Clinical assessment and treatment of patients with non-surgical shoulder instability can be complex and overlap with other clinical entities. Although a well-designed rehabilitation program can often prevent progress may be disrupted by several challenging pitfalls. This course will discuss the pathophysiology and related anatomy for shoulder micro – instability, as well as discuss traumatic causes for shoulder instability. The relationship between hyperlaxity, scapula dyskinesis, secondary impingement and sub-optimal rotator cuff neuromuscular control will be reviewed. The clinical evaluation, as well as differential diagnosis, for patients with suspected shoulder instability will be presented, and the most evidence-based clinical / special tests will be discussed. Updated clinical prediction rules pertaining to successful non-surgical vs. surgical management will be presented. A comprehensive evidence-based rehabilitation approach will be emphasized, with a focus on scapula stabilization and neuromuscular control exercises, posterior glenohumeral capsule stretches, rotator cuff neuromuscular control, postural correction and higher-level sport-specific exercises. Video demonstration of exercise and manual interventions are utilized to reinforce correct techniques rotator cuff program will be discussed for patients with different degrees of pathology or impairments. Phase-based rehabilitation guidelines are presented, including transitioning the patient to sport- specific training programs.
- Identify the most accurate clinical test for anterior shoulder micro-instability
- Identify 2 complications following anterior acute dislocation
- Identify 3 components of an initial evaluation for a patient presenting with non-traumatic shoulder instability
- Identify one appropriate intervention (exercise) for phase I, phase II and phase III non-surgical rehabilitation program for anterior micro-instability
- 8:00 – Functional Anatomy
- 8:10 – Classification of shoulder Instability
- 8:20 – Complications following acute dislocation
- 8:25 – Pathophysiology and relationship to associated conditions
- 8:35 – Evaluation & Differential Diagnosis
- 8:55 – Rehabilitation
- 9:30 – Q/A Session and Adjourn
- Dr. Robert McCabe, MS, DPT, OCS
Dr McCabe is a clinician, researcher, and educator with 25 years of clinical experience in orthopedic and sports physical therapy. He is currently the director of human performance at the Gabreski Air National Guard Base in Westhampton, NY. His role at Gabreski includes overseeing injury prevention, performance and rehabilitation services for all military personnel. He has extensive experience in the treatment of patients with orthopedic and sports-related conditions. including recreational, elite and professional athletes. He previously worked at NYU Langone Medical Center and the Andrews Institute, where he worked under Dr. James Andrews. Bob received his transitional doctorate degree in physical therapy from Arcadia University, a master’s degree in physical therapy from Long Island University and a master’s degree in Ergonomics and Biomechanics from New York University. He obtained his bachelor’s degree in health science from Cortland University. Bob is an NSCA certified strength and conditioning specialist (C.S.C.S) and an APTA Board Certified Orthopedic Clinical Specialist (O.C.S). He is certified in the Functional Movement Screen (F.M.S) and the Selective Functional Movement Screes (S.F.M.A) and is completing his certification in manual therapy through Evidence in Motion. He has advance training and coursework in Graston instrument-assisted soft tissue mobilizations, EXOS performance training system, Active Release Therapy and the McKenzie Method to Mechanical Diagnosis and Therapy (MDT). Bob has published several research studies in peer-reviewed journals and has presented at national conferences.
Contact Hours: 1.5