiotherapists, physical therapy students, sports medicine practitioners, and allied healthcare professionals interested in orthopaedic conditions and sports injuries.

Why This Course Matters

Understanding complex trauma from high contact sports like jujitsu is crucial for orthopedic and sports physical therapists. This case emphasizes the importance of a thorough neurological examination to differentiate between localized musculoskeletal pain and significant nerve involvement. Recognizing fatigable weakness and persistent radicular symptoms ensures clinicians can safely manage irritable tissues while identifying the precise moment an interdisciplinary medical referral is required for optimal patient safety.

Case Presenter: Marco Bandiera BScHonsKin, MScPT 

Marco Bandiera completed his Masters of Physical Therapy from the University of Western Ontario in 2021. Prior to his Physiotherapy degree he completed his Kinesiology degree at the University of Toronto receiving High Honours. Marco is currently in the process of becoming a fellow of the Canadian Academy of Manipulative Therapy (CAMPT) having completed level 5 this past winter. 

Panelists:

Marjorie Gingras, fellow pht B.Sc. D.E.P.A. physiothérapie avancée 

Marjorie has been a physiotherapist since 1999 and graduated with a postgraduate diploma in advanced neuromusculoskeletal physiotherapy in 2021 from the University of Montreal (UdeM). She was named a fellow in 2021 by the Ordre professionnel de la physiotherapie du Quebec (OPPQ). Since 2001, she has been working in the public health system for the CISSS Monteregie Centre with a variety of patients, currently working in a Family Medicine Group (GMF). She received the Prix d'Excellence in clinical supervision from Sherbrooke University in 2018. Marjorie is a trainer for the OPPQ and the company Atlas Medic and is involved in clinical reasoning activities in the UdeM physiotherapy program.

Darryl Viegas, BSc(PT), Dip. Manip., CGIMS, FCAMPT

Darryl graduated from the University of Toronto with a BSc(PT).  In 2005 Darryl completed the Advanced Diploma in Manual and Manipulative Physiotherapy.  Darryl is a senior instructor for the AIM program.  Darryl has continued his post graduate training with courses in exercise theory, medical acupuncture/dry needling, advanced spinal manipulation, advanced shoulder rehabilitation techniques, myofascial release and nerve mobilization techniques.  In his practice Darryl attempts to blend the use of manual therapy techniques with patient specific exercise programs and education in the treatment of patients with all orthopaedic conditions.

Terry Woodard, BMR(PT), B.Sc., FCAMPT, MClSc (Manip)

Terry graduated from the University of Manitoba in 1989 with a BSc and in 1993 with a Bachelor of Medical Rehabilitation (Physiotherapy). He became a Fellow of the Canadian Academy of Manipulative Physical Therapists (FCAMPT) in 2004. He obtained his MClSc (Manipulation) at Western University (WU) in 2014.  Terry works in private practice in Winnipeg and holds part time teaching positions at the U of M and WU. Terry is a mentor, instructor, and examiner in the CPA Orthopaedic Division AIM system.