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The Inside-Out Paradigm© - The Aspiration to Prevent Hip, Knee & Shoulder Replacements

The need is growing: by 2030 total knee replacement (TKR) surgeries will see a 673% increase.  In 2008 63% of all knee replacement operations were performed on women.  Half of those seeking TKRs are younger than 65.


The established models for why knee, hip and shoulder replacements occur do not include many relevant anatomical relationships that feed into these degenerations.


As allied Health professionals we can’t help all, yet we can assist many more than we ever imagined.


To help, we are required to have a more comprehensive anatomic understanding and palpation skill sets to apply this knowledge.


Dale strives to contribute to a foundation for us in the manual therapy professions to build a commonly accepted model of how and why the progression of hip, knee and shoulder joint degenerations occur and what we might do to stabilize their downward spirals.


His clinical experiences provide evidence that if these degenerations are identified in their early stages, these progressions may even be reversed.


Dale believes this course pioneers an understanding of how we as Allied Health Practitioners may contribute to people who desire to lead more full and active lives as they age.


Identifying these 3 joint degenerations in their earlier stages is a necessary skill as is a willingness to encourage one’s clients to seek a full medical evaluation.  And, Dale cautions potential participants that if they select to add these skill sets and understandings, they must be willing to reframe their notions of what assisting a client in practical terms means.


Most clients who seek you out in the beginning will be looking for a miracle.  Sometimes this does occur and it’s quite exhilarating when it does.  However, it is his considerable experience that assisting clients to make functional progress (thus delaying an eventual surgery or sometimes even encouraging it to happen sooner) can be quite satisfying.


Clients often feel like they have a new lease on their quality of life following a joint replacement and most often will work with you to assist their rehabilitation.  As a result, long term therapeutic relationships are formed.


During This Workshop You Will Learn:


The “Sacs and Tubes Theory of Stress”


The hip and shoulder have an innate evolutionary pre-disposition for subluxation


To help the knee, one must begin with the hip


The viscera must be mobilized to help the hips ... the kinetic chain begins inside


That there is a fascial linkage between the shoulders, hips and knees


That subcortical reflexes are a stealth variable contributing to joint degenerations


That attention to these same relationships assists to resolve many chronic low back conditions


That infections and pathologies may lurk in the background of joint degeneration


An assessment protocol for early detection of hip, knee and shoulder degeneration


How to counsel clients toward medical options


Techniques will be demonstrated and practiced that:


Assist the femoral and humeral heads to recapture their joint space and the femoral condyles to find their tracking in relationship to the tibial plateaus


Assist the myofascial suspension and re-balancing of these and related joints


Mobilize the related viscera which co-participate in these degenerations


Mobilize the joints of the pelvis, lumbars and cervical spine to assist in distribution of strain


Reduce the systemic congestion which inevitably accompanies such degenerations


This course has organically grown out of Dale’s personal experience. In 1983 Dale and his step-son were hit head-on by a drunk driver. Both experienced orthopedic injuries. Dale’s right hip was shattered, the tibial plateaus were cracked, and his ankle broken along with additional facial and neck trauma.


An intrinsic understanding began to grow within his clinical awareness as more and more clients started to show up with varying degrees of hip, knee and shoulder degeneration.


What to Bring:

Massage table, linens, 3 pillows.

Attire during technique practice exchange needs to allow access to the abdomen ... sports bra and shorts or underwear.  Light blanket to provide warmth as may be needed in A/C.  Packed lunch, beverages and snacks to keep your blood sugar level normalized.


Return to Workshop page.