Post-Operative Shoulder: Contemporary Perspectives for Evidence Enhanced Rehabilitation

Course Instructor

Karl Kolbeck, BScPT, OCS, SCS, COMT, FAAOMPT

  • Board Certified Orthopedic Clinical Specialist
  • Board Certified Sports Clinical Specialist
  • Certified Orthopedic Manipulative Therapist
  • ​Fellow American Academy of Orthopedic Manual Physical Therapist

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Course Description

Mr. Kolbeck developed this 2-day course to provide current evidence supporting post-surgical rehabilitation management about the shoulder girdle. Normal anatomy and pathoanatomy as well as normal age spectrum changes characteristic of joints and soft tissue about the shoulder girdle will be discussed. A review of tissue integrity perspectives at the time of surgery and its relationship to the surgeons’ choice for immobilization period and rehabilitation progression of forces will also be shared. Functional and objective outcomes relative to specific procedures as available in the literature will be presented and the importance of recognizing predictable limits reviewed.

Chronology and soft tissue healing rate based post-operative rehabilitation guidelines for procedures at the SC, AC and GH joint and subacromial space will be presented. Evidence supporting post-surgical management based on current literature to promote optimal rehabilitation guidelines for common and not-so-common surgical procedures will be shared.

Lesions specific to the overhead athlete and the throwing shoulder as well as post-surgical management of this population and unique considerations are shared. A comprehensive list of evidence based progressive resistive exercises is also discussed to allow optimal isolation for force progression strengthening. Lastly, demonstrations via video or real-time mode will be performed for mobilizations, manual rhythmic stabilization techniques therapeutic exercise about the shoulder girdle.

Objectives

  • ​Explain normal and pathoanatomy about the shoulder and normal age spectrum tissue changes
  • Understand the importance of soft tissue integrity at surgical repair sites and implications on immobilization periods and rehab CKC and OKC progression of forces
  • Scapula Dyskinesia, Total Arc of Motion, GIRD, SICK Scapula…explain the importance of each and correlations to pathology and rehab
  • Understand rehab considerations unique to the overhead and throwing athlete and the 50+ year old patient
  • Appreciate current evidence supporting post-operative functional and objective outcomes where available
  • Describe post-operative rehab guidelines for SC jt procedures, and AC jt coracoclavicular ligament auto-, allo-, and synthetic graft stabilization and AC jt decompression/distal clavicle resection techniques (Mumford procedure and variants of)
  • Describe post-operative rehab considerations for subacromial decompression procedures for primary (outlet) impingement and debridement for posterior internal impingement
  • Apply current evidence supporting GH joint pathology post-operative management for:
    • SLAP lesion Types I – IV and variants…open vs arthroscopic, and implications of the bicep long head based on preservation, tenodesis or tenotomy
    • Instabilities: MDI, Anterior and Posterior stabilization including Remplissage for the Hill-Sachs lesion and Latarjet for chronic anterior instability
    • Partial, Full-thickness and Massive rotator cuff repairs …open vs arthroscopic, single vs double row stitching and Graftjacket augmentation – how does rehab differ and are outcomes different – and the PASTA lesion
    • Total and Reverse Total Shoulder arthroplasties
  • Define peripheral nerve cysts at the shoulder and incidence with labral lesions, and sequelae useful in clinical detection
  • Describe optimal shoulder girdle therapeutic strengthening exercises based on EMG evidence
  • Apply exercises about the rotator cuff to foster reduced subacromial compressive forces and protect the supraspinatus during early stages of rehab

Testimonials

  • Mr. Kolbeck provides a gold-standard in continuing education for the clinician. Course material is second to none and overall presentation is relevant and professional. It is apparent how much time and energy is spent in developing this course. I would highly recommend to any physical therapist. Steve M
  • Karl was engaging, articulate, well-informed and compelling with his delivery. Courtland Reger, MSPT, OCS, AT-C; Anchorage AK
  • Would definitely recommend this course to others. Heather Augustines, PT; Anchorage AK
  • Amazing job of organizing – so well prepared. Very up to date info. Seattle WA
  • Impressive blending surgical, research and rehab concepts. Seattle WA
  • Clinically relevant; great speaker! Renee James, MSPT, OCS; Seattle WA
  • Very informative; like the evidence based info and research, exercise ideas and progression. Seattle WA
  • Karl is organized, very polite, respectful of audience…knowledgeable, great energy level. Love the evidence based approach to treatment. Mickey Townshend, PT, OCS; Seattle WA
  • Well presented and great to hear Karl presenting research as well as his anecdotal clinical experience. Seattle WA
  • Excellent professional course. Great review and new research. Cheryl Meyers, PT, DPT, DMT, OCS; Anchorage AK
  • Extremely helpful (course) with problem post-op patients, pitfalls and stiff shoulders. Seattle WA
  • Karl, I am grateful for your experience and gift of teaching! Great course. Anchorage AK
  • Great job. Very professional. Wonderful example of an evidence-driven, collaborative PT! Seattle WA
  • Karl is very knowledgeable, clear – willing to take time to answer questions. Anchorage AK
  • Even though I like to think I stay on top of the research I always feel so up-to-date after attending Karl’s classes. Seattle WA
  • Very approachable. Great experience and bring it all together to give a more complete picture. Seattle WA