LEVEL 2 ADVANCED SHOULDER COURSE

Lyn Watson
B.App.Sci. Phty., Grad.Dip.Manip.,M.P.A.A., Sports Physio.

Lyn Watson of Melbourne, Australia is a Clinical Manipulative Physical Therapist and

titled Sports Physiotherapist. She is Clinical Specialist at LifeCare Prahran Sports
Medicine Centre and Melbourne Orthopaedic Group. Lyn has conducted clinical
research into taping techniques, the frozen shoulder, hydrodilatation, thoracic outlet
syndrome, glenohumeral joint instability, scapula biomechanics and clinical outcome
measures. Lyn has published papers in the Journal of Shoulder and Elbow Surgery and
British Journal of Sports Medicine on the Frozen Shoulder, Thoracic Outlet Syndrome,
scapular biomechanics and glenohumeral joint instability outcome measures. Since
1992 Lyn has conducted shoulder workshops throughout Australia, Canada, Asia, USA
and the United Kingdom. Ms Watson also lectures on the Masters Manipulative Therapy
and Sports programmes for both Melbourne and Latrobe Universities. For the last 16
years Lyn has worked exclusively in the area of the shoulder and is the clinical
specialist in an elite surgical team.

Lyn has developed extensive clinical experience in the diagnosis, assessment and
rehabilitation of shoulder injuries and is a specialist consultant to the Australian Cricket
Team. She has treated a wide range of elite athletes including Olympic swimmers,
water polo players, tennis player and paddlers but also specializes in more common
shoulder conditions such as rotator cuff pathologies and the stiff shoulder. Lyn has also
conducted research into the long term clinical outcome of many surgical and
conservative management strategies that are commonly employed. She has developed
a unique, logical and progressive approach to assessment and rehabilitation
techniques.

Both the Level 1 and Level 2 courses have been fully accredited by the Australian
Physiotherapy Association.

Introduction and Course Philosophy

A unique 2-day practical course for physiotherapists with considerable
experience in the management of shoulder patients. There will be the
opportunity for the experienced therapist to observe “actual” patient assessment an
diagnosis and joint in an interactive discussion about clinical management strategies.
This course encourages therapists to openly discuss the “problem” areas of patient
management, look at difficulties encountered in clinical practice with progression of
rehabilitation, realistic clinical outcomes and time frames and problem pathologies
such as partial rotator cuff tears, thoracic outlet syndrome, hypermobile patients and
complex impingement syndromes. Substantial time is also committed to scapula
mechanics assessment and rehabilitation strategies.
Four “live” patient assessment sessions will provide a clinically beneficial practical
session to deal with the realistic issues faced by all shoulder therapists.
Course Aims
• To develop towards expertise in the assessment and management of
shoulder problems.
• To fine tune and enter into discussion of establishing evidence-based best
practice with regard to shoulder pathologies.
• To provide a framework for discussion and interactive development of clinical
skills for the higher level of therapist by providing a ‘hands on’ experience
with “real” patient demonstrations.

Learning Outcomes
On completion of the 2-day course the participant will be able to:

1. Examine detailed scapula mechanics dysfunctions and to be able to select appropriate

corrective strategies.
2. Differentiate shoulder and glenohumeral joint contributions to common clinical
assessment tests and findings.
3. Be able to specifically tailor scapula strengthening programmes to specific pathologies
and be able to progress appropriately.
4. Recognize problems encountered with shoulder rehabilitation programmes and be able
to try alternative strategies that may facilitate better progression of rotator cuff, deltoid
and scapula muscles.
5. Recognize the limitations that pathology may impose on realistic shoulder rehabilitation
programmes.
6. Demonstrate scapula and glenohumeral joint taping techniques.
7. Teach the assessment, diagnosis and treatment of thoracic outlet syndrome.
8. Assist in the development of clinical problem solving strategies by demonstration of
assessment of 4 patients.
9. Review and update conservative and surgical management strategies for glenohumeral
joint instability and SLAP lesions.
10. Review shoulder clinical outcome measurements and discuss appropriate selection for
specific patent populations.
11. Assist in assessment and management strategies for more complicated rotator cuff
pathologies.
12. Be aware of conservative and surgical management strategies available for the stiff
shoulder.
13. To facilitate integration of theoretical knowledge into the clinical setting.
14. Be aware of “common pitfalls” in the treatment of shoulder pathologies.
Teaching and Learning Methods
• Interactive lectures/discussion
• Case scenarios
• Practical classes
• Rehabilitation and taping demonstrations
• Video demonstration
• Case scenarios and Group problem solving sessions

