Full Course Description

Comprehensive Evaluation and Treatment of the Shoulder Complex

A shoulder patient is rarely ‘just a shoulder.’ Differentiating between the rotator cuff, impingement, referred pain from the cervical spine, the thoracic spine, postural dysfunction and more - will even leave experienced clinicians scratching their heads.

Adding to the challenge is the often vague and diffuse symptom reports patient’s offer as they struggle to describe what they feel, other than, “it hurts.”

Successful treatment of the shoulder is just as dependent on your differential diagnosis as it is on any of your interventions.

A complicated process — simplified! You will get to the root cause of impairment faster and confidently with a comprehensive assessment to:

Accurately assess the rotator cuff, labrum, joint capsule and ligaments
Identify contributions from the AC, SC and scapulothoracic joints
Objectively and efficiently assess involvement of the cervical and thoracic spine
Live demonstrations and case studies by physical therapist & athletic trainer, Katie DuFrene, PT, DPT, LAT

Knowing is half the battle, next is what you do about it. With an emphasis on function, treatment strategies utilize multiplanar dynamic application. Covered techniques include manual therapy, active mobilization techniques, strengthening, neuromuscular re-education, PNF and more! All of which can be done with simple tools you likely already have in the clinic.

Your success and recognition as the go to shoulder specialist awaits, and at an exceptional price when you register by May 22, 2023.

Program Information

Objectives

Investigate anatomy of the shoulder and its surrounding regions.
Develop a logical and practical assessment of the shoulder, cervical and thoracic spine (including assessment of posture, mobility, strength and palpation).
Propose and clarify the many differential diagnoses that can present as shoulder pain.
Investigate a wide range of treatment techniques to address impairments identified in a shoulder assessment.
Assess barriers/factors that limit progress in shoulder function as it relates to ADLs and occupational tasks.
Apply the assessments and interventions discussed in this seminar to a series of interactive case scenarios.

Outline

Assessment of the Shoulder, Thoracic Spine, Scapula

Posture
- Upper Crossed Syndrome
  - FHP, rounded shoulders, increased thoracic kyphosis
Contributing causes
Functional Impact
- Impaired scapular movement pattern
- Posterior/anterior: muscular tone
Joints
- GH joint
- SC and AC joints
- Scapulothoracic joint
Key muscle of the shoulder complex
Ligaments, joint capsule, labrum
AROM Screen of shoulder, c-spine and t-spine
- FMS/SFMA Movement Screen
  - Cervical spine
  - Shoulder positions 1 and 2
  - Multisegmental flexion/extension
  - Multisegmental rotation
Strength Assessment
Palpation
- Tenderness, tone, joint mobility
- Scapular glides, thoracic PA glides

Differential Diagnosis

Instability
Impingement
- Subacromial vs GH
Rotator Cuff Pathology
- Referral patterns, weakness
Labral Tear
- Catching, peel back mechanism
Biceps tendonitis
Cervical radiculopathy
Red flags- when to refer

Treatment – Mobilization

IASTM, cupping, STM, TPR
Joint mobilization
- Scapula, GH, thoracic/1st rib, AC & SC joint
Capsular stretch
Active Treatment Strategies
- Foam roll, tennis ball
Thoracic mobility
- Seated thoracic ext
- Physio ball
- Prone chin tuck
Self-Stretch/Home Program
- Pecs, lats, subscap, posterior capsule

Treatment - Strengthening

Scapular Stability
- Lower trap, serratus
  - Lower trap progression
  - Dynamic planks
- Mid Trap/Rhomboids
Neuromuscular Re-education
- Dynamic use of physio ball, medicine ball, foam, planking
Rotator Cuff Strengthening
- Isometric strengthening
- Resistance band
- Concentric/eccentric strengthening
- PNF, AROM

Critical Thinking – Bringing it all Together

Limited overhead shoulder flexion:
- What posture may be causing this?
- What shoulder extensors could be limiting it?
- What shoulder elevators may be weak/inhibited?
- What scapulothoracic mechanics are needed?
Limited overhead shoulder abduction:
- What posture may be causing this?
- What shoulder adductors could be limiting it?
- What shoulder elevators may be weak/inhibited?
- What scapulothoracic mechanics are needed?
Limited shoulder ER / Limited IR:
- What posture may be causing this?
- What muscles could be limiting it?
- What muscles may be weak/inhibited?
- What scapulothoracic mechanics are needed?

Target Audience

Physical Therapists
Physical Therapist Assistants
Occupational Therapists
Occupational Therapy Assistants
Athletic Trainers
Strength and Conditioning Specialists
Other Rehab and Healthcare Professionals

Copyright : 05/22/2023

Shoulder Disorders: An Evidence-Based Approach to Evaluation and Treatment

The shoulder is inherently instable – that’s why it has so much movement! One of the most daunting tasks facing rehab professionals is the in-depth understanding of the shoulder complex and how the intricate anatomy and biomechanics play into the non-surgical and post-surgical rehab process.

Dr. Rzepkowski bring 38 years of orthopedic experience to walk you through:

Which tests to use to quickly target the compromised structures
Manual and resistive exercise interventions to promote return of shoulder complex function
Best practices for pain management

But this seminar isn’t just for pre-op. When you’re following post-op protocol, it can be difficult to understand why the protocol is designed the way it is. In this seminar, you’ll also be able to SEE the surgical procedures to get a thorough understanding of why and how the protocols were developed. You’ll gain a better understanding of:

The importance of each ligament and how that impacts surgery and recovery
Why mechanical wear and tear is so common
The anatomy of impingement: videos that show what’s happening beneath the skin

When you treat patients requiring care for a wide range of shoulder pathologies ranging from tendonitis to total shoulder replacements, this in-depth understanding of the biomechanics is crucial. Watch Dr. Rzepkowski today to build your confidence in treating the various types of shoulder dysfunction you see in practice.

Program Information

Objectives

Assess the various mechanisms of shoulder injury both insidious and acute with the structures compromised.
Demonstrate clinical procedures (tests) for targeting compromised shoulder structures.
Evaluate surgical procedures for the shoulder.
Inspect the role of scapular force couples in scapulo-humeral rhythm required for normal shoulder movement.
Utilize manual and resistive exercise interventions to promote return of shoulder complex function.

Outline

MECHANISMS OF SHOULDER INJURY

Insidious and acute
Structures that become compromised
Biomechanical roles in shoulder function
Anatomy of impingement

TARGETING COMPROMISED STRUCTURES: CLINICAL PROCEDURES

Clinical tests that identify issues quickly
Tests that assess for:
- Impingement
- Rotator cuff disorders
- Labral pathology
- Glenohumeral instability
- Correctly interpreting the special test data

INSIDER ACCESS TO SURGICAL PROCEDURES

Surgical video reviews of shoulder repairs
Sub acromial decompression
Rotator cuff repair
Labral repair
Bankart repair
Proximal shoulder fracture
Total shoulder
Reverse total shoulder

PAIN MANAGEMENT

Peri-operative procedures that reduce pain
How are Interscalene blocks performed
Use of non-narcotic pain cocktails to expedite discharge comfort

PROMOTE RETURN OF SHOULDER COMPLEX FUNCTION

Kinesiology of scapula-humeral rhythm
Priority sequencing of muscle groups
Custom exercises to facilitate rehab intervention
Manual therapy progressions
Incorporate custom exercise videos

Target Audience

Physical Therapists
Physical Therapy Assistants
Occupational Therapists
Occupational Therapy Assistants
Athletic Trainers
Doctors of Chiropractic
Licensed Massage Therapists
Certified Strength and Conditioning Specialists
Other Rehab and Healthcare Professionals

Copyright : 09/16/2021

Total Shoulder Arthroplasty: How Outcomes are Being Minimized Through Functional Neglect

Advances in Total Shoulder Arthroplasty (TSA), including reverse total shoulder Subscapularis and Deltoid sparing approaches have led to a 243% increase in the number of procedures performed over the past decade. As more clients elect to undergo TSA, orthopedic surgeons continue to report remarkable reduction in pain and increased range of motion. However, data suggests functional outcomes, proprioception, and a return to normal function have not improved despite surgical advances. This course will specifically address this mystery and how function should be the foundation of your post shoulder protocol. In addition, techniques and interventions will be presented that directly impact the areas often neglected with standard post TSA protocols.

Program Information

Objectives

Investigate the current projections and trends regarding total shoulder arthroplasty and reverse total shoulder arthroplasty.
Differentiate and expand on current surgical procedures, components, and minimally invasive options for the TSA client.
Distinguish the role of therapy in maximizing functional outcomes and proprioception while expanding beyond range of motion and pain.
Construct evidence-based treatment strategies emphasizing function and proprioception for the TSA client.
Master documentation strategies and functional terminology for the TSA client to justify therapy services to payer sources.

