A GRADUATE’S GUIDE: THE SHOULDER
- : Online
The content of this module was created and presented by the late Wendy Braybon – an Honoured Member of the APA and a much-loved and respected member of the sports physiotherapy community. Wendy’s family wish for her legacy to live on and support the publishing of this module. A percentage of the sales proceeds of this module will be donated to the Physiotherapy Research Foundation.
Part 1) Shoulder Anatomy, Kinematics and Mechanical Shoulder disorders
In this great summary of shoulder anatomy and kinematics, Wendy outlines how bony and passive structures are reinforced and maintained by dynamic neuromuscular stability mechanisms which are vital for optimal dynamic functional of the shoulder complex.
Such functional understanding is pivotal to provide an efficient assessment and treatment scaffold to differentially diagnose shoulder clinical issues, tendon disrepair, scapula Dyskinesis and dynamic functional deficits.
Part 2) The Shoulder: Assessment and Manual therapy
Understanding the key questions and systematic approach to subjective examination which demonstrated by Wendy, will provide key pieces to the differential diagnostic puzzle for patients presenting with shoulder pain.
A comprehensive history will direct the requirement of key objective assessment tests as no single test of the shoulder when positive or negative can run in or out a diagnosis. Wendy effectively demonstrates screening tools combined with clinical reasoning to build a shoulder assessment scaffold.
Symptom modification techniques and strength testing during assessment is demonstrated to prioritise manual therapy and exercise strategies in the shoulder complex. Wendy extends her assessment tests to the influence of scapula dyskinesis, thoracic spine and lower body kinetic chain. Wendy goes on to demonstrate key manual therapy techniques combined with combined movements and soft tissue techniques.
Part 3) Exercise and rehab strategies in treating the shoulder
Wendy emphasises the importance of progressed exercise prescription when treating the shoulder. She demonstrates specific positioning to optimise neuromuscular recruitment around the shoulder and scapula region with progressions to incorporate spinal, gluteal and the entire kinetic chain.
Specific tendon rehab strategies for the shoulder joint are discussed to minimise tendon compression during rehab and dose specific loading utilised as “Panadol for the tendon”. Wendy outlines the ‘24 hours of symptoms’ to specifically alter load and progress strength, power and increased speed.
Exercise based programs for rehab of multidirectional shoulder instability to retrain neuromuscular feedback and muscular patterning is demonstrated, progressing to functional strength. Exercise programs for the stiff shoulder are demonstrated, in addition to stretches for shoulder muscular tightness and thoracic mobility and a variety of taping techniques to settle pain and encourage neuromuscular patterning.
Exercise based programs
- Rehabilitation of multidirectional shoulder instability
- Retraining neuromuscular feedback and muscular patterning
- Progressions to functional strength
- The stiff shoulder
- Stretches for shoulder muscular tightness and thoracic mobility
- Taping techniques to settle pain and encourage neuromuscular patterning
Wendy Braybon, FACP was a Specialist Sports Physiotherapist and an APA Titled Musculoskeletal Physiotherapist. Wendy was involved with the Victorian Institute of Sport since 1992 and she was the VIS Head Physiotherapist since 2003 where she treated and assessed athletes from wide range of sports. Her role also included the coordination of the physiotherapists and soft tissue therapists.
Wendy was the Head physiotherapist for the Australian Olympic Team in London 2012. She has represented Australia as a physiotherapist at four Olympics games, five Softball World Championships and two Gymnastics World Championships. Wendy was the Team Physiotherapy Coordinator for the Melbourne 2006 Commonwealth Games, organised and managed a large team of physiotherapists to support the competing countries and in 2009 she was the Physiotherapist to the Australian Women’s Gymnastics team at the World Championships in London at the 2012 Olympic venue