125. Cross education to improve shoulder strength. Physio Edge Shoulder success podcast with Jo Gibson
Jul 22, 2021
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Jo Gibson, a leading physiotherapy expert focused on shoulder rehabilitation, shares her insights on cross-education (CE) for maintaining shoulder strength during immobilization. She explains how training the uninjured arm can help mitigate atrophy and accelerate recovery. The conversation covers the neural mechanisms behind CE, its psychological impacts, and the best exercise techniques to optimize rehabilitation. Listeners will learn how to effectively incorporate CE in post-op recovery for improved strength and proprioception.
Cross education can effectively mitigate muscle atrophy and strength loss during shoulder immobilisation, promoting better recovery outcomes post-injury.
Incorporating specific techniques like eccentric contractions and visual feedback optimizes the effectiveness of cross education in shoulder rehabilitation.
Deep dives
Understanding Shoulder Pain Assessment and Treatment
The assessment and treatment of patients with shoulder pain require a comprehensive understanding of various underlying conditions, such as weakness, stiffness, and referred pain from the cervical spine. A thorough diagnosis is essential to tailor treatment plans effectively, ensuring that patients receive appropriate care based on their specific issues. Utilizing current research and practical applications, clinicians can significantly improve recovery outcomes for those dealing with shoulder pain, whether it's post-operative rehabilitation or management of chronic conditions. By fostering an engaging and supportive environment, therapists can help patients navigate their recovery process more effectively.
The Significance of Cross-Education in Rehabilitation
Cross-education is an important rehabilitation concept where exercising the uninjured arm can lead to strength gains in the immobilized or injured arm. Evidence suggests that patients can experience strength improvements ranging from 10% to 40% by employing this technique, particularly in scenarios involving immobilization. Focusing on neural mechanisms, this approach can minimize strength loss during recovery from surgery or injury, making it a valuable tool in physiotherapy. Specific applications within cross-education, such as targeting rotator cuff muscles during exercises, can enhance rehabilitation outcomes and reduce recovery time.
Practical Applications and Techniques for Effective Recovery
To maximize the benefits of cross-education, various practical techniques can be employed, including eccentric muscle contractions and visual feedback methods like using mirrors during exercises. Research indicates that a structured regime involving around four sets of six to eight repetitions at 60% of maximum voluntary contraction can yield optimal results. Additionally, offering reassurance and educating patients on their rehabilitation process can mitigate apprehension and build confidence during recovery. These practical strategies, when thoughtfully integrated into treatment plans, can significantly improve the outcomes of shoulder rehabilitation and empower patients throughout their recovery journey.
Immobilisation following a humeral fracture or shoulder surgery quickly results in muscle atrophy and decreased shoulder strength and proprioception. How can you limit strength deficits that develop while patients are in a sling?
During this period of immobilisation, cross education (CE) can help retain shoulder strength. This improved shoulder strength and proprioception after the immobilisation period concludes may enable a faster return to work, high load activities or sport. What is CE, and how can you use it in your treatment? Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist), and discover:
What is cross education (CE)?
What the latest research reveals about the effectiveness of CE?
Which patients benefit most from CE.
Common strength and proprioceptive deficits after shoulder stabilisation surgery.
How CE improves strength and proprioception.
Recommendations for CE exercise intensity and dosage.
Whether to use eccentric, concentric or isometric exercises.
How to amplify the strength and cortical effects of CE.
How to target the rotator cuff with CE.
How to incorporate proprioception into CE.
How to use CE in rehab for instability, movement apprehension & kinesiophobia.
When to include CE in MRCT post-op rehab.
Improve your rehab of post-op, post-fracture and immobilised patients now with this podcast.
Free webinar “5 common mistakes therapists make with shoulder pain, and what to do about them” with Jo Gibson
Shoulder: Steps to Success online course with Jo Gibson
Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess