Shoulder Girdle & Forearm.
Movement Analysis, Sub-classification & Neuromuscular Retraining for Functional Movement Control.
Avoir suivi le cours Sub-classification & Clinical Prediction Rules for Neuromuscular Rehab
Endroit où se déroule le cours
Clinique Physioactif Laval
3224 avenue Jean Béraud, Bureau 220
Laval, Québec, H7T 2S4
Date du cours
3 jours du 21 au 23 février 2020
21 février de 13h30 à 18h30
22 et 23 février de 8h30 à 16h30
897$ + taxes
Date limite pour s’inscrire :
4 semaines avant le cours, pour une inscription tardive, appelez-nous.
Politique d’annulation :
Plus de 4 semaines avant le début du cours : remboursement complet moins frais administratif de 50$
Entre 1 et 4 semaines avant le début du cours : remboursement de 50%
Moins d’une semaine avant le début du cours : aucun remboursement
Shoulder girdle and forearm symptoms can arise from trauma, but frequently it is an insidious, recurrent and an ongoing problem for many people. This is often related to their movement patterns and neuromuscular control around the scapula-thoracic, glenohumeral joints and forearm.
Alteration of muscle activation of the scapula-thoracic muscles can result in the scapula adopting a downwardly rotated resting position and / or a loss of dynamic control of the scapula in functional arm movements. This can cause tissue impingement under the subacromial arch or the coracoid causing or provoking the patient’s pathology. The glenohumeral joint frequently displays a dysfunctional pattern of excessive anterior translation, which is often combined with other neuromuscular deficits. This translation control deficit can contribute to an impingement and / or glenohumeral joint pathology. It is also a common neurodynamic interface. An anterior sitting humeral head also alters normal movement of the forearm and hand. This course involves a detailed assessment of neuromuscular control deficits of the scapula-thoracic, glenohumeral joints and forearm.
Specific motor control retraining strategies will be introduced using a comprehensive and evidence based clinical reasoning process. This involves; specific activation of the appropriate stability muscles to control segmental translation of the glenohumeral joint, scapulothoracic proximal and distal radioulnar joints, the carpus and the hand; the retraining of specific muscles to correct movement pattern control deficits; dynamic control of the scapula in functional movements; and the integration of these training strategies into a wider base of rehabilitation options. This can remove the tissue provocation and promote the normal healing process. Assessing and correcting scapula and glenohumeral movement can significantly improve post operative results as well.
Also covered are the relationship between scapular control and cervical movement control deficits and the diagnostic accuracy of shoulder girdle orthopaedic tests. Some beneficial taping techniques will also be used.
The exercise progressions are described and strategies for the integration into function are discussed with participant examples and case studies.
- Make an accurate movement pattern control diagnosis and relate this to the client’s presentation
- Distinguish shoulder pain between the scapula, glenohumeral joint and cervical spine with a movement pattern control assessment
- Understand the relationship of scapular dysfunction to cervical dysfunction and glenohumeral dysfunction to forearm dysfunction
- Use movement patterns as a clinical reasoning tool to help guide manual therapy and other techniques
- Integrate the treatment of movement patterns and translation control into clinical practice
What Will You Get From This Course That You May Not Already Have?
The grasp primitive reflex is present in about 40% of the population. This contributes to increased muscle tone in the shoulder girdle and upper limb. We will show you how to treat it and how other primitive reflexes and sensory motor deficits are related to ongoing motor control deficits.
Kinetic Medial Rotation Test
The Kinetic Medial Rotation test is a newly validated test of shoulder girdle function (Morrisey, 2005). This test differentiates between scapular and glenohumeral joint problems within the shoulder girdle. This helps give us a diagnosis and also lets us set priorities in rehabilitation.
Upper Trapezius is a Good Guy Muscle
Upper trapezius does not elevate the scapula – it has a local and global stability role for the neck and shoulder girdle. It has a major stability influence on the neck, shoulder and thoracic spine. It has an anticipatory timing pattern and is delayed with pain – similar to Transversus. It also experiences sudden atrophy – similar to Multifidus. It rarely loses extensibility so assessment and retaining needs to be specific. Lower trapezius does not pull the inferior angle of the scapula down and in. There are better ways to train lower trapezius for scapular stability!
Anconeus, Supinator and Pronator Quadratus
These muscles have a translation control role in the forearm. We have developed specific exercises like multifidus in the lumbar spine.
Wrist and Thumb Stability
Our detailed dissection has identified a mechanism to stabilize the wrist, thumb and individual joints of the fingers.
Myofascial Trigger Point Release (MTPR)
Mobilizer muscles tend to get short and/or dominate movements which contribute to faulty patterns and pain. MTPR to the mobilizer muscles can create a good window of opportunity to change movement quality and help manage symptoms.
Neurodynamic reactivity can significantly affect the way people move. We’ll show how movement can be used to treat neurodynamic reactivity.
There are some great taping techniques for the shoulder girdle, forearm and neurodynamics!
Sean Gibbons graduated from Manchester University in 1995. He has been rehabilitating movement patterns for over 20 years. He researched and developed numerous advances to the cognitive control of movement including which postural and primitive reflexes influence move- ment and key aspects neurodevelopment. His PhD was on the development of a prescriptive clinical prediction rule for specific motor control exercises in low back pain.
Key new sub-classifications were identified: Neurological Factors, which are related to poor movement and the ability to learn; Midline as a sensory system which is critical to Body Image Pain; and Neuro-Im- mune dysregulation, which is critical for Central Sensitization and Psychosocial Factors. His current work involves further researching the sub-classification model. His dissection and research into psoas major, gluteus maximus and other muscles has led to the development of new rehabilitation options. He has presented his research at national and international confe- rences and has several journal publications and book chapters.
He is an Assistant Clinical Professor (Adjunct) at McMaster's Advanced Orthopaedic Musculoskeletal / Manipulative Physiotherapy specialization and lectures at Manchester Metropolitan University's Masters in Advanced Physiotherapy program.