shoulder

Sport Physical Therapy

Physio

shoulders

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Adam Weir talks to Ben Kibler from the Shoulder Center of Kentucky about the 2013 consensus statement on scapular dyskinesis in shoulder injury.

Read the editor's choice article for free online: http://bjsm.bmj.com/content/47/14/877.full

The second international consensus conference on the scapula was held in Lexington Kentucky. The purpose of the conference was to update, present and discuss the accumulated knowledge regarding scapular involvement in various shoulder injuries and highlight the clinical implications for the evaluation and treatment of shoulder injuries. 

Scapular summit 2013 with Ben Kibler

After a patient has undergone ACL surgery, rehabilitation is bread and butter in many physiotherapy/sports medicine clinics. Many BJSM podcast listeners will be expert in this role. If you are less expert and wondering if there is an ‘optimum’ way to guide the patient back to sport, Dr Andy Franklyn-Miller provides some food for thought. 

He discusses some novel ways of assessing a patient’s progress after ACL reconstruction, advocates for the use of video in the clinic, and shares the dynamic tests he uses before allowing a player to return to sport. He shares exercises that both test, and help rehabilitate athletes in this setting.
 
Dr Franklyn-Miller is a sports physician at the Sports Surgery Clinic in Dublin, Ireland. He has published widely in sports medicine and his book, Clinical Sports Anatomy (2011), co-authored with Eanna Falvey and Peter Brukner, is an international best-seller. You can follow him on Twitter @AFranklynMiller and his blog provides great resources (www.drAndyFranklyMiller.com) including a further series of podcasts.
 
See also:
His previous podcasts on BJSM relating to running injuries (http://bit.ly/1bqMh8C) and groin pain (http://bit.ly/1fo2TAW).

Consensus criteria for defining ‘successful outcome’ after ACL injury and reconstruction: a Delaware-Oslo ACL cohort investigation: http://bjsm.bmj.com/content/early/2013/07/23/bjsports-2013-092299.full

Lower extremity performance following ACL rehabilitation in the KANON-trial: impact of reconstruction and predictive value at 2 and 5 years: http://bjsm.bmj.com/content/47/15/980.full
 

Andy Franklyn-Miller - Tuning up rehabilitation after ACL reconstruction

Dr Alex Kountouris is the physiotherapist or the Australian men’s cricket team, a position he has held for 8 years. He has just completed his PhD on the relationship between quadratus lumborum and lumbar stress fractures. 

In this podcast he discusses strategies for the prevention and treatment of lumbar spine injuries in cricket. The interesting questions posed to him come from our twitter followers, so hear his responses to your questions!

See also:

Biomechanics of lumbar spine injury in young Australian fast bowlers: http://bjsm.bmj.com/content/44/Suppl_1/i4.3.abstract

MRI findings in the lumbar spines of asymptomatic, adolescent, elite tennis players: http://bjsm.bmj.com/content/41/11/836.full

A stress fracture of the lumbar spine in a professional rugby player: http://bjsm.bmj.com/content/41/5/337.full

Injuries in West Indies cricket 2003–2004: http://bjsm.bmj.com/content/40/2/119.full

@PeterBrukner discusses today’s major headline: Successful antibiotic treatment in a subset of people with chronic low back pain: http://blogs.bmj.com/bjsm/2013/05/08/peterbrukner-discusses-todays-major-headline-successful-antibiotic-treatment-in-a-subset-of-people-with-chronic-low-back-pain/

Book Review: Clinical anatomy of the lumbar spine and sacrum: http://blogs.bmj.com/bjsm/2008/10/16/book-review-clinical-anatomy-of-the-lumbar-spine-and-sacrum/



Lower back injuries in cricket players, with Alex Kountouris

Welcome to the Sports Medcast, brought to you in association with the American Medical Society for Sports Medicine.

In this episode, AMSSM members discuss the recently published 'Overuse Injuries and Burnout in Youth Sports: A Position Statement from the AMSSM' with statement authors Dr John DiFiori, Dr Joel S Brenner and Dr Neeru Jayanthi.

Read the statement: http://goo.gl/lczEHo

Please feel free to contact us at thesportsmedcast@gmail.com regarding this or any other Sports Medcast.

