Lesson 1Anatomy review: rotator cuff (supraspinatus, infraspinatus, teres minor, subscapularis), bursa, acromion and coracoacromial archThis section reviews the functional anatomy of the rotator cuff, subacromial bursa, acromion, and coracoacromial arch, emphasising how structure, vascularity, and biomechanics relate to subacromial pain, tendon overload, and common degenerative changes.
Roles of supraspinatus and infraspinatus in elevationSubscapularis and teres minor in rotation controlSubacromial bursa structure and pain generationAcromion shape and coracoacromial arch mechanicsAge-related changes in rotator cuff tissuesLesson 2Red flags and when to refer: systemic signs, cervical radiculopathy, inflammatory disease, septic arthritisThis section reviews red flags that require medical referral, including systemic signs, suspected cervical radiculopathy, inflammatory arthropathy, fracture, and septic arthritis, and outlines decision-making for urgent versus routine referral pathways.
Systemic signs suggesting serious pathologyScreening for cervical radiculopathy featuresRecognizing inflammatory and autoimmune diseaseIdentifying possible septic arthritis or fractureCriteria for urgent versus routine referralLesson 3Strength testing and load tolerance assessment: isometric strength, resisted tests for supraspinatus and external rotators, pain provocation vs weaknessThis section outlines methods for assessing shoulder strength and load tolerance, including isometric testing, resisted tests for supraspinatus and external rotators, and strategies to distinguish pain inhibition from true weakness during clinical examination.
Standardized isometric strength testing positionsResisted supraspinatus testing and interpretationAssessing external rotator strength and enduranceDifferentiating pain inhibition from true weaknessDocumenting strength changes over rehabilitationLesson 4Interpreting imaging reports (ultrasound, MRI) and integrating with clinical findings: partial-thickness vs full-thickness tears, tendinopathy signsThis section explains how to interpret ultrasound and MRI reports for subacromial pain, distinguish partial- from full-thickness rotator cuff tears, recognise imaging signs of tendinopathy, and integrate these findings with clinical examination and patient symptoms.
Key ultrasound findings in rotator cuff tendinopathyMRI features of partial- and full-thickness tearsCorrelating imaging severity with symptomsCommon incidental findings and their relevanceCommunicating imaging results to patientsLesson 5Palpation, special considerations for night pain, sleep positions, and load-related symptom patternsThis section covers targeted palpation of the rotator cuff and bursa, interpretation of tenderness patterns, and how night pain, sleep position, and load-related symptom behaviour help differentiate subacromial pain from other shoulder and cervical conditions.
Palpation of supraspinatus and infraspinatus tendonsIdentifying subacromial bursal tendernessInterpreting night pain and sleep disturbanceAdvising shoulder-friendly sleep positionsLoad-response patterns in daily and sport tasksLesson 6Key clinical tests for subacromial pain and rotator cuff tendinopathy: painful arc, empty can/full can, resisted external rotation, Hawkins-Kennedy, Neer impingement testThis section details the most useful clinical tests for subacromial pain and rotator cuff tendinopathy, including performance, interpretation, and diagnostic value of painful arc, empty and full can, resisted external rotation, Hawkins-Kennedy, and Neer tests.
Standardized test order and patient positioningPerforming and interpreting the painful arc testEmpty can and full can test technique and pitfallsResisted external rotation and lag signsHawkins-Kennedy and Neer impingement proceduresLesson 7History-taking specific to shoulder pain: onset, aggravating/relieving factors, night pain, activity demands (tennis, computer work)This section focuses on targeted history-taking for shoulder pain, including onset pattern, aggravating and easing factors, night pain, occupational and sport demands, and prior treatments, to guide hypothesis generation and individualised assessment.
Clarifying onset, trauma, and symptom progressionMapping aggravating and relieving activitiesExploring night pain and 24-hour symptom patternWork demands such as computer and manual tasksSport and overhead activity load profilingLesson 8Assessing psychosocial factors and fear-avoidance: brief screening tools and interviewing strategiesThis section addresses psychosocial contributors to shoulder pain, including fear-avoidance, catastrophising, and low mood, and describes brief screening tools and interviewing strategies to integrate these factors into assessment and treatment planning.
Recognizing fear-avoidance and catastrophizingBrief screening questionnaires for shoulder painOpen-ended questions to explore patient beliefsValidating distress while promoting self-efficacyIntegrating psychosocial findings into rehabLesson 9Range of motion and scapular kinematics assessment: active vs passive ROM, scapular upward rotation, posterior tilt, and protraction testsThis section explains how to assess active and passive shoulder range of motion and scapular kinematics, including upward rotation, posterior tilt, and protraction, and how to relate movement findings to pain, function, and exercise planning.
Measuring active and passive glenohumeral ROMIdentifying painful versus restricted end rangesObserving scapular upward rotation and timingAssessing scapular posterior tilt and protractionLinking movement findings to exercise selection
