Introduction shoulder course
This is the first course in the series of Orthopaedic Medicine.
What you will learn
- A thorough knowledge of the functional anatomy of the tissues of the moving parts.
- A precise palpatory anatomy of the different regions of the body.
- A basic knowledge in the biomechanics of the different joints.
- A detailed knowledge of the clinical examination (history taking and functional examination) of patients with complaints in the locomotor system.
- Training in clinical reasoning.
- Interpretation of the clinical examination leads to proper diagnosis:
- Pattern thinking.
- Recognition of clinical pictures and syndromes.
- A detailed differential diagnosis for the different conditions of the moving parts.
- The recognition of warning signs, contraindications and indications for therapy.
- A drawing up of a treatment strategy, containing precise treatment procedures such as:
- Injection, infiltration
- Deep transverse massage, capsular stretching, traction
- Mobilization, manipulation;
- ESWT/rESWT.
- The integration of the therapeutic techniques in a global treatment strategy.
- The making of a prognosis and of a prophylactic approach.
- A link to other treatment procedures and methods.
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A detailed information about the current literature in the field of orthopaedic medical conditions.
Curriculum
- 🟠 🫱 5.1 Shoulder – Palpatory anatomy – Bony landmarks
- 🟠 🫱 5.2 Shoulder – Palpatory anatomy – m supraspinatus
- 🟠 🫱 5.3 Shoulder – Palpatory anatomy – m infraspinatus
- 🟠 🫱 5.4 Shoulder – Palpatory anatomy – m subscapularis
- 🟠 🫱 5.5 Shoulder – Palpatory anatomy – m biceps
- 🟠 🫱 5.6 Shoulder – Palpatory anatomy – Bursae
- 🔵 🦉 8.1. Shoulder -The capsular pattern. Part 3.
- 🟤 🤔 8.2 Shoulder Interpretation Passive movementent. Capsular pattern. Practical session.
- 🟤 🤔 8.3 Shoulder – Interpretation and treatment arthritis – Capsular stretching and distraction. Practical session.
- 🟡💉 8.4 Shoulder – Intraarticular injection – Glenohumeral joint. Practical session.
- 🔵 🦉 9.1 Shoulder -The non-capsular pattern. Part 4.
- 🟡💉 9.2 Shoulder – Infiltration of the subacromial bursae. Practical session.
- 🟡💉 9.3 Shoulder – Infiltration of the subdeltoid bursae. Practical session.
- 🟤 🤔 9.4 Shoulder -Clinical findings and localization of the acromioclavicular- joint. Practical session.
- 🟡💉 9.5 Shoulder – Intra-articular injection of the acromioclavicular joint. Practical session
- 🔴 🤌 9.6 Shoulder – Deep transverse friction of the acromioclavicular joint. Practical session.
- 🟢 🔊 9.7 Shoulder – ESWT – acromioclavicular joint. Practical session.
- 🟣 ↘️ 9.8 Shoulder –Radial ESWT acromioclavicular joint
- 🔵 🦉 10.1 Shoulder - Tendinopathies. Part 5.
- 🔴 🤌 10.2 Shoulder – Deep transverse friction of the m. supraspinatus Practical session.
- 🟡💉 10.3 Shoulder – Infiltration of the m. supraspinatus. Practical session.
- 🟢 🔊 10.4 Shoulder – ESWT m. supraspinatus. Practical session.
- 🟣 ↘️ 10.5 Shoulder – Radial ESWT m. supraspinatus. Practical session.
- 🟤 🤔 10.6. Shoulder – Interpretation supraspinatus tendinopathy - 4 different clinical pictures.
- 🔴 🤌 10.7a and b. Shoulder – Deep transverse friction of the m. infraspinatus. First clip - tenoperiostal junction, second clip musculartendinous junction Practical session.
- 🟡💉 10.8 Shoulder – Infiltration of the m. infraspinatus. Practical session.
- 🟢 🔊 10.9 Shoulder – ESWT m. infraspinatus. Practical session.
- 🟣 ↘️ 10.10 Shoulder – Radial ESWT m. infraspinatus. Practical session.
- 🟤 🤔 10.11 Shoulder – Interpretation m. infraspinatus tendinopathy - 4 different clinical pictures.
- 🔴 🤌 10.12 Shoulder- Deep transverse friction of the m. subscapularis. Practical session
- 🟡💉 10.13 Shoulder- Infiltration of the m. subscapularis. Practical session.
- 🟢 🔊 10.14 Shoulder- ESWT m. subscapularis. Practical session.
- 🟣 ↘️ 10.15. Shoulder - Radial ESWT m. subscapularis.
- 🟤 🤔 10.16 Shoulder – Interpretation m. subscapularis tendinopathy - 2 different clinical pictures
- 🔴 🤌 10.7 Shoulder- Deep transverse friction of long head m.biceps
- 🟢 🔊 10.18 Shoulder- ESWT long head m. biceps
- 🟣 ↘️ 10.19 Shoulder- Radial ESWT long head m. biceps
- 🟤 🤔 10.20 Shoulder- Interpretation m. biceps brachii tendinopathies - Clinical pictures
Aims
This course aims to let you:
- Acquire the knowledge and the comprehension of the theory of the methods of Ortopaedic Medicine to reach precise diagnosis and differential diagnosis in musculoskeletal disorders.
- Learn, discuss and exercise the methods to apply an efficient medical and physical treatment on well defined lesions.
- Learn to evaluate and re-evaluate the progress of the patient during the treatment.
- Advise and teach the patient how to avoid recurrences of the disorder.
