Physio Edge podcast

Do you include stretches in your treatment of shoulder pain? Have you ever identified a glenohumeral internal rotation deficit (GIRD) and used the "Sleeper stretch" to help improve internal rotation? Do stretches have any value for shoulder pain, or are there better treatment options?

In this podcast, Jo Gibson (Clinical Physiotherapy Specialist) discusses how to differentiate true capsular stiffness from muscle stiffness, what information GIRD provides, and whether sleeper stretches for shoulder pain are a useful treatment.

Jo explores the current research and clinical implications on your treatment, including:

  • What is the driver of decreased range of movement (ROM)?
  • If we get immediate changes in ROM with a sleeper stretch, does that mean we should use this as a treatment?
  • Is stretching an effective, efficient and evidence-based treatment?
  • Can we use strengthening movements to improve range and cuff recruitment?
  • What exercises can you use with patients with GIRD to improve ROM and cuff recruitment?
  • Humeral retroversion and how torsional load from throwing sports at a young age impact your ROM assessment.
  • If you have a patient with GIRD, what does this tell you?
  • In patients with true capsular stiffness, does stretching in combination with damp heat have a role?
  • Does eccentric strengthening have a role in improving GIRD in patients with true capsular stiffness or fibrosis?
  • How can you use GIRD to monitor your athletes fatigue and recovery?

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Shoulder surgery in athletes is common following dislocation. Accelerated post-op shoulder stabilisation rehab protocols include early mobilisation to reduce movement, proprioceptive and strength deficits. This has allowed earlier return to play (RTP), however athletes often still have significant proprioceptive and strength deficits up to 2 years post surgery. Despite getting back to play, athletes may struggle to get back to performance.

Following surgery, contact athletes such as rugby players, throwing athletes and young players have additional RTP challenges. Redislocation risks in contact sports such as rugby are high, leading to poor outcomes. Younger athletes are not skeletally mature, and with early RTP following stabilisation surgery may have higher failure rates. How can you identify and address these challenges?

Which tests and features in a patients history help you determine whether a patient is suitable for an early RTP? In this podcast with Jo Gibson (Clinical Physiotherapy Specialist), you’ll explore:

  • Which shoulder tests are most valuable with your patients?
  • How has emerging evidence challenged our previous approach to RTP testing?
  • What are the risks associated with early RTP following shoulder surgery?
  • How can you help identify athletes at risk of redislocation?
  • Which psychosocial factors impact RTP?
  • How does fear of reinjury and levels of anxiety about their shoulder affect RTP?
  • How does your patient’s sport of choice affects dislocation risks?
  • How is RTP impacted by patients age?
  • How do daily stressors impact RTP and predict outcomes?
  • Which psychosocial factors impact RTP?
  • What is the biggest factor in whether an athlete gets back to play?
  • Which question are key to ask your patients?
  • Which questionnaires can you use with your post-op shoulder patients?
  • Which tests and combinations of tests have been validated and are evidence-based?
  • How can you assess range of movement (ROM)?
  • How can you measure patients strength?
  • How is rate of force development (RFD) affected following shoulder injury?
  • How can you assess RFD?
  • How does fatigue impact strength testing eg testing at the start of training compared to the after training?
  • How does the kinetic chain impact RTP testing for throwers?
  • How can you assess shoulder endurance?
  • RTP tests for swimmers
  • What role does manual therapy have in shoulder rehab?

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Direct download: 101._Return_to_play_testing_after_shoulder_surgery_with_Jo_Gibson.mp3
Category:general -- posted at: 10:48am AEDT

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