Physio Edge podcast with David Pope

When paediatric or skeletally immature patients have shoulder pain, what diagnoses should be kept in mind? What are the potential diagnoses following trauma, in overuse injuries or “little leaguers shoulder”? What assessment and imaging is required in these patients? Find out in this podcast/video with Jo Gibson (Clinical Physiotherapy Specialist), and explore: What growth plate injuries may occur in skeletally immature athletes? The case study of a young athlete with misdiagnosed pain over the acromioclavicular joint (ACJ) A recap of acromial apophylysis and distal clavicular osteolysis. What are the common mechanisms of injury for ACJ? How are ACJ injuries classified? What are the limitations of ACJ injury classifications? Why are there often differences in ACJ injury classification between X-ray and MRI? How can ACJ imaging lead to incorrect return to play timeframes in mature athletes? In paediatric patients, what differential diagnosis do you need to keep in mind with an apparent ACJ injury? How does imaging help guide prognosis and treatment in younger athletes with ACJ injuries? How can growth plate injuries be identified? Can patients have a slipped humeral epiphysis? What are the most common humeral fractures What are humeral Salter-Harris fractures? Which fractures may impact future growth in the humerus? When is imaging absolutely required in paediatric shoulder injuries? What is “little leaguers shoulder” and why is it important to identify this early? When is glenohumeral internal rotation deficit (GIRD) relevant in lateral humeral pain? What are the risk factors for shoulder pain in young athletes? What causes GIRD in paediatric and skeletally mature athletes? What tests help with diagnosis in stiff shoulders? When is GIRD relevant? Why should the term “shoulder impingement” be avoided? How can you describe shoulder pain to patients? Can osteolysis of the whole scapula occur? Podcast handout The handout for this podcast consists of articles referenced in the podcast. There is no additional transcript or handout available. Free webinar “5 common mistakes therapists make with shoulder pain, and what to do about them” with Jo Gibson Register now for the free webinar "5 common mistakes therapists make with shoulder pain, and what to do about them" with Jo Gibson (Upper Limb Specialist Physio) Frozen and stiff shoulder assessment & treatment with Jo Gibson Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder 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 Links associated with this episode: Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Jo Gibson live on Facebook & ask your shoulder related questions every Monday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Jo Gibson on Twitter Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Infographics by Clinical Edge Articles associated with this episode: Download the podcast handout to receive the articles associated with this podcast. Hall K, Borstad JD. Posterior shoulder tightness: to treat or not to treat?. journal of orthopaedic & sports physical therapy. 2018 Mar;48(3):133-6. Zajac JM, Tokish JM. Glenohumeral Internal Rotation Deficit: Prime Suspect or Innocent Bystander?. Current reviews in musculoskeletal medicine. 2020 Feb 12:1-0.

What are the best rehab options for patients with an irreparable rotator cuff tear? Can we predict which patients will do well and how long rehab will take? Find out in this video/podcast with Jo Gibson (Clinical Physiotherapy Specialist), discussing rehab options, a patient case study and the latest evidence for massive rotator cuff tear (MRCT) rehab. Discover: When patients are unable to have surgery, what rehab options are available to rehab MRCT? What is classified as a MRCT? What common issues do patients with MRCT face? What proprioceptive deficits exist in MRCT patients functionally and on fMRI? Is the “Anterior deltoid program” really the best rehab program for MRCT patients? What MRCT rehab exercises & programs are supported by the latest research? Which MRCT patients are likely to respond to rehab? Is scapular dyskinesis important to target in MRCT rehab? When patients are unable to lie supine, and are therefore unable to complete the anterior deltoid program, what options are available for rehab? How do rotator cuff imaging results help guide treatment? Which rotator cuff tendons need to be intact for successful rehab? Specific exercise ideas and progressions that can be used in rehab. How long is recovery likely to take? What key messages are important to convey to patients? What is the evidence for injections in MRCT, including prolotherapy, PRP? How can rehab programs target subscapularis strength? Is humeral head depression an important component in rehab? Podcast handout The handout for this podcast consists of articles referenced in the podcast. There is no additional transcript or handout available. Free webinar “5 common mistakes therapists make with shoulder pain, and what to do about them” with Jo Gibson Register now for the free webinar "5 common mistakes therapists make with shoulder pain, and what to do about them" with Jo Gibson (Upper Limb Specialist Physio) Frozen and stiff shoulder assessment & treatment with Jo Gibson Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder 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 Links associated with this episode: Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Jo Gibson live on Facebook & ask your shoulder related questions every Monday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Jo Gibson on Twitter Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Infographics by Clinical Edge Articles associated with this episode: Download the podcast handout to receive the articles associated with this podcast. Agout C, Berhouet J, Spiry C, Bonnevialle N, Joudet T, Favard L, Society FA. Functional outcomes after non-operative treatment of irreparable massive rotator cuff tears: Prospective multicenter study in 68 patients. Orthopaedics & Traumatology: Surgery & Research. 2018 Dec 1;104(8):S189-92. Cavalier M, Jullion S, Kany J, Grimberg J, Lefebvre Y, Oudet D, Grosclaude S, Charousset C, Boileau P, Joudet T, Bonnevialle N. Management of massive rotator cuff tears: prospective study in 218 patients. Orthopaedics & Traumatology: Surgery & Research. 2018 Dec 1;104(8):S193-7. Cools AM, Van Tongel A, Berckmans K, Spanhove V, Plaetevoet T, Rosseel J, Soen J, Levy O, Maenhout A. Electromyographic analysis of selected shoulder muscles during a series of exercises commonly used in patients with symptomatic degenerative rotator cuff tears. Journal of Shoulder and Elbow Surgery. 2020 Oct 1;29(10):e361-73. Levy O, Mullett H, Roberts S, Copeland S. The role of anterior deltoid reeducation in patients with massive irreparable degenerative rotator cuff tears. Journal of shoulder and elbow surgery. 2008 Nov 1;17(6):863-70.