Objectives
At the end of the course the students should be able to:
- Demonstrate a profound knowledge of the dermatomes and myotomes: the anatomy, physiology, neurology and embryological derivation of the structures, discussed in the different parts of the course.
- Explain the factors that influence the reference of pain, as well as the mechanisme and rules of refered pain and their significance as a diagnostic tool.
- Explain the diagnostic importance of multisegmentally and segmentally referred pain and paraesthesia.
- Understand the behaviour of nerve tissue during entrapment, dependent on the localization of the compression.
- Explain the anatomy and physiology of the connective tissue, as well as the reaction to mechanical damage.
- Explain the mechanism of ‘self-perpetuating inflammation’ of soft tissue.
- Understand the effects of immobilization and mobilization on the healing process.
- Explain the rationale for the treatment of acute, subacute and chronic lesions of the soft tissues of the locomotor system.
- Demonstrate the utility of passive movements or isometric testing in the differential diagnosis of lesions of inert and contractile structures (along the principles of ‘/selective tension/’).
- Recognize the value of a chronological anamnesis as well as the meaning of ‘expanding’ and ‘shifting’ pain.
- Explain the characteristics of mechanical and inflammatory pain.
- Take a detailed history in chronological order and interpret the findings.
- Recognize the most important items during inspection.
- Recognize the necessity of a preliminary examination of an entire segment.
- Execute a standardized functional examination, whereby the different structures are put selectively under tension, and taking note of the results.
- Explain the objective and diagnostic meaning of testing by means of active movements.
- Explain the objective and diagnostic meaning of testing by means of passive movements.
- Explain the objective and diagnostic meaning of testing by means of isometric tests.
- Execute a logic examination of the relevant inert and contractile structures, and judge the neurological integrity.
- Use test movements, sensitive and accurate and technically efficient, in order to gain all available information.
- Interpret the patterns, occurring by considering the positive and negative findings, and their importance to make diagnosis.
- Explain the capsular and non-capsular patterns and their diagnostic meaning.
- Understand the diagnostic meaning of the patterns of neurological dysfunction.
- Recognize the inconsistencies in history and physical examination, as well as their evaluation and diagnostic meaning.
- Interpret the different types of end-feel and recognize their importance in evaluation/diagnosis as well as in manipulative treatment.
- Demonstrate the palpation for tenderness and recognize the misleading possibility as well as the value to accurately localize a lesion.
- Interpret the findings, taking into account the differential diagnosis and inconsistencies, in order to make an accurate diagnosis.
- Explain the objective and diagnostic meaning of clinical accessory tests.
- Recognize the necessity of technical investigations or further referral to refine the clinical diagnosis, to exclude certain lesions or to facilitate the differential diagnosis.
- Recognize warning signs in history and/or functional examination, which suggest an unusual disorder.
- Choose an appropriate treatment.
- Know the contra-indications for treatment.
- Consider the prognosis of a condition and the probable duration of the treatment.
- Advise the patient correctly in order to speed up recovery and to prevent recurrences.
- Apply a proper treatment at the exact localization of the cause of the pain/disability and know when to stop treatment.
- Evaluate the evolution of a condition by precise re-evaluation before and after each session or manoeuver.
- Take note of the results of examination and treatment.
- Remain informed about the recent medical literature.
- Critically judge and resume the medical literature.
In our comprehensive digital course on musculoskeletal medicine, we prioritize drawing from authoritative resources to offer students a well-rounded education. Foremost among these resources is "A System of Orthopaedic Medicine," which has long been regarded as a cornerstone of knowledge in the field.
"A System of Orthopaedic Medicine," now in its third edition, stands as a steadfast companion for clinicians deeply immersed in the realm of orthopaedic medicine. This edition consistently underscores the significance of clinical reasoning and diagnostic proficiency. It provides comprehensive guidance on palpating anatomical structures and executing therapeutic techniques with precision. Clinicians adopting this systematic approach embark on a structured clinical assessment of the involved joints, followed by an interpretation of findings and a classification of disorders and conditions into clinical syndromes. Furthermore, this resource delves into the natural progression of each condition and outlines conservative treatment strategies.
Another essential reference within our course is the fully updated fifth edition of "Injection Techniques in Musculoskeletal Medicine." This trusted and comprehensive step-by-step guide caters to a diverse range of healthcare professionals who frequently encounter patients dealing with painful joints and soft tissue issues, including those resulting from sports-related injuries and overuse. This latest edition offers specialized, area-specific recommendations, simplifying patient selection and ensuring the precise administration of pharmaceuticals. Renowned for its meticulous attention to detail, each technique is presented across a dedicated two-page layout.
Complementing these references is "A Practical Approach to Musculoskeletal Medicine," now in its fifth edition. This updated edition reflects modern research and the latest evidence, making it a textbook based on Dr. James Cyriax's approach. It comprehensively covers the assessment, clinical diagnosis, and conservative management of common soft tissue lesions. This resource is ideal for postgraduates enrolled in courses at the Society of Musculoskeletal Medicine and remains highly relevant for undergraduates, allied health professionals, advanced nurse practitioners, and medical practitioners – essentially all orthopaedic and musculoskeletal clinicians working in various settings as part of a multi-professional team.
Collectively, these references – "A System of Orthopaedic Medicine," "Injection Techniques in Musculoskeletal Medicine," and "A Practical Approach to Musculoskeletal Medicine" – form the bedrock of knowledge and skills for practitioners and students in the field of musculoskeletal medicine within our digital course. These invaluable assets, meticulously updated with the newest relevant scientific evidence available, ensure that learners are exceptionally well-equipped to assess and effectively manage musculoskeletal pain in clinical practice while staying at the forefront of advancements in the field.