Presenters: Simon Balster & Rod Whiteley

The primary aim of this workshop is to give attendants a thorough understanding of shoulder strength testing background, knowledge and practical skills to perform safe and reliable testing on their clinic patients or their sporting team. Then, to be able to analyse and use this information to make, data informed decisions on rehabilitation, strengthening progressions, readiness to return to work, gym or sport.

The following will be discussed:

• the pros, cons and data produced from different devices
• techniques and tools used to conduct reliable and repeatable assessments
• how to interpret key strength metrics: peak force, time to peak force, endurance
• strength data analysis
• safe, sport and functionally specific upper limb strength testing positions
• limitations of current methods and the potential for innovation through real-time feedback systems and app-based monitoring

Presenters: Leanne Bisset

Lateral elbow tendinopathy is the most common musculoskeletal injury affecting the adult elbow. Exercise is considered the cornerstone of effective management; however exercise prescription for the elbow is frequently extrapolated from research on lower limb tendinopathies, despite notable anatomical and functional differences. While exercise-induced analgesia is well-documented in healthy populations, its efficacy and mechanisms in individuals with persistent pain, such as those with chronic lateral elbow tendinopathy, remain less well understood.

This workshop will critically examine the current evidence underpinning exercise prescription for elbow tendinopathy, with particular emphasis on the unique considerations that distinguish it from lower limb tendinopathy management. Participants will engage in discussion and demonstration of manual therapy techniques that may assist in pain modulation, review prognostic factors influencing clinical outcomes, and consider the role of pain mechanisms in guiding treatment.

Presenters: Rebecca Dickinson, Sean Kennedy, Jacob Storey

This workshop will focus on the clinical examination and treatment of thoracic outlet syndrome (TOS), with a brief review of pertinent anatomy and physiology.

TOS can cause a wide breadth of both neurogenic and vascular symptoms in the upper extremity due to compression of the neurovascular bundle. Resultantly, there are several areas within the thoracic outlet in which this can occur. This workshop will review these key areas of the thoracic outlet and also the effects of different functional positions while also discussing differential diagnosis.

Focus will then switch to the best evidence for clinical evaluation and treatment techniques for TOS as well as a demonstration of neuromuscular control components of exercise that will affect the compression of the neurovascular bundle, and in turn, patient outcomes

Presenters: Karen Ginn, Ingrid Hultenheim Klintberg, Kathryn Fahy

Exercise is the mainstay of conservative treatment for shoulder dysfunction. However, evidence to support the efficacy of specific exercises for different categories of shoulder dysfunction is limited leaving clinicians with the dilemma of how to choose effective, efficient exercises for their patients with shoulder dysfunction.

This workshop will explore a rationale, evidence-based approach to determining and progressing patient-specific therapeutic shoulder exercises. It will begin by exploring recent evidence on the function of shoulder muscles, particularly the mechanisms whereby the rotator cuff and axioscapular muscles perform their stabiliser function, in order to provide you with the anatomical basis to explain the presenting shoulder symptoms. By applying this anatomical knowledge to the clinical assessment of the shoulder the workshop is designed to provide you with a logical, evidence-based clinical reasoning process to determine the most appropriate exercise strategy for each of your patients with shoulder dysfunction & to be able to progress these exercises in a functionally appropriate manner.

Presenters: Karen Ginn, Ingrid Hultenheim Klintberg, Kathryn Fahy

Resisted rotation exercises are the mainstay of conservative treatment designed to rehabilitate the rotator cuff. But how specific are rotation exercises to the rotator cuff muscles & are they adequate to functionally retrain the rotator cuff for the crucial dynamic stability role this muscle group performs at the shoulder joint?

The workshop will begin by exploring recent evidence on the function of shoulder muscles, particularly the mechanisms whereby the rotator cuff and axioscapular muscles perform their stabiliser functions. This information will then be applied to analyse the rotator cuff & axioscapular muscle activity during rotation exercises commonly used in rotator cuff muscle rehabilitation programs

Presenters: Anju Jaggi, Marcus Bateman

Atraumatic shoulder instability (ASI) is described as resultant subluxation or dislocation of the glenohumeral joint without the presence of trauma. ASI is associated with reduced quality of life, both physically and mentally. Patients can become fearful and avoid use of the shoulder leading to a spiralling decline, with reduced strength, compensatory strategies and chronic disability.

The literature supports structured strengthening programs in the management of ASI, reporting effective outcome rates of between 50-80%. However clinical assessment of ASI has traditionally focused on testing static structures and imaging to confirm the diagnosis rather than specific assessment of the motor strategy and or psychosocial factors.

The workshop will practically address how the evidence base should support the clinical assessment, exercise prescription, education and advice for patient management with the use of clinical case studies.

Presenters: Chris Littlewood, Maria Moffat, Natasha Maher

Clinical practice guidelines consistently recommend shared decision making as the preferred method of care for people with shoulder pain. A shared decision-making philosophy should be central to history taking, physical examination, selection and interpretation of diagnostic tests, patient education, and treatment recommendations. However, universally, shared decision-making is poorly understood and not well implemented by clinicians, with the dominant method of care being clinician-led, reflecting historical practice.

Effective shared decision-making ensures that individuals are supported to make decisions that are right for them. This is particularly important in the context of the latest research evidence which suggests considerable uncertainty about the effectiveness of different treatment options including wait-and-see, analgesics, injections, treatments supported by a physiotherapist, and surgery for people with shoulder pain. Where there are multiple viable treatment approaches but no clear steer from research evidence about the most effective treatment options, patients need support to make decisions about the treatment that is right for them taking into account their preference, values, and circumstances.

Through this interactive workshop we will provide opportunity for clinicians to reflect on their clinical reasoning skills and current method of care as a platform from which to incorporate effective shared decision-making into their practice.

Presenters: Margie Olds, Edel Fanning

Recurrent shoulder instability remains a significant challenge for athletes returning to sport, with high rates of reinjury underscoring the complexity of rehabilitation and readiness. Despite a growing body of research on physical performance tests (PPTs) for shoulder instability, their clinical adoption remains limited, and evidence supporting their predictive validity is sparse.

Simultaneously, psychological readiness—a critical yet often overlooked component of rehabilitation—is rarely addressed in standardized protocols.

This workshop will emphasize a holistic, evidence-informed approach to return-to-sport (RTS) decision-making integrating cutting-edge physical testing, psychological strategies, and emerging technologies to optimize RTS outcomes for athletes recovering from shoulder instability.

Presenters: Alexis Ramos

Shoulder disorders are highly prevalent, affecting between 15% and 50% of adults annually. Prognosis is often variable, with symptoms persisting for 6 to 12 months in up to 50% of patients. These conditions typically lead to physical limitations, such as pain, loss of mobility, weakness, instability, or impaired movement coordination. The burden of shoulder disorders extends beyond physical limitations to encompass psychological, emotional and social dimensions.

Focusing solely on physical impairments is insufficient. The biopsychosocial (BPS) model, introduced by Engel in 1977, offers a comprehensive framework that incorporates biological, psychological, and social factors in understanding health. An evolution of the BPS model, known as the enactive-BPS approach, has recently been proposed to address the theoretical and practical limitations of the original model. This model draws on cognitive science, phenomenology and pragmatism, emphasizing patients’ lived experiences and the importance of an efficient communication and shared decision-making.21,22

Applying this model and asking the right questions is a daily-challenge for clinicians.20 This workshop is designed to help clinicians move beyond theoretical knowledge toward confident implementation.

Presenters: Sarah Warby, Lori Michener, Lyn Watson, Ann Cools

The primary aim of this workshop is to give attendants practical exposure on how to assess, diagnose and conservatively manage the unstable shoulder in multidirectional instability (MDI) and Ehler’s Danlos Syndrome (EDS), including handing for shoulder special tests, novel instability tests and exercise prescription. will be explored. The following will be delivered within an evidence-based framework:

• traditional tests (e.g. special tests) described in the literature for diagnosing MDI, including clusters of history and tests that inform the diagnosis of the condition
• clinical assessment of scapular and humeral head motor-control dysfunction in MDI including therapist-assisted (or symptom modification) corrective techniques to understanding a patient’s specific motor control dysfunction
• a 6-stage evidence-based program for managing MDI conservatively
• the application and modification of exercises appropriate for the MDI patient with EDS.

Presenters: Lyn Watson, Jacki Sadi, Tania Pizzari

Despite the plethora of published rehabilitation programs for anterior instability, there are limited resources for clinicians for the conservative management of posterior shoulder instability (PSI). Given the typical aggravating factors inherent in PSI rehabilitation programs need to be specific for the condition, yet clinicians are often unaware of which exercises and progressions produce optimal outcomes for PSI patients.

The objective of this workshop is for attendants to learn and practise the objective tests and exercise techniques to assess and treat PSI conservativity. demonstrate the assessment and diagnosis of PSI as featured in the scientific literature, including the limitations surrounding some of these traditional PSI tests. The clinical assessment of PSI will be demonstrated including how and why this may differ from traditional PSI tests described in the literature. The clinical assessment of scapular and humeral head motor dysfunction in PSI will be performed, including the effect of therapist assisted manual correction (or symptom modification procedures). Finally, the clinical application of a 6-stage evidence-based program for managing PSI conservatively will be demonstrated, including exercises for patient-specific scapular dysfunction and regaining posterior humeral head control in lower and higher ranges.