AMSSM Sports Medcast: Overuse injuries and burnout

Professor Philippe Neyret from Lyon, France, is a renowned sports orthopaedic surgeon. Following from his talk at the Isokinetic Football Medicine Conference in Milan, BJSM editor Karim Khan reached him via mobile phone. 

Prof Neyret discusses patellar dislocation in the setting of football and explains that certain anatomic variations (including trochlea dysplasia) make the condition more likely to occur. For players who have suffered patellar dislocation, next steps are not straightforward. Professor Neyret explains which players he would recommend have surgery.  

See also:

Injuries of the sporting knee: http://bjsm.bmj.com/content/34/6/467.1.full

Patient Information Sheet: Patellar Instabilities (dislocation or subluxation of the kneecap): http://blogs.bmj.com/bjsm/2008/10/16/patient-information-sheet-patellar-instability-dislocation-or-subluxation-of-the-kneecap/

Patellar dislocation in football, with Professor Philippe Neyret, France

Here’s the podcast that over 12,000 listeners have been demanding – physiotherapist Adam Meakins (@TheSportsPhysio)on a number of controversial topics, including:
Is diagnostic palpation accurate?
Can the sacroiliac joint really be ‘unstable’?
How does ‘touch’ in physiotherapy have its therapeutic effect? 

Adam provides great value on Twitter and on his blog – here you can listen to him in your favourite podcast setting. 

Adam shares his way of explaining neural pain to patients and that alone is worth the price. 

He also discusses his popular blogs on ‘5 Least Favourite Shoulder Rehab Exercises’ as well as ‘Top 5 Shoulder Rehab Exercises’. 

He argues that the key to managing some knee conditions is to manage load and he refers to Scott Dye’s classic ‘envelope of function’ concept. 

And we close by discussing a couple of  figures that have gained great traction in the Twittersphere. You might find them useful in your clinical practice. But it’s a risk on radio – I get that! Enjoy and comment via @BJSM_BMJ or on Facebook.

See also:

Why does my shoulder hurt? A review of the neuroanatomical and biochemical basis of shoulder pain: http://bjsm.bmj.com/content/47/17/1095.full

Effectiveness of soft tissue massage and exercise for the treatment of non-specific shoulder pain: a systematic review with meta-analysis: http://bjsm.bmj.com/content/48/16/1216.full

Rehabilitation for shoulder instability: http://bjsm.bmj.com/content/44/5/333.full

Biomechanics laboratory-based prediction algorithm to identify female athletes with high knee loads that increase risk of ACL injury: http://bjsm.bmj.com/content/45/4/245.full

Adam Meakins' practical physio tips – explaining neural pain, shoulder rehab and managing knee load

Professor Lorimer Moseley holds the Inaugural Chair in Physiotherapy at the University of South Australia as well as being a Professor of Neurosciences. He completed his PhD in 2002 and has both learned and shared wisdom at the Universities of Queensland, Sydney and Oxford before settling in Adelaide. He leads the Body in Mind Research Group and coauthored the best-selling ‘Explain Pain’.

In this podcast he answers questions from Ebonie Rio, Department of Physiotherapy, Monash University, covering the important difference between pain and nociception, and sharing thoughts on how pain science can help clinicians working in sports medicine. 

You’ll hear him share the best, and worst, ways to explain pain to patients. He predicts how low back pain management will look in 100 years’ time. As always with Lorimer Moseley. expect thoughtful reflections shared with big dob of humour and humility. 

See also:

TEDx talk ‘Why things hurt’: http://www.youtube.com/watch?v=gwd-wLdIHjs

Acupuncture applied as a sensory discrimination training tool decreases movement-related pain in patients with chronic low back pain more than acupuncture alone: a randomised cross-over experiment http://goo.gl/zaNX8s

Are children who play a sport or a musical instrument better at motor imagery than children who do not? http://goo.gl/Xv9Qum

Exercise is medicine, for the body and the brain: http://bjsm.bmj.com/content/48/12/943.full

Chronic traumatic encephalopathy in sport: a systematic review: http://bjsm.bmj.com/content/48/2/84.full

Professor Lorimer Moseley on the brain and mind in chronic pain

Shoulder pain – what are the causes, and how can you treat it? Are your special tests around the shoulder really isolating and identifying pathology? How can the rotator cuff still function with small and large tears?

