How can you rehab patients with an acromioclavicular joint (ACJ) injury, or end of range elevation shoulder pain, long term shoulder pain, clavicular osteolysis, or osteoarthritis? What exercises and manual therapy can you use in your rehab program? Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist), and discover:

• Common ACJ mechanisms of injury
• A recap of ACJ injury classification and treatment pathways for different grades of injury.
• How useful is X-ray in ACJ injuries, and what is the best imaging for this injury?
• What imaging should ACJ injury patients have?
• What are the long term risks for ACJ patients?
• What factors correlate with worsening ACJ pain?
• Can atraumatic instability occur at the ACJ?
• What movements should be assessed in ACJ injury patients?
• Why is symptom modification helpful in shoulder pain and ACJ patients?
• What compensatory movement patterns do patients adapt that may contribute to ongoing pain?
• How can we help to break the cycle of ACJ pain?
• What tests can be performed to identify the best treatment for individual ACJ patients?
• What muscles help to improve stability around the ACJ, and how can these be targeted in ACJ injury patients?
• What exercises can be used in initial ACJ rehab?
• How can ACJ rehab be progressed?
• How can end range pain (ERP) be improved in ACJ patients?
• How to identify when scapular mechanics affect the ACJ.
• Exercises that improve scapular mechanics in ACJ patients?
• When is manual therapy useful in ACJ patients?
• What combination of manual therapy or mobilisation with movement and exercises can be used in ACJ patients?
• What role can the ACJ play in shoulder pain?
• Does the ACJ need to be symptomatic to cause shoulder pain?
• What common symptoms make you suspect the ACJ is involved in shoulder pain?

Answers to live listener questions:

• What humeral fractures or bone stress injuries occur in throwing athletes?
• Who develops humeral spiral fractures or stress fractures?
• Are recreational or high level athletes more likely to develop humeral fractures?
• Are players more or less likely to have a fracture after having a 6 week break from training?
• How can players prevent humeral stress fractures?

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

How can you diagnose posterior shoulder, neck and supraclavicular pain in your weightlifting patients and throwing athletes? Could a bone stress injury be responsible for your patients pain?

Explore how to assess, diagnose and rehab shoulder pain from bone stress injuries in weightlifters or throwing athletes in this podcast with Jo Gibson (Clinical Physiotherapy Specialist). Discover:

• Bone stress injuries in the upper limb and ribcage that cause shoulder pain.
• What causes first rib stress fractures?
• Which patients develop first rib bone stress injuries - common populations and activities.
• Common areas of pain with first rib stress fractures.
• How to assess & diagnose first rib bone stress injuries.
• Common painful and restricted movements that help with diagnosis.
• How to differentiate between a rotator cuff injury and first rib bone stress injuries.
• Cervical spine & shoulder strength and control assessment tests that help identify where to target your rehab.
• Do biomechanics in weightlifting matter?
• How to assess and address weightlifting biomechanics to allow healing and return to sport.
• Imaging
  • Why imaging is vital in patients with this injury.
  • Common imaging that misses 1st rib bone stress fracture, and what imaging to request that actually identifies it.
• Why non-healing with the formation of pseudoarthrosis may lead to better outcomes than bony callous formation.
• Whether patients can return to sport if rib stress fractures don’t heal.
• How can you rehab patients with 1st rib stress fracture?
• How to progress rehab exercises.
• Treatment when 1st rib callus formation is causing thoracic outlet syndrome.

Podcast handout

The handout for this podcast consists of an article 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

Article associated with this episode:

• Download the podcast handout to receive the article associated with this podcast.

• Miller A, Dodson CC, Ilyas AM. Thrower's fracture of the humerus. The Orthopedic Clinics of North America. 2014 Aug 3;45(4):565-9.

Time for some detective work - can you diagnose the cause of this man’s shoulder pain? Listen out for the clues in this interesting case study.

When your shoulder pain patient has bilateral shoulder pain after starting a gym program, difficulty lifting their arms overhead due to weakness, significant bilateral scapular winging and muscle atrophy, what are your potential diagnoses?

Find out in this case study with Jo Gibson (Clinical Physiotherapy Specialist), and discover:

• When patients have uncommon shoulder pain presentations, what potential diagnoses can you keep in mind?
• How does it impact your diagnosis if your patient has difficulty smiling, whistling and drinking through a straw?
• What’s this patients’ diagnosis?
• What tests can be performed to confirm the diagnosis?
• Which muscles are commonly affected?
• How much muscle weakness commonly occurs?
• What is the long term prognosis for this condition?
• What treatment is supported by the evidence?
• Are braces helpful?
• Which medical specialists are important to include in diagnosis & management?

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
• The Facioscapulohumeral Muscular Dystrophy (FSHD) Society
• 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.

• Hamel J, Tawil R. Case Studies on the Genetic and Clinical Diagnosis of Facioscapulohumeral Muscular Dystrophy. Neurologic Clinics. 2020 Aug 1;38(3):529-40.

• Mul K, Lassche S, Voermans NC, Padberg GW, Horlings CG, van Engelen BG. What's in a name? The clinical features of facioscapulohumeral muscular dystrophy. Practical neurology. 2016 Jun 1;16(3):201-7.

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