REGISTER NOW FOR NATIONAL SHOULDER COURSES & THE VANCOUVER LECTURE SERIES (VLS)
THE COMPLEX SHOULDER / CASP DESIGNATION
MTS™ LEVEL 4
Our multidisciplinary shoulder course with PT certification.
Our finishing shoulder course with an in depth look at managing calcific tendinopathy, proficiency in shoulder imaging, working with rare disorders and understanding complex shoulder pain.
This course includes the CASP certification exam.
Level 4 syllabus - THE COMPLEX SHOULDER / CERTIFICATION
MTS™ Level 4 - Day I
TOPIC 11 - CALCIFIC TENDINOPATHY
- Examination signs & symptoms
- Classifications of calcific tendinopathy
- Pathology lifecycle
- Physiotherapy management
- Prevention strategies
- Barbotage / UGPL vs Shockwave
- Post recovery management
- Treatment resistant options
Case Studies / Q&A
TOPIC 12 - UNDERSTANDING IMAGING - PEARLS & PITFALLS
- X-Ray Investigations - what's missing ?
- MRI vs US vs MRA - what to look for ?
- CT & Bone Scans - when are these important ?
- Imaging vs Surgical Observations - hidden pathologies.
Case Studies & Discussion
TOPIC 13 - NEUROVASCULAR & RARE DISORDERS OF THE SHOULDER
- EMG studies - how do they work
- Vascular workup for TOS symptoms
- Management of suprascapular, axillary, accessory and LTN nerve palsies
- A selection of uncommon and rare disorders affecting the shoulder including MDI, EDS, FSHD, Stiff Person's Syndrome, PMR, HNPP, Brachial Neuritis
- Vascular complaints affecting the shoulder
- Neural provocation tests and use - clinical practice effects
MTS™ Level 4 - Day 2
TOPIC 14 - SOLVING COMPLEX PAIN PATTERNS
- Mechanical, inflammatory and neuropathic factors
- Recommended approaches to deciphering pain drivers
- The use of specific pharmacology for MSK disorders
- Injection strategies and surgical choices
- Cycle of recovery with spinal integration
- Staging manual therapy, exercise and technical components
EXTENDED REVIEW AND Q&A LEVELS 1-4
- Small breakout groups for review
- Q&A of any material from MTS™ Levels 1-4
CASP EXAMINATION
- 100 question, 90 minute examination
- (Downloadable sample exam at registration)
certification - advanced shoulder practice (CASP)
A Complete Understanding of the Shoulder
Solving shoulder disorders can be complex. There are over 50 different shoulder disorders, multiple joint considerations and often more than one source of pain for any patient complaint. Patients are often seeking clinical management expertise when attending specialty MSK physio.
Mastering the Shoulder™ Series provides a complete training program in shoulder disorders with certification offered after successful examination and completion of MTS™ Levels 1-4.
The CASP designation (Certified Advanced Shoulder Practice) is offered to clinicians interested in demonstrating their advanced training in shoulder pathology, movement disorders and pain.
Three distinctive skills of MSK practice make up the CASP designation:
- Reliable and accurate examination skills, including applied anatomy, pathology & radiology
- Understanding common disorders, effective treatment strategies & applied problem solving skills
- Sports medicine and surgical knowledge to assist patients with treatment direction and procedures.
The Most Comprehensive Shoulder Series Available.
Over four weekends, we cover examination, multidisciplinary management and how to successfully treat more than 20 specific shoulder disorders. You'll learn the skills to problem solve, assess radiology, understand difficult disorders and develop exceptional clinical skills in your practice.
A final weekend is offered, Level V - The Spine, to incorporate key examination, treatment and multidisciplinary skills in solving complex shoulder pain and upper quadrant complaints.
ADVANCED PRACTICE Certification
Advanced practice certification is offered with the following benefits:
- Use of the CASP designation, demonstrating your advanced skills in managing shoulder / upper quadrant complaints.
- Wall certificate indicating your successful completion of the examination
- Complimentary access to Shoulder PT.ca - updates, clinical cases and new topics
- Access to THE SPINE course that adds cervical and thoracic techniques, including new stabilization training skills for collapsing many upper quadrant complaints.
The Spine
After successful completion of the Level 4 course and examination, you will be invited to participate in the final course - THE SPINE, covering key technical aspects of cervical mobilization and stabilization, preferred thoracic treatments and solving complex upper quadrant pain patterns.
The final piece of the puzzle to solving many shoulder pain complaints that are amplified or generated from the upper spine.
Ongoing Professional Support @ ShoulderPT
ShoulderPT offers all physiotherapists the option of staying up to date with specialty MSK skills. This includes new protocols, radiology pearls, surgical insights and new treatments being clinically tested in specialty MSK practice.
ShoulderPT has a unique multidisciplinary team of experts spanning radiology, sports medicine, physiatry, neurology and surgical fields to add to your multidisciplinary knowledge.
We'll offer concise, quarterly updates on clinically applied topics using case examples, recommended treatments for specific conditions, MSK self tests and the opportunity for direct Q&A.
We believe this is the best balance of new information, tested protocols and multidisciplinary knowledge for the busy clinician and the clinician looking for the best clinical results.
