Return to sports after shoulder injury: progressive performance training

Ann Cools, Clinical Pearls

During the RTP phase of rehabilitation, the practitioner must balance 2 conflicting components, on one hand the knowledge that premature RTP increases the risk for re-injury and on the other hand that the player as well as the team desire return to participation as quickly as possible. Combining evidence with clinical expertise, the clinician plans […]

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Gentle exercises for Parsonage Turner

Ann Cools, Clinical Pearls

Parsonage-Turner syndrome (PTS) is an uncommon neurological disorder characterized by rapid and idiopathic onset of severe pain in the shoulder and arm. It involves mainly the plexus brachialis and/or the n. thoracicus longus or accessorius. Often the patient reports getting up in the morning with a painful arm and a substantial scapular malpositioning (“I felt […]

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Message in a physio-bottle: what can we tell our patients and more importantly, how?

Ann Cools, Clinical Pearls

Efficient communication with patients is challenging but crucial in our shared pathway through rehabilitation. There is a great body of evidence highlighting the importance of acknowledging the psycho-social and emotional context of the patient (De Baets et al. 2019), efficient communication (Bukstein et al. 2016),  shared decision making, and patient centered approach (Wijma et al. […]

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Gentle progression of closed chain shoulder exercises: which variables to consider?

Ann Cools, Clinical Pearls

Closed chain exercises (where the hand is supported on a moveable or fixed surface) are considered to be safe in the early stages of rehab in patients with shoulder instability, and are supposed to increase proprioceptive quality and neuromuscular control. Many variables determine the level of difficulty of these exercises, such as the body weight […]

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Clinical examination of the shoulder: time to change direction from diagnosing the structural diagnosis towards symptom modification tests.


Ann Cools, Clinical Pearls

The purpose of the physical examination of a patient with shoulder pain is multifactorial. The clinician seeks information about tissue irritability, pain mechanisms, activity and participation limits, the patient’s expectations and goals etc…During the clinical examination, one of the purposes it to examine possible underlying biomechanical factors causing or perpetuating the current movement limitations and/or […]

January 11, 2019

Comparison of 2 rehabilitation programs for multidirectional MDI: which exercise program is the best and what is the rationale behind it?


Birgit Castelein, New in

A new study of Warby et al. (2018, BJSM) compared 2 exercise programs of 12 weeks in patients with non-traumatic multidirectional instability. The effect on function and satisfaction (with questionnaires investigating instability, such as WOSI & MISS) and pain, muscle strength, scapular movement was investigated at 6, 12 and 24 weeks. Participants attended a weekly […]

January 11, 2019

Exercise Therapy in the non-operative treatment of degenerative rotator cuff tears: which exercises should we prescribe?


Ann Cools, Clinical Pearls

Recent studies have shown that patients with degenerative rotator cuff (RC) tears have similar good results from an exercise program compared to surgical intervention (Jeanfavre M et al. IJSPT 2018). In the conservative treatment of RC tears, it is advised to use function-based rather than structure-based exercises. In other words it is much more important […]

January 11, 2019

Is a non-operative treatment an effective and long-lasting option for patients with full-thickness rotator cuff tears?


Birgit Castelein, New in

Both surgical repair as conservative management may serve as treatment options for patients with full-thickness rotator cuff tears. It is important to know if conservative treatment has also a successful result in the long-term. Boorman et al. (2018, JSES) examined 5-year outcomes of patients with chronic full-thickness rotator cuff tears previously enrolled in a nonoperative, […]

January 11, 2019

The Mission…


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With this blog we want to share our passion for quality in shoulder physiotherapy. Recent scientific publications, ongoing research, experience from practice, interesting lectures and so on each add a piece of knowledge. With our selection from the mass of information we want to filter what matters to physios in practice treating shoulder patients. We […]

January 9, 2019

Does evidence support practice in overhead athlete exercise prescription?


Annelies Maenhout, New in

Results and thoughts on “Exercise prescription for overhead athletes with shoulder pathology: a systematic review with best evidence synthesis.” (Wright et al., 2018) This interesting review summarizes the evidence on exercise prescription for overhead athletes with shoulder pathology. The authors included 6 level I-IV studies and 33 level V studies. They extracted a list of exercises […]

November 14, 2018