THE ATHLETIC SHOULDER
MTS™ LEVEL 3
A complete course for managing the athletic shoulder.
Diagnosing and treating athletic complaints can be particularly challenging with 'buried' pathology and treatment resistant outcomes.
We look closely at subacromial, SLAP, ACJ and GHJ disorders affecting adolescent through to senior athletes.
Level 3 syllabus - the athletic shoulder
MTS™ Level 3 - Day I
TOPIC 8 - SUBACROMIAL & SLAP DISORDERS
- Examination of the Athletic Shoulder
- Bursal, Cuff & Biceps Disorders
- Acute vs Chronic inflammatory patterns
- Acute Inflammatory Bursitis management
- Cuff Tendinopathy - does it produce pain ?
- SLAP lesions of the shoulder
- Managing pain symptoms
- Exercise corrections
- Strength & conditioning recommendations
- Managing effective rehabilitation
Practical Session
TOPIC 9 - IMPINGEMENT OF THE SHOULDER
- Impingement - where are we at ?
- Subacromial, subcoracoid and internal impingement
- ACJ considerations - what to look for
- A deep dive on plain films
- Key findings in US & MRI
- Solving impingement symptoms
- Injection & Surgical options
Case Studies
MTS™ Level 3 - Day 2
TOPIC 10A - GHJ OA - PHYSIO & SPORTS MEDICINE
- Clinical vs radiological findings
- Copycat pain drivers
- Exercise strategies for mild-mod GH OA
- Injection management outcomes
- Resistance training and clinical pearls
Practical Session
TOPIC 10B - GHJ OA - SURGICAL / POST SURGICAL
- Mod-severe GH OA options
- Hemi arthroplasty & interposition surgeries
- Total Shoulder Arthroplasty (TSA) vs rTSA
- Rehabilitation pearls
- Outcomes and athletic options
- Key rehabilitation technqiues
Case Studies
LEVEL 3 course QUESTIONS / DISCUSSION POINTS
Bursal, Cuff & Biceps Tendinopathy
Bursal, Cuff & Biceps Tendinopathy
Bursal, Cuff & Biceps Tendinopathy
- How does acute vs chronic bursitis management differ ?
- How is cuff tendinopathy measured ?
- When is cuff tendinopathy symptomatic ?
- Can you clinically test for cuff tears ?
- What are the normal cuff changes related to age ?
- What is swimmer's shoulder ?
- What is the ideal progression for cuff tendinopathy ?
- Can you solve chronic bursitis with exercise methods ?
- How do you keep the shoulder pain free ?
Solving Impingement Disorders
Bursal, Cuff & Biceps Tendinopathy
Bursal, Cuff & Biceps Tendinopathy
- Where is the research at ? How successful is physiotherapy ?
- What problems are we looking for ?
- Are there particular x-rays that are important ? Will it be reported ?
- What should you look for on US and MRI/A reports ?
- Are there clinical tests that are helpful to use ?
- What are the sports medicine options ? Surgical options ?
- How, where and how often should injections be applied ?
- Is there a role for dry / wet needling ?
- What should a patient ask a surgeon and how do you avoid poor outcomes ?
Glenohumeral Osteoarthritis
Glenohumeral Osteoarthritis
Glenohumeral Osteoarthritis
- What are the differentials for GHJ osteoarthritis ?
- Is it important to see the films directly ?
- What are the key measures for grading GHJ OA ?
- Are there exercise choices to avoid in mid stage OA ?
- What are the recommended movements for reducing OA pain ?
- How should exercise be progressed ?
- What is the role of injection work ? How often and what injectables are best for the shoulder ?
- Are manual therapy techniques useful for pain relief ?
- Are EPAs effective for pain relief ?
- How do you maximize function of the GHJ OA shoulder ?
Total Shoulder Arthroplasty
Glenohumeral Osteoarthritis
Glenohumeral Osteoarthritis
- What determines the choice of shoulder replacement ?
- How good are the outcomes for hemi, interposition and total joint surgeries ?
- Explain the key rehabilitation issues for reverse TSR (rTSR) ?
- What type of movement is normally seen in reverse prostheses ?
- What are the early and late complications of replacements ?
- What do you need to know from the surgeon ?
- How do you avoid joint stiffness for TSR and rTSR ?
- What are the ideal range of motion goals ?
- Are there particular precautions for both surgeries ?
- What are the limitations for sport and exercise ?
MTS™ CLINICAL CASE
39 y/o female competitive athlete with restricted shoulder rotation and pain
A competitive volleyball player has noticed increasing shoulder pain on serving, blocking and spiking for the past 4 months. The symptoms have been ongoing for the past 3 years, and a full season of rest, two weeks of anti-inflammatories and regular icing has not improved the concern. She regularly strength trains and has seen several therapists without improvement. She is considering a PRP injection with her sports medicine doctor.
Examination reveals a mixture of positive subacromial, bicep and ACJ tests. Rotational movements in flexion create high sensitivity. X-rays are reported as normal, a recent US demonstrates some bursal thickening and no cuff tears visible. Posterior joint and suprascapular notch are clear. MRI shows some distal clavicle edema, no cuff tear, type II acromion and no obvious labral pathology.
- Cuff and overhead exercises make the shoulder sore - how would you proceed ?
- What parts of the current investigations would you need to confirm ? What could you be looking for ?
- Are there manual therapy and exercise choices that are likely to help ?
- What clinical tests would be helpful in determining injection choices ?
- What advice would you give for return to training, play and competition ?
- What might the surgical remedies look like and how should they be approached for best outcomes ?
- What are the likely points to consider between management and curative solutions ?