Outline

Projections and trends regarding total shoulder arthroplasty and reverse total shoulder arthroplasty

Introduction
Trends/Projections of TSA
Why TSA is increasing
Pandemic of Pain
Norms for ROM
Textbook vs. functional

Current surgical procedures, components, and minimally invasive options for the TSA client

Standard TSA surgical procedure
Reverse TSA
Subscapularis and Deltoid-Sparing
Outcomes TSA vs. RTSA

Role of therapy in maximizing functional outcomes

How is Post-TSA success measured?
Functional Neglect with standardized assessments
Constant, ASES, DASH, Simple, UCLA

Constructing evidence-based treatment strategies

Emphasizing function and proprioception for the TSA client
TSA protocols (what’s the problem?)
TSA Functional treatment emphasis
Seated/Standing Sliders

Documentation strategies

Justify therapy services to payer sources
Documentation Platforms with TSA client
Questions and Wrap-up

Target Audience

Physical Therapists
Physical Therapy Assistants
Occupational Therapists
Occupational Therapy Assistants
Athletic Trainers
Massage Therapists
Chiropractors

Copyright : 11/14/2021

Functional Movement Techniques for Golf Rehabilitation & Performance

Create custom programs tailored to the needs of golfers and increase your cash-based revenue stream! Dr. Meghan Helwig will help you to assess the most common impairments and walk through her tried and true methods for treating patients with impingement, poor movement patterns, post-joint replacement/labral tear repair and osteoarthritis. These streamlined tactics will improve posture and balance while also addressing mechanical issues commonly found in the golf swing. Best of all? Explore novel approaches that incorporate the tools you already own for faster recovery and better outcomes: myofascial cups, kinesiology tape, IASTM tools and compression bands. You’ll learn functional movement techniques that address the most common complaints from golfers, get results fast and set your services apart!

Program Information

Objectives

Investigate the combination of the joint by joint model and the skin/brain connection
Differentiate stability and/or mobility dysfunctions in the golf swing and how to identify possible “leaks in the system”
Appraise the general concepts behind the use of various tools and how they can be used to facilitate changes in posture and performance.

Outline

Systemic Influences on Movement & Performance

Joint by joint model
Skin/brain connection
Implications for kinematic swing sequence

Screening and Assessment for Golf Performance

Typical swing faults + correlated movement screens
Identify if stability or mobility is the main issue
Most common injuries and their impact on golf swing

Tools and Techniques to Improve Performance

Myofascial cups
Kinesiology tape
Instrument assisted soft tissue mobilization
Compression band therapy
Therapeutic exercise
Specific strategies for:
- Posture
- Balance
- Position
- Set up

Target Audience

Physical Therapists
Physical Therapy Assistants
Athletic Trainers
Massage Therapists
Chiropractors

You are more than a Geriatric Therapist! How to think Bigger

Your unique skillset is in DEMAND and your opportunities are vast. There’s so much more than the clinical role in a traditional setting such as skilled nursing, rehab hospital, and home health. In this session, we’ll explore trends occurring now and in the future, discuss how therapy professionals like you can make a bigger impact with the geriatric population, and provide ideas for programs and business opportunities that therapists can create and develop to help them move beyond the traditional therapist role.

Program Information

Objectives

Assess the trends occurring in the geriatric population now and in the future.
Determine how therapy professionals can make a bigger impact with the geriatric population.
Investigate potential programs and business opportunities that take therapists beyond the clinical role.

Outline

Assess trends occurring in the geriatric population
- Current & Future
Current State of Geriatric Therapy Practice
Identification of the major problem areas concerning the geriatric population and how therapy professionals can help solve these problems
Breakdown of potential programs and business opportunities

Target Audience

Athletic Trainers
Occupational Therapists
Occupational Therapy Assistants
Physical Therapists
Physical Therapy Assistants

Manual Therapy to Release the Frozen Shoulder

Adhesive capsulitis (AC) results in significant financial burden, pain and loss of quality of life. With a lack of understanding, clinicians may painfully and forcibly mobilize with disregard for the myofascial component of AC. This often negatively impacts future functional activity. This session will teach you proven manual therapy techniques that significantly improve outcomes for frozen shoulder. You’ll be better equipped to help your patient with mobility, circulation and pain management for peak functional performance.

Program Information

Objectives

Distinguish etiology, incidence, clinical presentation and classification of the stiff shoulder/adhesive capsulitis.
Assess examination techniques to identify shoulder impingement and AC.
Evaluate the use of manual therapy interventions to improve mobility and function for AC.
Assess current clinical practice guidelines (CPG) for management of AC and review of current evidence with case study example.

Outline

Assess for Adhesive Capsulitis
•   Etiology, incidence, clinical presentation
•   Diagnosis and classification
•   Orthopedic exam tools to identify AC and shoulder impingement
Manual Therapy Interventions
•   Myofascial
•   Soft tissue mobilization
•   Cupping therapy
•   Muscle energy/PNF
Clinical Practice Guidelines
•   Research review of current interventions
•   Case study

Target Audience

Athletic Trainers
Chiropractors
Occupational Therapists
Occupational Therapy Assistants
Physical Therapists
Physical Therapy Assistants