In Episode 21 of the Physio Edge podcast, Jeremy Lewis and David Pope discuss these questions and more including:

What is the value of special tests around the shoulder?
What diagnosis can you provide your patients for their shoulder pain
How can you identify if you need to focus your treatment on the scapula, glenohumeral joint, cervical spine or thorax?
How can you identify a rotator cuff tendinopathy?
What is the Rotator Cable, and how is it important in rotator cuff tears?
Is the acromion really the cause of “impingement” or subacromial pain?
If a patient has a biceps tendinopathy and a rotator cuff tendinopathy, which should be treated first?
What contributes to biceps tendinopathy?
Theraband – valuable?
When imaging of the shoulder is valuable, and when it is a waste of time
Frozen shoulder – what treatments work well
And much more.

PE #021 Shoulder Pain With Dr Jeremy Lewis

Shoulder dislocation is common in sports, and management for the active athlete who dislocates for the first time remains controversial. Canada’s Olympic Medical Committee Medical Director, Prof Bob McCormack, explains the ways to assess patients to help decide whether to trial rehabilitation first or to opt for reconstruction. 

Bob has vast experience as an Olympic team doctor (beginning with Sydney) and as a team physician in the Canadian Football League and Major League Soccer. 

This is the first of 3 podcasts; he discusses management of AC joint separation and clavicle fracture in the others. BJSM welcomes the Canadian Academy of Sport & Exercise Medicine (CASEM) as one of 17 member societies (Full access to all content).   


Shoulder dislocation: to operate or rehabilitate? Prof Bob McCormack (Olympic physician)

Clavicle fractures are common in contact sports as well as cycling trauma. Canada’s Olympic Team Chief Medical Officer shares dramatic results from a large RCT which has been a game changer. 

Thanks to the Canadian Academy of Sports and Exercise Medicine (CASEM) for permission to steal this content from the CASEM Annual Meeting. 

Enjoy this second of Bob McCormack’s three BJSM podcasts. 

The first was on first time shoulder dislocation: http://goo.gl/3rvsLC

The third will cover AC joint separation.

Mid-clavicular fracture: Open surgery or collar and cuff? Prof Bob McCormack (Olympic physician)

Modern surgical techniques can make a traditional treatment obsolete. Think of the Herbert screw for scaphoid fracture. Professor Bob McCormack tested a new hook plate in a Canadian multi-centre trial of management of complete dissociation & dislocation of the AC joint. You have to listen to find out how the story ends!   

Enjoy this 3rd of Bob McCormack’s 3 BJSM podcasts. 

You can find Bob’s other podcasts here: 
1.	First time shoulder dislocation: https://soundcloud.com/bmjpodcasts/shoulder-dislocation-to-operate-or-rehabilitate-prof-bob-mccormack-olympic-physician?in=bmjpodcasts/sets/bjsm-1

2.	Managing mid-clavicular fractures. https://soundcloud.com/bmjpodcasts/mid-clavicular-fracture-open-surgery-or-collar-cuff-prof-bob-mccormack-olympic-physician?in=bmjpodcasts/sets/bjsm-1


Complete AC joint dislocation (Grade 3): What’s best management? Bob McCormack (Olympic physician)

Dr Kieran O’Sullivan, PT, PhD, was one of the first podcast guests to crack 9,000 listens! From the University of Limerick, Ireland, he has vast clinical experience and he completed a PhD on the role of sitting in back pain. In this 18-minute podcast he reviews his 2015 podcast in the first 3 minutes and then rattles off at least 7 practical tips. 

Kieran was a guest of PhysioFirst (UK) when BJSM interviewed him in April 2015. The 2017 PhysioFirst conference is on April 1-2 (2017!) in Nottingham (UK) and guest speakers include Professor Paul Hodges, Dr Tania Pizzari and Dr Igor Tak. 

Timeline: 
1.00 m Back pain is neither explained by what patients and clinicians see on scans nor just by load

2.00 m When treating, you need to assess the various factors that could be playing a role, such as load, posture, stress, and address the right one. 

4.00 m Should we try to prevent all back pain? Listen to Dr O’Sullivan challenge the belief that it’s important to never have back pain. He likens back pain to conditions like sadness, constipation – not great but not a major problem as long as it doesn’t persist. Athletes need to load their bodies and adapt rather than avoid load and become vulnerable (See Gabbett papers and podcast, below). Don’t pass on fear (of back pain coming on or persisting) to athletes. 