When swimmers and overhead athletes have superior & anterior shoulder pain, what are your likely diagnoses? How can you successfully treat shoulder pain that improves with rest from sport, then comes back each time they return to training or sport? Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist), where you’ll discover: What are your likely diagnoses? Distal clavicular osteolysis (DCO) - what is it? How to differentially diagnose acromial apophysitis/apophylysis (AA) in young overhead athletes. What are common areas of pain and aggravating movements in DCO patients? Common training errors and weight training exercises that can cause or aggravate symptoms. Which athletes are likely to develop DCO, and common mechanisms of injury. Imaging you need to order. What Xray and other imaging reveals in DCO. What are potential long term issues following DCO, and how can this be avoided? The MOST important treatment for patients with DCO and AA. How can DCO be successfully managed? How to modify work activities in DCO patients. How long recovery takes. Why asymptomatic stress tests and palpation doesn’t mean your patient is safe to return to sport. How to work with coaches when your patients are experiencing DCO. How to successfully return DCO patients to sport. Free webinar “5 common mistakes therapists make with shoulder pain, and what to do about them” with Jo Gibson Register now for the free webinar "5 common mistakes therapists make with shoulder pain, and what to do about them" with Jo Gibson (Upper Limb Specialist Physio) Frozen and stiff shoulder assessment & treatment with Jo Gibson Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder 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 Links associated with this episode: Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Jo Gibson live on Facebook & ask your shoulder related questions every Monday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Jo Gibson on Twitter Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Infographics by Clinical Edge

When your female patient has shoulder pain, how can you identify if the cause is musculoskeletal, or related to women’s health issues? Find out in this video/podcast with Jo Gibson (Clinical Physiotherapy Specialist). You’ll explore two separate case studies of female shoulder pain patients with different diagnoses, that’ll help you discover: Which female reproductive issues can cause shoulder pain? How can you differentiate musculoskeletal and non-musculoskeletal causes of shoulder pain? Is pain at different stages of the menstrual cycle really just “hormones”? What questions can you ask your patients to help guide your diagnosis? What is the typical history of patients with shoulder pain related to women’s health? If patients wake with acute shoulder pain, what are the potential musculoskeletal and non-musculoskeletal diagnoses? Free webinar “5 common mistakes therapists make with shoulder pain, and what to do about them” with Jo Gibson Register now for the free webinar "5 common mistakes therapists make with shoulder pain, and what to do about them" with Jo Gibson (Upper Limb Specialist Physio) Frozen and stiff shoulder assessment & treatment with Jo Gibson Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder 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 Links associated with this episode: Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Jo Gibson live on Facebook & ask your shoulder related questions every Monday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Jo Gibson on Twitter Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Infographics by Clinical Edge

