Anne Cools - ShoulderDoc.co.uk
Anne Cools - ShoulderDoc.co.uk
Anne Cools - ShoulderDoc.co.uk
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Early detection of<br />
shoulder pathology in<br />
the overhead athlete<br />
A clinical reasoning algorithm<br />
Ann M. <strong>Cools</strong>, PT, PhD (Belgium)
Impingement symptoms<br />
External<br />
Subacromial<br />
impingement<br />
Internal<br />
(posterior)<br />
impingement<br />
Primary<br />
Impingement<br />
Secundary<br />
Impingement<br />
Rotator cuff<br />
pathology<br />
Biceps<br />
Scapular dyskinesis instability G.I.R.D.<br />
SLAP<br />
A <strong>Cools</strong> Wrightington 2009<br />
(<strong>Cools</strong> et al. BJSM 2008)
Impingement symptoms<br />
Jobe +<br />
Neer + ant<br />
Hawkins +<br />
Jobe –<br />
Neer + post<br />
Hawkins –<br />
External<br />
Subacromial<br />
impingement<br />
Internal<br />
(posterior)<br />
impingement<br />
Primary<br />
Impingement<br />
Secundary<br />
Impingement<br />
Rotator cuff<br />
pathology<br />
Biceps<br />
Scapular dyskinesis instability G.I.R.D.<br />
SLAP<br />
(<strong>Cools</strong> et al. BJSM 2008)
Impingement symptoms<br />
Jobe +<br />
Neer + ant<br />
Hawkins +<br />
Apprehension +(pain) ant<br />
External<br />
Subacromial<br />
impingement<br />
Internal<br />
(posterior)<br />
impingement<br />
Jobe –<br />
Neer + post<br />
Hawkins –<br />
Apprehension +(pain) post<br />
Relocation -<br />
Relocation+<br />
Release +(pain)<br />
Relocation+<br />
Release +(pain)<br />
Primary<br />
Impingement<br />
Secundary<br />
Impingement<br />
Rotator cuff<br />
pathology<br />
Biceps<br />
Scapular dyskinesis instability G.I.R.D.<br />
SLAP<br />
(<strong>Cools</strong> et al. BJSM 2008)
Impingement symptoms<br />
Jobe +<br />
Neer + ant<br />
Hawkins +<br />
Apprehension +(pain) ant<br />
External<br />
Subacromial<br />
impingement<br />
Internal<br />
(posterior)<br />
impingement<br />
Jobe –<br />
Neer + post<br />
Hawkins –<br />
Apprehension +(pain) post<br />
Relocation -<br />
Relocation+<br />
Release +(pain)<br />
Relocation+<br />
Release +(pain)<br />
Primary<br />
Impingement<br />
Secundary<br />
Impingement<br />
Full Can +<br />
Rotator cuff<br />
pathology<br />
Biceps<br />
Scapular dyskinesis instability G.I.R.D.<br />
SLAP<br />
(<strong>Cools</strong> et al. BJSM 2008)
Impingement symptoms<br />
Jobe +<br />
Neer + ant<br />
Hawkins +<br />
Apprehension +(pain) ant<br />
External<br />
Subacromial<br />
impingement<br />
Internal<br />
(posterior)<br />
impingement<br />
Jobe –<br />
Neer + post<br />
Hawkins –<br />
Apprehension +(pain) post<br />
Relocation -<br />
Relocation+<br />
Release +(pain)<br />
Relocation+<br />
Release +(pain)<br />
Primary<br />
Impingement<br />
Secundary<br />
Impingement<br />
Full Can +<br />
Rotator cuff<br />
pathology<br />
SAT +<br />
SRT +<br />
Biceps<br />
Scapular dyskinesis instability G.I.R.D.<br />
SLAP<br />
(<strong>Cools</strong> et al. BJSM 2008)
Impingement symptoms<br />
Jobe +<br />
Neer + ant<br />
Hawkins +<br />
Apprehension +(pain) ant<br />
External<br />
Subacromial<br />
impingement<br />
Internal<br />
(posterior)<br />
impingement<br />
Jobe –<br />
Neer + post<br />
Hawkins –<br />
Apprehension +(pain) post<br />
Relocation -<br />
Relocation+<br />
Release +(pain)<br />
Relocation+<br />
Release +(pain)<br />
Primary<br />
Impingement<br />
Secundary<br />
Impingement<br />
Full Can +<br />
Rotator cuff<br />
pathology<br />
SAT +<br />
SRT +<br />
Laxity tests +<br />
Appr + (appr)<br />
Relocation + (appr)<br />
Biceps<br />
Scapular dyskinesis instability G.I.R.D.<br />
SLAP<br />
(<strong>Cools</strong> et al. BJSM 2008)
Impingement symptoms<br />
Jobe +<br />
Neer + ant<br />
Hawkins +<br />
Apprehension +(pain) ant<br />
External<br />
Subacromial<br />
impingement<br />
Internal<br />
(posterior)<br />
impingement<br />
Jobe –<br />
Neer + post<br />
Hawkins –<br />
Apprehension +(pain) post<br />
Relocation -<br />
Relocation+<br />
Release +(pain)<br />
Relocation+<br />
Release +(pain)<br />
Primary<br />
Impingement<br />
Secundary<br />
Impingement<br />
Full Can +<br />
Rotator cuff<br />
pathology<br />
SAT +<br />
SRT +<br />
Laxity tests +<br />
Appr + (appr)<br />
Relocation + (appr)<br />
O’Brien+<br />
Speeds+<br />
Biceps load II+<br />
Biceps<br />
Scapular dyskinesis instability G.I.R.D.<br />
SLAP<br />
(<strong>Cools</strong> et al. BJSM 2008)
Impingement symptoms<br />
Jobe +<br />
Neer + ant<br />
Hawkins +<br />
Apprehension +(pain) ant<br />
External<br />
Subacromial<br />
impingement<br />
Internal<br />
(posterior)<br />
impingement<br />
Jobe –<br />
Neer + post<br />
Hawkins –<br />
Apprehension +(pain) post<br />
Relocation -<br />
Relocation+<br />
Release +(pain)<br />
Relocation+<br />
Release +(pain)<br />
Primary<br />
Impingement<br />
Secundary<br />
Impingement<br />
Full Can +<br />
Rotator cuff<br />
pathology<br />
SAT +<br />
SRT +<br />
Laxity tests +<br />
Appr + (appr)<br />
Relocation + (appr)<br />
O’Brien+<br />
Speeds+<br />
Biceps load II+<br />
Biceps<br />
Scapular dyskinesis instability G.I.R.D.<br />
SLAP<br />
IR<br />
ROM↓<br />
(<strong>Cools</strong> et al. BJSM 2008)
More information?<br />
www.standaarduitgeverij.be<br />
Ann.<strong>co</strong>ols@ugent.be<br />
A <strong>Cools</strong> Wrightington 2009
Thank you<br />
(Gent- Belgium)<br />
A <strong>Cools</strong> Wrightington 2009
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