5.00 m Screen for red flags of course, if the clinical picture warrants it – but most long-term back pain is NOT due to something listed as a red flag. 

6.00 m Reassurance – being empathetic without inducing fear. 

7.00 m Think through. What precipitated the pain? Too much load, too much stress, bad posture, movement patterns? If unknown, have patient create a pain diary. Look for trends. Examine all the dimensions of the biopsychosocial model. 

9:00 m Don’t just make the diagnosis but be practical. Patient sad? Don’t just say ‘You are sad, your back pain will go away’. Provide specific treatment for the specific threat. 

10:00 m Empower the patient to choose the exercises he or she wants and what he or she will do! Exercise has benefits across systems. 

11:00 m Don’t give up. Here Kieran walks us through a challenging real life case. A simple tissue diagnosis would not have helped this person at the centre of the case 

12:00 m Explain! Explain the pain! (HT to Professor Lorimer Moseley and Dr David Butler).  

13:00 m The period at 4-6 weeks of pain can be difficult – patient has not adapted to the contemporary model and may still be on waiting list for imaging. 

14:00 m What is the evidence for this approach? How does the evidence compare, with, for example Hamstring injuries? 

Links to previous podcast: 
2015 – Dr O’Sullivan on “Effective treatments for back pain: Kieran O'Sullivan’s practical tips within a guiding framework” http://ow.ly/4nepGu

BJSM paper: 
O'Sullivan K, O'Sullivan P. The ineffectiveness of paracetamol for spinal pain provides opportunities to better manage low back pain. Br J Sports Med. 2016 Feb;50(4):197-8. http://ow.ly/4neqbS (Members Only/subscribers)

Manual Therapy paper: 
Hurley J, …., O'Sullivan K. Effect of education on non-specific neck and low back pain: A meta-analysis of randomized controlled trials. Man Ther. 2016 Mar 10. pii: S1356-689X(16)00017-5. doi: 10.1016/j.math.2016.02.009. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/27026111


Dr Kieran O’Sullivan on managing back pain: 7 habits of highly effective clinicians. Part 2, 2016

Professor Damian Griffin talks about the Warwick Agreement, an international consensus on the management of femoroacetabular impingement syndrome. This podcast brings you right up to date on the most current thinking about hip impingement or FAI.

0.38 Aim of the consensus
1.36 Consensus methodology
2.26 What is FAI syndrome? Symptoms, clinical signs, and imaging findings.
3.40 How should FAI syndrome be diagnosed?
6.26 What is the appropriate treatment for FAI syndrome?
8.26 What is the prognosis of FAI syndrome?
10.23 How should someone with an asymptomatic hip, with cam or pincer morphology, be managed?
11.53 What research is now needed?
14.15 How is this new definition of FAI syndrome going to influence clinical care?

@DamianGriffin #WarwickAgreement

Damian Griffin is the Professor of Trauma and Orthopaedic Surgery at the University of Warwick. He trained in Cambridge, Oxford and the United States, and worked as a Consultant in Oxford before taking up the Foundation Chair in Warwick and helping to establish Warwick Medical School.

Damian’s passion is the diagnosis and treatment of hip and groin pain in young adults. His clinical practice and research focus on joint-preserving surgery for early arthritis, hip arthroscopy, the management of femoroacetabular impingement and sport injuries of the hip. He runs the largest national referral service for young and active people with hip pain in the UK, based at the University Hospital of Coventry and Warwickshire NHS Trust, and for private patients and elite athletes in London and Coventry (www.hiparthroscopyclinic.co.uk).

Damian leads a research team based at the University of Warwick, with a portfolio of hip research. In particular he is the chief investigator for the FASHioN trial, a large, multicenter randomised controlled trial of treatments for people with FAI syndrome, comparing surgery with physiotherapy-led rehabilitation:www.nets.nihr.ac.uk/projects/hta/1310302

You can follow Damian on Twitter @DamianGriffin and @WarwickOrtho or reach him on damian.griffin@warwick.ac.uk



The Warwick Agreement on the management of femoroacetabular impingement syndrome with Damian Griffin

Professor Peter O’Sullivan is among the top 3 most popular physiotherapy voices on podcasts and here he focuses on myths and harmful beliefs about back pain. He takes a swing at clinicians who rely excessively on imaging findings to attempt to explain the source of pain. He shares the story of a clinician who told a patient his spine was ‘shredded’. 

