Neck pain is a highly prevalent condition that leads to considerable pain, disability, and economic cost. Many people suffering from neck pain or headache receive treatment for their complaints by healthcare providers. Although rare, people presenting with headache, neck pain or orofacial symptoms may present with complaints that appears musculoskeletal related, but in fact have an underlying vascular pathology or blood flow limitation. Therefore, all healthcare providers managing people with neck pain, headache, and/or orofacial symptoms should develop an index of suspicion for vascular sources of clinical musculoskeletal presentations, and understand the underlying mechanisms that may lead to injury or flow limitation.

On completion of the workshop, participants will have up-to-date knowledge about screening for vascular pathologies and blood flow limitations. They will be able to conduct an evidence based clinical reasoning process, including a contemporary patient interview focused on identifying underlying (vascular) pathologies and risk factors. Moreover, attention will be given to communication, including providing appropriate information and advice.

The second part of the workshop will focus on the physical examination, including practical application of (screening) tests.

Nathan Hutting studied physiotherapy (2003) and manual therapy (2009). In 2015, he was awarded a PhD for his dissertation on self-management for employees with complaints of the arm, neck or shoulder (Radboud University, the Netherlands). Nathan is currently working in the Netherlands as an associate professor at HAN University of Applied Sciences in the Occupation & Health research group. He also works as a physiotherapist and manual therapist in private practice. Since 2022, Nathan has served on the board of the VvAA, the largest association of healthcare professionals in the Netherlands with over 130,000 members. He is also a board member of the Physiotherapy Research Society (United Kingdom) and the Pain, Mind and Movement Special Interest Group of the International Association for the Study of Pain (IASP). Since July 2024, Nathan is the Vice-President of IFOMPT, the International Federation of Manual and Musculoskeletal Physical Therapists, a Specialty Group of World Physiotherapy.

Nathan has been a member and chair of many working groups and advisory committees related to manual therapy and physiotherapy. Nathan was a board member of the Dutch Manual Therapy Association (NVMT) for nine years (2014−2023) and served as an IFOMPT Member Organisation delegate for over seven years (2016−2023). Currently, he is a member of the Scientific College of Physical Therapy (WCF) of the Royal Dutch Society for Physical Therapy (KNGF) and a member of the scientific advisory board of the Dutch RSI association. Nathan was a member of the congress programme committee of the 2023 World Physiotherapy Congress and he is a current member of the congress programme committee for the 2025 World Physiotherapy Congress.

Nathan’s current research topics include chronic conditions, musculoskeletal conditions, self-management, patient-centred care, occupational health, work-focused healthcare and vascular conditions. He has published over 50 peer-reviewed articles. Many of these articles have significantly influenced musculoskeletal physiotherapy practice (for example, regarding the assessment of the neck region for potential vascular conditions and blood flow limitations, and the provision of person-centred care and self-management support in musculoskeletal practice).

Nathan has delivered numerous international keynote speeches and congress presentations, and lectured in Africa, Europe, Asia, North America and Oceania/Australia. He chaired focused symposia at the World Physiotherapy congresses in 2017, 2019, 2021 and 2023. Nathan is an associate editor of the European Journal of Physiotherapy and a member of the editorial board of BMC Musculoskeletal Disorders. He is also a member of the international advisory board of Musculoskeletal Science and Practice.

On completion of this workshop, participants will be able to:

• Conduct an evidence based clinical reasoning process
• Conduct a contemporary patient interview
• Conduct a contemporary physical examination (if you follow the second part of the workshop)
• Provide appropriate information and advice

8: 30 – 9:00 Registration and welcome

• 9:00 – 9:30 Part 1 Introduction and polling questions 
• 9:30 – 9:45 Risks
• 9:45 – 10:00 Relevant anatomy
• 10:00 – 10:30 Clinical reasoning and vascular flow limitations

10:30 – 10:45 Break

• 10:30 – 11:45 The patient interview
• 11:45 – 12:30 Case vignettes

12:30 – 13:15 Lunch break 

• 13:15 – 14:00 Information and recommendations
• 14:00 – 14:15 Wrap up part 1

14:15 – 14:45 Break

• 14:45 – 15:15 Part 2 Introduction and polling questions 
• 15:15 – 16:30 The physical examination
• 16:30 – 16:45 Treatment
• 16:45 – 17:00 Wrap up 

Charles Meredith Building, McGill University 
School of Physical and Occupational Therapy
1130 Pine ave
Montreal, QC H3A 1A3