Are eccentric exercises useful in subacromial shoulder pain rehab? When shoulder pain rehab has stalled, and patients aren’t improving, will eccentric exercises help? Are eccentric exercises the missing component in successful rehab programs for recalcitrant shoulder pain? Find out in this discussion with Jo Gibson (Clinical Physiotherapy Specialist). Also discover: Should eccentric exercises be included in shoulder rehab programs? What does the research reveal about eccentric shoulder exercises? How can the research be applied and adapted clinically with shoulder pain patients? If eccentric exercises are helpful, which exercises should patients use? When and how often should eccentric exercises be performed? Are eccentric exercises helpful in acute shoulder pain? How long does shoulder pain normally take to recover from? How can gym programs be adapted to allow shoulder pain to recover while patients continue training or exercising? How many exercises should be included in shoulder pain rehab programs? Free webinar “5 common mistakes therapists make with shoulder pain, and what to do about them” with Jo Gibson Register now for the free webinar "5 common mistakes therapists make with shoulder pain, and what to do about them" with Jo Gibson (Upper Limb Specialist Physio) Frozen and stiff shoulder assessment & treatment with Jo Gibson Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder 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 Links associated with this episode: Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Jo Gibson live on Facebook & ask your shoulder related questions every Monday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Jo Gibson on Twitter Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Infographics by Clinical Edge

An unusual cause of shoulder pain - what's the diagnosis? Solve this patient case study with Jo Gibson (Clinical Physiotherapy Specialist) and discover musculoskeletal and non-musculoskeletal causes of shoulder pain that are important to keep in mind when features don't fit. Free webinar “5 common mistakes therapists make with shoulder pain, and what to do about them” with Jo Gibson Register now for the free webinar "5 common mistakes therapists make with shoulder pain, and what to do about them" with Jo Gibson (Upper Limb Specialist Physio) Frozen and stiff shoulder assessment & treatment with Jo Gibson Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder 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 Links associated with this episode: Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Jo Gibson live on Facebook & ask your shoulder related questions every Monday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Jo Gibson on Twitter Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Infographics by Clinical Edge

When is shoulder pain from the C/sp? When a patient presents with shoulder pain and stiffness, how can C/Sp referral be identified? If a patient has full neck range of movement, and neck movements don’t reproduce shoulder pain, can their pain still be from the C/sp? Recent research shows that including treatment of the C/sp can improve results in up to ⅓ of shoulder pain patients. In this video with Jo Gibson (Clinical Physiotherapy Specialist) discover how to identify, assess and treat patients with cervical referral, including: What history and pain features will patients with cervical referred shoulder pain report? What assessment tests can be performed to diagnose or rule out the C/Sp involvement in shoulder pain? What information does palpation and repeated movements in the objective assessment provide? What does the research reveal about cervical referred shoulder pain? What biopsychosocial factors may be involved in cervical referred shoulder pain? How can manual therapy to the C/Sp improve shoulder range of movement? What education can be provided to patients with cervical spine referral? What exercises and exercise variations may be used to improve cervical referred shoulder pain? Are upper muscle fibres of trapezius “overactive” or are these muscles actually weak? What exercises can be used for upper traps in C/sp referred shoulder pain? What manual therapy can be used for C/sp referred shoulder pain? Does the thorax get “stiff”, and what exercises help improve thoracic range of movement? Podcast handout The handout for this podcast is articles referenced in the podcast. There is no additional transcript or handout available. Free webinar “5 common mistakes therapists make with shoulder pain, and what to do about them” with Jo Gibson Register now for the free webinar "5 common mistakes therapists make with shoulder pain, and what to do about them" with Jo Gibson (Upper Limb Specialist Physio) Frozen and stiff shoulder assessment & treatment with Jo Gibson Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder 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 Links associated with this episode: Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Jo Gibson on Twitter Articles associated with this episode: Download the podcast handout to receive the articles associated with this podcast. Alonso-Perez JL, Lopez-Lopez A, La Touche R, Lerma-Lara S, Suarez E, Rojas J, Bishop MD, Villafañe JH, Fernández-Carnero J. Hypoalgesic effects of three different manual therapy techniques on cervical spine and psychological interaction: A randomized clinical trial. Journal of Bodywork and Movement Therapies. 2017 Oct 1;21(4):798-803. Hauswirth J, Ernst MJ, Preusser ML, Meichtry A, Kool J, Crawford RJ. Immediate effects of cervical unilateral anterior-posterior mobilisation on shoulder pain and impairment in post-operative arthroscopy patients. Journal of back and musculoskeletal rehabilitation. 2017 Jan 1;30(3):615-23. Katsuura Y, Bruce J, Taylor S, Gullota L, Kim HJ. Overlapping, Masquerading, and Causative Cervical Spine and Shoulder Pathology: A Systematic Review. Global Spine Journal. 2020 Apr;10(2):195-208. Vicenzino B, Collins D, Benson H, Wright A. An investigation of the interrelationship between manipulative therapy-induced hypoalgesia and sympathoexcitation. Journal of manipulative and physiological therapeutics. 1998 Sep 1;21(7):448-53.

