031. Scapula assessment in shoulder pain with Ann Cools

Shoulder pain patients often have poor scapula control. Is their shoulder pain caused by poor scapula control, or is their scapula dysfunction caused by shoulder pain? When your patients present with shoulder pain, should your focus be on scapula control, glenohumeral control, or treatment of the neck and thorax? 

In this podcast, David Pope talks to Ann Cools, a Physiotherapist and Head of Education for Rehabilitation Sciences and Physiotherapy at Ghent University in Belgium, and is also the founding member and president (2010–2012) of EUSSER - European Society of Shoulder and Elbow Rehabilitation. We discuss in detail assessment of the scapula, the role of the scapula in shoulder pain and how to retrain unruly scapulae.

Other topics covered in this podcast include:

• Research by Ann Cools

• What we currently know from the research about the role, movement and control of 

• the scapula

• Scapula dyskinesis - what is it

• Static vs dynamic assessment of the scapula

• Altering muscle balance and timing with specific exercises

• How altering scapula mechanics effects muscle balance around the shoulder

• Important parts of the subjective history

• Scapula vs glenohumeral joint

• How subjective will guide your objective assessment and treatment

• Red flags around the shoulder, nerve pathology and frozen shoulder

• Frozen shoulder imaging

• Nerve injuries - symptoms, objective examination and treatment

• Assessment of the scapula, Type 1 scapula dyskinesis

• Differentiating contributors to Type 1 scapula dyskinesis (anteriorly rotated scapula)

• Testing GHJ IR

• Clinical Edge and online education on the shoulder

• Stretching and shoulder joint mobilisation

• Palpation, stretching and manual therapy for pec minor

• Type 2 scapula dysfunction

• Handheld dynamometry - serratus

• Handheld dynamometry - middle and lower traps

• Pain when strength testing

• Type 3 scapula dysfunction

• Dynamic assessment of the scapula

• To retract and depress the scapula or not?

• Shoulder Symptom Modification Procedure (SSMP) by Jeremy Lewis

• Special tests around the shoulder

• Laxity tests for the GH joint

• Posterior GHJ laxity

• Anterior GHJ laxity

• Explanations of scapula dysfunction to your patients

• Information on Ann Cools 

• EUSSER

Timeline:

0:30 Research by Ann Cools

4:20 What we currently know from the research about the scapula

6:30 Scapula dyskinesis - what is it

8:30 Static vs dynamic assessment of the scapula

11:45 Altering muscle balance and timing with specific exercises

13:15 How altering scapula mechanics effects muscle balance around the shoulder

14:10 Important parts of the subjective history

16:20 Scapula vs glenohumeral joint

18:20 How subjective will guide your objective assessment and treatment

18:55 Red flags around the shoulder, nerve pathology and frozen shoulder

21:15 Frozen shoulder imaging

21:45 Nerve injuries - symptoms, objective examination and treatment

30:30 Assessment of the scapula, Type 1 scapula dyskinesis

35:00 Differentiating contributors to Type 1 scapula dyskinesis (anteriorly rotated scapula)

36:10 Testing GHJ IR

42:00 Clinical Edge

44:00 Stretching and shoulder joint mobilisation

51:45 Palpation, stretching and manual therapy for pec minor

55:40 Type 2 scapula dysfunction

59:20 Handheld dynamometry - serratus

1:00:51 Handheld dynamometry - middle and lower traps

1:03:54 Pain when strength testing

1:04:50 Type 3 scapula dysfunction

1:10:03 Dynamic assessment of the scapula

1:15:00 To retract and depress the scapula or not?

1:16:23 Shoulder Symptom Modification Procedure (SSMP) by Jeremy Lewis

1:17:50 Special tests around the shoulder

1:20:35 Laxity tests for the GH joint

1:23:00 Posterior GHJ laxity

1:24:30 Anterior GHJ laxity

1:26:20 Explanations of scapula dysfunction to your patients

1:31:00 Information on Ann Cools 

1:32:20 EUSSER

1:33:00 Wrap up

Links of Interest

• Anne Cools on Linked In
• Ann Cools’ Research
• Ann Cools at Ghent University
• Ann on Twitter
• Clinical Edge
• Show your love for the Physio Edge podcast with a review on iTunes