Prof O’Sullivan emphasizes the importance of history taking, finding factors that can sensitize neural tissue and gives an overview of treatment. He will be the keynote Refshauge Lecturer at Sports Medicine Australia’s 2016 Conference (#SMAConf16, @SMA_Events). 

Timeline: 
0.35 m - A sneak preview of the Refshaughe lecture plan – back pain is a big problem and those in sport can learn from what is known in back pain in the general population

2.17 m - Patients respond well to a combination of explanation, being shown ways they can get back to the things they love to do, and appropriate progressive exercises

4.21 m - A case where a patient could have been treated with early investigation, aggressive medical intervention, potentially surgery. An alternative approach to management

6.48 m - How junior clinicians can approach the patient who presents with a bag of images or a medical note that may not reflect current best practice for managing back pain

9.45 m - The biology of how neural tissue can be sensitized by lack of sleep, stress. Fascinating neuroimmunology

10.55 m - You do treat the back don’t you? It’s not just explaining pain, counseling?  

12.30 m - Parallels with work of other physiotherapists such as Prof Jill Cook (@ProfJillCook) and Dr Alison Grimaldi (@alisongrimaldi) who advocate for progressive loading as a stimulus for healing. “Backs love movement”

13.55 m - A 30-second summary!  

Related podcasts: 
Please consider downloading the mobile app “BJSM’ from iStore or GooglePlay. There are over 250 to choose from and the 10 most recent are very easy to get via the app. 

1. Professor Peter O’Sullivan (@PeteOSullivanPT) on Tiger Woods’ back and ‘core strength’
http://ow.ly/uNgj304udUI

2. Dr Kieran O’Sullivan (@KieranOSull) on how top clinicians approach back pain
http://ow.ly/18Ru304ue96



Prof Peter O’Sullivan’s sneak peek of Refshauge Lecture on Back Pain: Sports Medicine Australia 2016

Dr Clare Ardern is a sports physiotherapy researcher at Linkoping University in Sweden. She carries Australia’s prestigious NHMRC’s top scholarship for clinician researchers – the 4-year Fellowship Award.  You may know of her publications that highlight the relatively low return to play rates after ACL reconstruction. In this podcast, she addresses return to play more broadly. From 12-15th October this year she will be a keynote speaker at Sports Medicine Australia’s conference. You can follow that via BJSM Twitter #SMAConf16 and Facebook.

She was interviewed by Dr Christian Barton, who is a well-published physiotherapist PhD as well. He serves as BJSM Deputy Editor and the Editor responsible for Social Media (small job! easy!).

Timeline:
1:00m - Where did the Return To Play Consensus come from?

2:00m - Defining Return to Play; what does it mean in different settings

3:00m - The difference in RTP for o/c acute – removal from play?

4: 10 - Decision making – how should the return to play decision be made?

3:30m - Return to Play is a continuum that requires meticulous planning

4:00m - When can the athlete return to a pre-injury (or better) level of performance?

4:30m - What is the evidence for return to play decisions? Spoiler alert! – It’s limited. 

5:20m - Taking the emphasis of the ‘one day’ that players focus on to be back at sport. The concept of a continuum (from when you first see the athlete). 

6:45 - Return to play and returning to perform at the previous level. Are there important differences? What can clinicians do to help players get back to that level?

8:30m - Does ‘Return to Play’ end? It’s very different for different athletes. 

10:10m - Should athletes have ACL reconstruction after ACL injury? What does the research show? 

11:40 - Clare’s perspective on the return to play data after ACL reconstruction in the non-elite players. 

12:15 - An example of a player in the English Premier League who was ACL deficient.

Dr Clare Ardern (Sweden) shares the latest on Return to Play – World Congress Consensus Statement

In this podcast, Steffan Griffin of the BJSM speaks to Dr Andrew Murray – SEM consultant & adventurer (amongst other things!), who is currently undertaking a PhD looking into ‘Golf and Health’. We talk about how the Golf and Health project was born, and some of the notable findings from his recently published scoping review. This is a must-listen for any SEM professional/student, not only due to some of the clinical pearls, but due to the fact that this is a shining light of what other sports could also be doing!

Contents
1.00: Andrew tells us about the Golf and Health project

2.30: What are the main findings from the scoping review?

5.30: Deeper dive into the potential benefits

6.45: What about mental health?

