031. Scapula assessment in shoulder pain with Ann Cools




Physio Edge podcast show

Summary: Shoulder pain patients often have poor scapula control. Is their shoulder pain caused by poor scapula control, or is their scapula dysfunction caused by shoulder pain? When your patients present with shoulder pain, should your focus be on scapula control, glenohumeral control, or treatment of the neck and thorax?  In this podcast, David Pope talks to Ann Cools, a Physiotherapist and Head of Education for Rehabilitation Sciences and Physiotherapy at Ghent University in Belgium, and is also the founding member and president (2010–2012) of EUSSER - European Society of Shoulder and Elbow Rehabilitation. We discuss in detail assessment of the scapula, the role of the scapula in shoulder pain and how to retrain unruly scapulae. Other topics covered in this podcast include: Research by Ann Cools What we currently know from the research about the role, movement and control of  the scapula Scapula dyskinesis - what is it Static vs dynamic assessment of the scapula Altering muscle balance and timing with specific exercises How altering scapula mechanics effects muscle balance around the shoulder Important parts of the subjective history Scapula vs glenohumeral joint How subjective will guide your objective assessment and treatment Red flags around the shoulder, nerve pathology and frozen shoulder Frozen shoulder imaging Nerve injuries - symptoms, objective examination and treatment Assessment of the scapula, Type 1 scapula dyskinesis Differentiating contributors to Type 1 scapula dyskinesis (anteriorly rotated scapula) Testing GHJ IR Clinical Edge and online education on the shoulder Stretching and shoulder joint mobilisation Palpation, stretching and manual therapy for pec minor Type 2 scapula dysfunction Handheld dynamometry - serratus Handheld dynamometry - middle and lower traps Pain when strength testing Type 3 scapula dysfunction Dynamic assessment of the scapula To retract and depress the scapula or not? Shoulder Symptom Modification Procedure (SSMP) by Jeremy Lewis Special tests around the shoulder Laxity tests for the GH joint Posterior GHJ laxity Anterior GHJ laxity Explanations of scapula dysfunction to your patients Information on Ann Cools  EUSSER Timeline: 0:30 Research by Ann Cools 4:20 What we currently know from the research about the scapula 6:30 Scapula dyskinesis - what is it 8:30 Static vs dynamic assessment of the scapula 11:45 Altering muscle balance and timing with specific exercises 13:15 How altering scapula mechanics effects muscle balance around the shoulder 14:10 Important parts of the subjective history 16:20 Scapula vs glenohumeral joint 18:20 How subjective will guide your objective assessment and treatment 18:55 Red flags around the shoulder, nerve pathology and frozen shoulder 21:15 Frozen shoulder imaging 21:45 Nerve injuries - symptoms, objective examination and treatment 30:30 Assessment of the scapula, Type 1 scapula dyskinesis 35:00 Differentiating contributors to Type 1 scapula dyskinesis (anteriorly rotated scapula) 36:10 Testing GHJ IR 42:00 Clinical Edge 44:00 Stretching and shoulder joint mobilisation 51:45 Palpation, stretching and manual therapy for pec minor 55:40 Type 2 scapula dysfunction 59:20 Handheld dynamometry - serratus 1:00:51 Handheld dynamometry - middle and lower traps 1:03:54 Pain when strength testing 1:04:50 Type 3 scapula dysfunction 1:10:03 Dynamic assessment of the scapula 1:15:00 To retract and depress the scapula or not? 1:16:23 Shoulder Symptom Modification Procedure (SSMP) by Jeremy Lewis 1:17:50 Special tests around the shoulder 1:20:35 Laxity tests for the GH joint 1:23:00 Posterior GHJ laxity 1:24:30 Anterior GHJ laxity 1:26:20 Explanations of scapula dysfunction to your patients 1:31:00 Information on Ann Cools  1:32:20 EUSSER 1:33:00 Wrap up Links of Interest Anne Cools on Linked In Ann Cools’ Research Ann Cools at Ghent University Ann on Twitter Clinical Edge Show your love for the Physio Edge podcast with a review on iTunes