Terry Trundle – Rotator Cuff Dysfunction: Functional Recovery from Impingement & Surgery

Outline

Shoulder “The Open Kinetic Chain Challenge”

• What questions should we be asking about “today’s shoulder”
• Missing link in treating the geriatric shoulder
• Components of functionality
• Phases of rehabilitation based on recent evidence-based applications
• Concepts of the three P’s (Pivotors, Protectors, and Positioners)
• Role of scapula-thoracic stabilization for retraction, repositioning, and protraction preparation

Lab #1: Manual Mobility for the Scapula-Thoracic Articulation

• Glenohumeral primary impingement
  • Vital three-motion patterns
  • Decompression of the painful shoulder
  • Manual preparation glides for the glenohumeral joint
  • Updates on capsule mobility
  • Positional recruitment based on the therapeutic value of intervention
  • Non-operative and operative treatment of primary impingement
  • Development of the “healthy cuff” with the vital five home exercise programs

Lab #2: Manual Mobility for the Glenohumeral Joint

• Operative repairs for the rotator cuff lesions, including the geriatric considerations
  • Defining delayed intervention and its role in treatment guidelines
  • Scapula control for core stabilization
  • How to address shoulder “hike” dysfunction
  • Concepts of the “Geriatric Big Three” exercises
  • Benefits of closed kinetic chain stabilization
  • Outcome studies
• Secondary impingement and its rehabilitation to instability
  • Why secondary impingent is so difficult to access
  • Subjective assessment outweighs objective findings
  • Protective exercise guidelines for labrum, SLAP lesions, and capsule instability

Lab #3: Screening of the Painful Shoulder – How Do You Define Shoulder Function?

• History of the problem
• Subjective level of pain
• Location of pain
• Clinical screening with special testing
• Discussion of the three components of referral
• Case presentations