7.30: Could spectators also be reaping some of the health rewards associated with playing?

9.45: What lessons are there for other sports?

Links
Scoping Review http://bjsm.bmj.com/content/early/2016/09/26/bjsports-2016-096625.full

Infographic http://bjsm.bmj.com/content/early/2016/09/20/bjsports-2016-096866.full.pdf+html

Golf and Health website http://www.golfandhealth.org/ 

Golf and Health twitter https://twitter.com/GolfAndHealth 

Golf and Health facebook https://www.facebook.com/GolfAndHealth/?fref=ts

Dr Andrew Murray on golf and its effects on health

Dr. Jeremy Lewis is a Consultant Physiotherapist and Professor of Musculoskeletal Research (University of Limerick, Ireland). Originally born in New Zealand, he trained in Australia before moving to England where he now works in both the Public (NHS) and Private sectors.

Dr. Lewis has distinguished himself and become a globally respected voice in the area complex shoulder issues in both clinical and research capacities.

This podcast has been adapted from one originally published by our friends Kinetic Labs (https://kineticlabs.ca/ - where you can find the full version). Dr. Lewis shares his thoughts with the listeners on;

•	Shoulder Impingement
•	Rotator Cuff tears
•	Shoulder special tests and why they aren't that special
•	Shoulder Surgery
•	Shoulder Symptom Modification Procedures and how they help treat patients
•	What mistakes we commonly make when treating shoulder pain

For extra podcast resources on shoulder issues in SEM, check out;
•	Practical Clinical Shoulder Pearls with Adam Meakins - https://soundcloud.com/bmjpodcasts/shoulder-focus-with-leading-sports-physiotherapist-adam-meakins-practical-clinical-pearls?in=bmjpodcasts/sets/bjsm-1 
•	Prof McCormack on whether to operate on Shoulder Dislocations - https://soundcloud.com/bmjpodcasts/shoulder-dislocation-to-operate-or-rehabilitate-prof-bob-mccormack-olympic-physician?in=bmjpodcasts/sets/bjsm-1 
•	Scapular Summit with Ben Kibler - https://soundcloud.com/bmjpodcasts/scapular-summit-2013?in=bmjpodcasts/sets/bjsm-1
•	5 Clinical shoulder tips with Dr. Mark Hutchinson - https://soundcloud.com/bmjpodcasts/five-clinical-tips-for?in=bmjpodcasts/sets/bjsm-1
•	Prof Jeremy Lewis on Rotator Cuff Tendinopathy - https://soundcloud.com/bmjpodcasts/prof-jeremy-lewis-rotator-cuff?in=bmjpodcasts/sets/bjsm-1
•	Shoulder Injuries with Ann Cools - https://soundcloud.com/bmjpodcasts/shoulder-injuries-with-ann?in=bmjpodcasts/sets/bjsm-1
•	The Shoulder in Sport with Ben Kibler - https://soundcloud.com/bmjpodcasts/the-shoulder-in-sport-with-ben?in=bmjpodcasts/sets/bjsm-1
•	Clinical assessment of the Tennis Shoulder with Ben Kibler - https://soundcloud.com/bmjpodcasts/dr-ben-kibler-examination-and-diagnosis-of-the-tennis-player-part-one?in=bmjpodcasts/sets/bjsm-1

Dr Jeremy Lewis clarifies shoulder confusion: Common pitfalls and how to avoid them

Jo Gibson is a Clinical Physiotherapy Specialist at the Liverpool Upper Limb Unit based at the Royal Liverpool Hospital, UK. She lectures both nationally and internationally about rehabilitation of the shoulder. Her research interests are shoulder instability and motor learning. Jo is currently Squad Physiotherapist for the Great Britain Endurance riding Team.

How to rehabilitate the athlete after shoulder surgery. Top physio Jo Gibson on shoulder and mind

Jeremy Lewis, consultant physiotherapist and visiting professor of Physiotherapy at Chelsea and Westminister NHS Foundation Trust, talks to Prof Jill Cook about management of rotator cuff tendinopathy. They cover the role of the subacromial bursa in the condition, new treatment paradigms, hopes for future developments.

Bursa: 3.40
Changing treatment paradigms:  6.00
Future developments: 13.30

How to rehabilitate the athlete after shoulder surgery. Top physio Jo Gibson on shoulder and mind

BMJ talk medicine