When your patient has neck and arm pain, or low back and leg pain from neural tissue pain disorders (NTPD) such as peripheral nerve sensitisation (PNS), how will you treat them? Pain associated with PNS can occasionally be mild and non-irritable, but more often than not, it’s severe, highly irritable, and easy to stir up. How can you provide treatment that settles their pain, without stirring them up? What advice, education, manual therapy and exercise will you provide to help improve symptoms and speed up recovery? What are the keys to success with PNS patients? In Physio Edge podcast 104, Dr Toby Hall and I discussed PNS, common symptoms, causes, questions to ask, and how to assess and diagnose PNS in your patients. In this followup podcast, the second in our two-part series, Dr Toby Hall and I take you through the next phase - how to treat PNS. You’ll discover: The 7 keys to success with PNS How to successfully treat PNS in the neck and upper limb, AND the low back and lower limb. What education and advice should you provide to your patient about activities to avoid or reduce, and which activities should they increase? What are the most effective exercises for patients with PNS? Should exercise be painful or painless? When is neural mobilisation an effective treatment? When should you avoid using neural mobilisation as a treatment? Is manual therapy effective in PNS? Which manual therapy techniques can you use to improve symptoms and range of movement (ROM) immediately? How to perform effective manual therapy techniques that reduce pain without stirring up your patients. How can you combine neural mobilisation with manual therapy? If you use manual therapy to improve symptoms, what home exercises should patients perform after each treatment session? CLICK HERE to get access to Sherlock Holmes and the sign of the four hypotheses with Nick Kendrick Links associated with this episode: Physio Edge podcast 104 - Peripheral nerve sensitisation & neural tissue pain disorders with Dr Toby Hall Comprehensive, practical training to improve your skills, clinical reasoning, treatment results & confidence with a free trial Clinical Edge membership The new “Making sense of pain” module available with a free trial Clinical Edge membership Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Sherlock Holmes & the Sign of the Four Hypotheses case study with Nick Kendrick Comprehensive, practical training to improve your skills, clinical reasoning, treatment results & confidence with a free trial Clinical Edge membership Dr Toby Hall on Twitter Low back pain treatment online course with Dr Toby Hall and Manual Concepts Manual Concepts Dr Annina Schmid Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Join live Q&A podcasts on Facebook Infographics by Clinical Edge

Explore cervical radiculopathy, central sensitisation, achilles tendinopathy, hip & groin pain, & strength tests for athletes with Simon Olivotto, Dave Toomey, Paula Peralta & Nick Kendrick. The Clinical Edge Senior Physio Education & Presentation team and I sat down to answer Clinical Edge member questions, and we wanted to share this one with you, so you can benefit from it too. In this Q&A, we discussed: Cervical radiculopathy patients with an irritable presentation Do imaging findings such as modic changes, alter our management How can you approach treatment of cervical radiculopathy? Are medications indicated? Red flags you need to rule out Are sliders and gliders a useful treatment? Sensitivity to cold or ice How can you use tests to identify sensitivity to cold or ice to guide your treatment? Does ice sensitivity indicate central sensitisation? How does this impact management? If your whiplash patients have sensitivity to cold or ice, how does this impact treatment & prognosis? Which research articles cover this topic? Calf & achilles strengthening When is it best to perform calf raises into dorsiflexion (DF)? When should you avoid strengthening the calf into end of range (EOR) DF? What ankle issues may lead you to avoid strengthening or stretching into EOR DF? Hip joint pain and the acetabular labrum Can we identify when the labrum is responsible for hip or groin pain? What tests are important to perform in patients with hip or groin pain? If deep structures such as the hip joint are painful or injured, does this mean more superficial structures such as the acetabular labrum are also pain generators? Strength assessment & screening of athletes What strength screening tests can you perform in athletes with large demands such as motorcross? Which areas do you need to assess? What are simple and more complex ways to assess strength in different regions of the body? What are important considerations when designing a S&C program for a motocross athlete? Making sense of pain How can you make sense of pain? How can you describe pain to your patients in a way that makes sense, and doesn’t tell them “it’s all in your head”? Find out how to improve your confidence with acute and persistent pain in the upcoming “Making sense of pain” module. Warning: Contains swearing. Links associated with this episode: Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Improve your clinical reasoning, assessment and treatment effectiveness, efficiency and results with a free trial Clinical Edge membership Clinical reasoning module - simplify complex patients, clarify your assessment and get great results with clinically reasoned treatment “Making sense of pain” module Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Clinical Edge Education & presentation team Simon Olivotto Paula Peralta David Toomey Nick Kendrick Articles associated with this episode: Maxwell S, Sterling M. An investigation of the use of a numeric pain rating scale with ice application to the neck to determine cold hyperalgesia. Manual therapy. 2013 Apr 1;18(2):172-4. Machado GC, Maher CG, Ferreira PH, Day RO, Pinheiro MB, Ferreira ML. Non-steroidal anti-inflammatory drugs for spinal pain: a systematic review and meta-analysis. Annals of the rheumatic diseases. 2017 Jul 1;76(7):1269-78. Zhu S, Zhu J, Zhen G, Hu Y, An S, Li Y, Zheng Q, Chen Z, Yang Y, Wan M, Skolasky RL. Subchondral bone osteoclasts induce sensory innervation and osteoarthritis pain. The Journal of clinical investigation. 2019 Mar 1;129(3):1076-93. 