Learning Resources for Students

Comprehensive referenced workbook. Copies of referenced material can be provided
by tutor where available.
CD can be purchased illustrating practical aspects of examination treatment and
rehabilitation techniques.

Publications

Watson L, Dalziel R, Story I (2000) “Frozen Shoulder: a 12-month clinical
outcome trial” Journal of Shoulder and Elbow Surgery (pp16-22)

Watson L, Dalziel R ((1996- Edited Allan Skirving) “Conservative Treatment of

Thoracic Outlet Syndrome by Scapula Strengthening Techniques” Shoulder
Surgery The Asian Perspective. Vol.2 Asian Shoulder Association (pp219-222)

The MISS Questionnaire – A New Clinical Outcome Measure for Glenohumeral

Joint Instability (in press) Journal of Shoulder and Elbow Surgery.

Thoracic Outlet Syndrome – Clinical Case Presentations (in press)

Green SG, Buchbinder R, Forbes A, Bellamy N, Benger D, Bills C, Bosworth C,

Nitschtke, Watson L, Wilson A “ A standardized protocol for measurement of
range of movement of the shoulder using the Plurimeter-V inclinometer and
assessment of its intrarater and interrater reliability” Arthritis Care and
Research, 1998. 11:p.43-52.

Watson L, Bialocerkowski A, Pollington H, Dalziel R, Hoy G. “Validity of the MISS

Questionnaire – a 2-year outcome study” (in press) Journal of Shoulder and
Elbow Surgery.

“Measurement Of Scapula Upward Rotation: A Reliable Clinical Procedure" (in

press) British Journal of Sport Medicine.

Watson L, Bialocerkowski A, Dalziel R, Balster S. “Hydrodilatation (Distension

Arthrography; A Long Term Clinical Outcome Series)” (in press) Journal of
Shoulder and Elbow Surgery.
Level 2 / Advanced Shoulder Course - Lyn Watson
Outline
Day 1
Interactive Lecture/Demonstration
9.00 am - 10.30 am Advanced scapulohumeral assessment techniques.
Objective measurement techniques for scapula.
Research findings
Video presentation of scapula asymmetry

10.30 am - 11.00 am Morning tea & Questions

Practical Session
11.00 am - 12.45 pm Scapulohumeral Assessment continues
Progression of Shoulder strengthening – detailed discussion of how to structure
progression of shoulder recruitment and strengthening techniques.

12.45 pm - 1.30 pm Lunch

Patient Demonstration
1.30 pm - 2.30 pm Patient 1

Patient Demonstration
2.30 pm - 3.30 pm Patient 2

3.30 pm - 3.45 pm Afternoon Tea

Interactive Lecture/Demonstration
3.45 pm - 4.30 pm Thoracic Outlet Syndrome
Taping techniques

Day 2
Interactive Lecture/Demonstration
9.00 am - 10.30 am Instability Update/SLAP lesions
Outcome measurements

10.30 am - 11.00 am Morning Tea & Questions

Patient Demonstration
11.00 am - 12.00 pm Patient 3

Patient Demonstration
12.00 – 1.00 pm Patient 4

1.00 pm – 1.45 pm Lunch

Interactive Lecture
1.45 pm – 2.45 pm Rotator cuff
-partial tears
-subscapularis tears
-sub-coracoid impingement
-surgical success & failure

Practical Interactive Session

2.45pm – 3.30 pm Patient Problem solving session