Level 4 Course questions / discussion points
Calcific Tendinopathy
Understanding Imaging - Pearls & Pitfalls
Understanding Imaging - Pearls & Pitfalls
- Who gets calcific tendinopathy ?
- How does it clinically present ?
- How is calcium best imaged ?
- What is the gold standard of imaging ?
- What measurements should be taken ?
- Is it important to see the film ?
- Why isn't MRI helpful ?
- Can calcium be asymptomatic ?
- What is the ideal treatment for calcific tendinopathy ?
- Which manual therapy techniques are helpful ?
- When should I start stretching or exercising the shoulder ?
- How do you choose between barbotage (UGPL) vs shockwave ?
- What are the current research outcomes ? Are they clinically applicable ?
- How do you solve 'treatment resistant ' cases ?
- Are steroid injections just as helpful as barbotage ?
- What are the risks of barbotage ? Shockwave ?
- Is surgery ever indicated for this problem ?
- Are there other useful injection procedures ?
Understanding Imaging - Pearls & Pitfalls
Understanding Imaging - Pearls & Pitfalls
Understanding Imaging - Pearls & Pitfalls
- What are the key x-rays views of the shoulder ?
- What are the novel views used for ?
- How should you interpret x-ray reports ?
- What is a good vs poor report ?
- What to look for when directly assessing films ?
- What does AVN look like ?
- What interval measurements are useful ?
- What unusual problems can be found on x-rays ?
- Challenges for radiologists
- What are the limitations of ultrasound exams ?
- What are the required shoulder positions ?
- How reliable is the US report that your are reading ?
- What are the common errors and rates on US ?
- How can you tell if an US report is accurate ?
- Challenges for radiologists
- What are the limitations of MRI / MRA scans ?
- What are the key indications for use ?
- What to look for on an MRI report ?
- Radiology vs Surgeon differences ?
- Pitfalls of MRI scans for surgical review
- Challenges for radiologists
- Bone scans and CT for the shoulder
- Indications and use
Neurovascular & Rare Disorders
Neurovascular & Rare Disorders
Neurovascular & Rare Disorders
- What is involved in a neurology exam ?
- What key features are tested ?
- Neurology pearls and pitfalls
- Understanding EMG examinations
- What are the known vascular disorders of the shoulder ? How are they tested ?
- When is angiography used for the shoulder ?
- What is the workup for TOS ? What criteria have to be satisfied ?
- What are the treatment principles for TOS ? Vascular vs neurogenic ?
- How can EDS affect the shoulder ?
- What are some of the mechanical challenges ?
- What are some diagnostic clues for stiff person syndrome ?
- What are the outcomes for FSHD like ?
- How does PMR present ? What is the diagnostic measure ?
- What are the MDI principles of treatment ? What are the patient characteristics ?
- How can you differentiate HNPP vs Brachial Neurits ?
- What are the management principles for LTN palsy ? SSP palsy ?
- How successful are operative procedures and what is appropriate ?
Solving Complex Pain Patterns
Neurovascular & Rare Disorders
Neurovascular & Rare Disorders
- How should complex pain patterns be organized ?
- What key information is important to identify ?
- Are there clues buried in the history ?
- Understanding limitations of shoulder examination ?
- What are the known pathologies that can lead to long term pain ?
- Do we need to separate mechanical and inflammatory pain ?
- When should you class pain as neuropathic ?
- When should you class pain as neuropathic ?
- How can you use medication for diagnostic and treatment purposes ?
- What are the expected recovery times ?
- What are the essential radiology investigations ?
- When should I ask for an US ? MRI ?
- How to distinguish between radicular and non-radicular pain ?
- How do you exclude the spine as a source of pain ?
- What are the key strategies for solving spinal pain ?
- Should you treat the spine or shoulder first ?
- Serial examination while solving chronic upper quadrant pain - how and when ?
- When should you use injection therapy ?
- Identifying surgical need - when is it appropriate to refer ?
MTS™ CLINICAL CASE
47 y/o female patient with severe shoulder pain
A patient is referred to you for severe right shoulder pain of 2 weeks. She complains of regular night pain, difficulty with arm movement and no prior history of shoulder disorders. No trauma, minimal improvement with physiotherapy in her community, a recent flare with massage and no effect of regular OTC NSAID use. Right dominant.
Examination reveals difficulty in early movement, particularly flexion and abduction (limited to 30 deg). Muscle power around the shoulder is reduced 4-/5 in elbow flexion, abduction, IR and ER, limited by pain. Special tests are limited. No muscle loss around the scapula. She is tender to palpation over the ACJ and subacromially. Passive movement in ER is moderately restricted (50.70,90 throughout standard abduction points), with GHJ abd to 80 deg.
Mild restriction in cervical movements and moderate pain to light - med palpation along the facet line on the in all directions ar notch are clear. No reaction to cough and unable to perform spurling's test due to neck discomfort ( but no increase in shoulder pain).
She works as a musician and is having difficulty with preparing for an up coming performance in two weeks. She is hoping for a diagnosis and effective pain relief as she is unsure about her upcoming performance.
- What further investigations would be helpful in this time period ?
- What methods / medications are likely to be successful for pain relief ?
- What are the spinal and shoulder differentials for her pain ?
- Are there precautions with physiotherapy treatment ?
- What would be your first treatment ?
- What expectations of pain relief can you provide to the patient ?
