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 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?

Accurately assess, diagnose & treat stiff shoulders, including frozen shoulder, with this free videos series from Jo Gibson (Clinical Physiotherapy Specialist) at clinicaledge.co/shoulder

The handout for this podcast consists of articles referenced in the podcast. There is no additional transcript or handout available.

Links associated with this episode:

• Accurately assess, diagnose & treat stiff shoulders, including frozen shoulder, with this free videos series from Jo Gibson (Clinical Physiotherapy Specialist)
• Improve your acute shoulder pain diagnosis with 3 free videos from 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:

• CLICK HERE to download 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 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?

Get free access to video series on assessment & diagnosis of acute shoulder pain and stiff shoulders at clinicaledge.co/shoulder

For improved clinical skills, knowledge and treatment results with all other areas of the body, get a free trial Clinical Edge membership at clinicaledge.co/freetrial

The handout for this podcast consists of articles referenced in the podcast. There is no additional transcript or handout available.

Links associated with this episode:

• Accurately assess, diagnose & treat stiff shoulders, including frozen shoulder, with this free videos series from Jo Gibson (Clinical Physiotherapy Specialist)
• Improve your acute shoulder pain diagnosis with 3 free videos from 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:

• CLICK HERE to download 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.