presented by Terry Malone
In this course, Terry Malone examines glenohumeral instability related to subluxation and dislocation from a functional perspective. He presents his view that the etiology of many difficult shoulder patients can be described through concepts of micro trauma and the process of repetitive stress requiring tissue adaptation. The course begins with a focus on anatomy and biomechanics of the glenohumeral complex and then continues with concentrated sections related to both glenohumeral dislocation and subluxation. Learners will be able to recommend the proper examination procedures for the shoulder instability, describe concepts of the initial management of patients after glenohumeral dislocation or subluxation, and select the proper exercises for both types of glenohumeral instability. Terry will describe the surgical approaches for instability and their implications for rehabilitation, as well as contrast open and closed chain exercise sequences for the shoulder and appropriately outline their use after instability surgery. The course is concluded with a discussion of real case studies from Terry’s own clinical experience.
Dr. Terry Malone received his EdD and MSPT from Duke University in North Carolina and his BA from Bluffton College in Ohio. At Duke, he served as the initial Sports Physical Therapist and was the Coordinator of the Sports Medicine Clinic. He served as the initial Chairman of the Sports Specialization Council of the APTA and has been liaison to the American Orthopaedic Society for Sports. Dr. Malone was the initial chair and dean of the Krannert School of Physical Therapy at the University of Indianapolis, and served as the Physical Therapy Program Director at UK from 1993-2006. Terry is now a full time professor at the University of Kentucky, and enjoys most sports with a particular love for golf.
Discuss the epidemiology of shoulder instability, identify the risk factors contributing to shoulder instability, and describe the glenohumeral complex and the types of lesions in the shoulder joint.
Perform the evaluative tests to screen patients for shoulder instability, including the sulcus sign, load and shift, apprehension, relocation, and posterior drawer tests. Compare and contrast anterior and posterior dislocation in the shoulder.
Identify surgical procedures used in repairing shoulder instability, including Latar-jet and Bankart repair procedures. Explain rehabilitation concepts after shoulder repair and discuss post-surgery complications.
Identify the mechanism of injury in patients with posterior shoulder instability. Explain rehabilitation concepts for patients with posterior shoulder instability. Discuss post-operative management and rehabilitation for posterior instability patients.
Describe proper evaluation and management of anterior and posterior shoulder dislocation as related to the real life case studies presented in the chapter.