When you assess your patients shoulder movements, and notice a winging scapula, altered resting position or timing of scapula movement, do you need to treat it? Can we diagnose “Scapular dyskinesis”, and does it matter? How can you simplify your scapular assessment? In this podcast, Jo Gibson (Clinical Physiotherapy Specialist) explores common beliefs and myths around the scapula, including: Abnormal scapular kinematics cause pain We can predict patients that are going to get shoulder pain Upper traps should be retrained to decrease their activation Scapular-based interventions are superior to rotator cuff based treatment There are reliable and valid ways to assess scapular movement Alongside this mythbusting, you’ll explore: Is there any point assessing the scapula? Is scapular asymmetry normal or abnormal? Is scapular dyskinesis a normal response to exercise or loading? How accurate are we at identifying scapular dyskinesis compared to findings in laboratory studies of scapula movement? What scapular findings will you commonly observe in patients with massive rotator cuff tears, nerve injuries & stiffness? How does rotator cuff fatigue impact scapular movement? How does fear avoidance and worry about particular movements impact muscle activity and movement? When is increased upper traps activity helpful and beneficial? Should we try to decrease upper traps activity in patients with C/Sp driven shoulder pain? Can we preferentially target the scapular or rotator cuff with our exercises? Do improvements in shoulder pain correlate with changes or “improvements” in scapular movement? How do scapular assessment test (SAT) results impact your treatment and exercise prescription? If the SAT improves pain, does that mean we should perform scapular based exercises? Can we use scapular dyskinesia classification to stratify patients or guide our treatment? Is there any reliability in scapular assessment? Does the SAT simply identify those that have a favourable natural history ie are going to get better on their own regardless? Do scapular treatments increase the subacromial space, and does this matter? Is winging post-surgery (posterior stabilisation + labral repair) a product of surgery or does this need to be addressed? How does incorporating the kinetic chain into rehab impact patient movement strategies, scapular and rotator cuff recruitment? Are scapulothoracic bursae relevant to shoulder pain? How can you address patient beliefs and fear avoidance around their shoulder pain? Podcast handout Free webinar “5 common mistakes therapists make with shoulder pain, and what to do about them” with Jo Gibson Register now for the free webinar "5 common mistakes therapists make with shoulder pain, and what to do about them" with Jo Gibson (Upper Limb Specialist Physio) Frozen and stiff shoulder assessment & treatment with Jo Gibson Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder 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 CLICK HERE to get access to Sherlock Holmes and the sign of the four hypotheses with Nick Kendrick  Links associated with this episode: Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Jo Gibson on Twitter Articles associated with this episode: Download the podcast handout to receive the articles associated with this podcast. Andersson SH, Bahr R, Clarsen B, Myklebust G. Risk factors for overuse shoulder injuries in a mixed-sex cohort of 329 elite handball players: previous findings could not be confirmed. British journal of sports medicine. 2018 Sep 1;52(18):1191-8. Asker M, Brooke HL, Waldén M, Tranaeus U, Johansson F, Skillgate E, Holm LW. Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis. British journal of sports medicine. 2018 Oct 1;52(20):1312-9. Christiansen DH, Møller AD, Vestergaard JM, Mose S, Maribo T. The scapular dyskinesis test: Reliability, agreement, and predictive value in patients with subacromial impingement syndrome. Journal of Hand Therapy. 2017 Apr 1;30(2):208-13.