September 20, 2020
The course topic is the “Shoulder”. The course aim is to synthesize the current scientific evidence in a simple clinical approach. The anatomy of the shoulder and the mechanisms responsible for its specific painful disorders will be revisited. Different sub-groups will be presented together with a critical analysis of the shoulder assessment, including special tests and Symptoms Modification Procedures.
The clinical application of the Hand Held Dynamometer will be integrated for the analysis of the strength ratios and the progression criteria as well as for the achievement of the best exercise plan compliance.
A careful analysis of the whole Kinetic Chain will be presented for different Sports for full recovery as well as for enhanced Performance. Manual Therapy application for the different profiles will be critically outlined.
Furthermore the course will provide information regarding the latest clinical trials regarding conservative and surgical interventions as well as the predictive factors for full recovery.
Content
Introduction
Biopsychosocial Model
Explanation and clinical implication of the different types of pain (inflammatory, nociceptive, neuropathic, dysfunctional/nocipathic)
Explanation and clinical implication of different pain mechanisms (peripheral vs central sensitisation)
Strength and Conditioning/Mechanotherapy
Shoulder pain – which factors perpetuate pain? Which myths to abandon?
Patient as a profile
Practical application of the biopsychosocial model
Therapeutic neuroscience education applied to the shoulder (imaging + tissue loading tolerance + metaphors)
-simplification of shoulder disorders in 3 subgroups (Littlewood et al.):
1) weak (and stiff) and painful
2) stiff and painful
3) unstable and painful
Examination procedure (questionnaires/outcome measures and clinical impact)
Objective assessment:
- Differential diagnosis
-Tests and special tests
-use of Dynamometer per strength testing and strength ratios (referenced from Riemann, Cools , Ginn, Mansche, Struyf, Whiteley)
Symptoms modification procedures (referenced from Lewis , Meakins, Kibler )
The role of the kinetic chain in different sports (Swimmers/Overhead Athletes)
Performance tests
Application of the Musculoskeletal Framework
Explanation and demonstration – expectancy violation (conditio sine qua non)
Review of the most recent clinical trials and current research
TREATMENT AND MANAGEMENT
Use of Graded Exposure combined with Mechanotherapy
Use of Manual Therapy
Use of Strength and Conditioning principles for achieving full Performance/Efficiency:
Criteria for exercise selection
Use of periodisation
Load Management (RPE utilization)
Developing endurance, strength and power/speed
-KPI for shoulder: how to move to the next phase in safety
-presentation of different PROFILES as clinical examples
-discussion/questions
SCHEDULE:
Day 1
09:00 –09:30 Introduction
09:30 –11:00 Evidence on Shoulder Pain (T)
11:00 –11:15 Coffee
11.15 – 13.00 Presentation of different profiles (T)
13.00 – 14:00 Lunch
14.00 – 15.45 Subjective Examination and Outcome Measures/Questionnaires (T-P)
15.45 – 16.00 Coffee
16.00-18.00 Differential Diagnosis / Objective examination of different profiles (P) (T-P)
Day 2
9:00 – 10.30 Treatment Stiff and Painful (P)
10.30 - 10.45 Coffe
10.45 - 12.30 Treatment Weak and Painful (P)
12.30 - 13.30 Lunch
13.30 - 15:30 Treatment Unstable and Painful (P)
15:30 –15:45 Coffee
15:45 – 17.30 Questions and review (P)
P= PRACTICAL
T=THEORY