Shoulder instability is rarely a simple strength problem. Athletes often present with ongoing symptoms despite good capacity, and the challenge becomes understanding what is actually failing — and how to target it effectively.

This session breaks down the management of shoulder instability into a clear clinical framework, from early-stage rehabilitation through to advanced loading. You’ll explore anterior and posterior cuff strategies, scapular contribution, and the role of co-contraction in restoring control and confidence.

The emphasis is on making better decisions in clinic — knowing what to target, how to load it, and how to progress without over-complicating rehabilitation.

Managing shoulder instability: from an acute episode through to end stage rehabilitation

9:00 – Clinical assessment of the unstable shoulder

• Review assessment processes / special tests

9:30 – Diagnosis of instability

• Assessment of the unstable athlete

10:30 – Morning Tea

11:00 – Managing instability

11:30 – Theoretical – Acute, Subacute, Advanced

• Sub-acute management
• Subscapularis protocols

12:00 – 1:00 – Lunch

1:00 – Subacute management

• Infraspinatus protocols

2:15 – Scapula assessment and treatment options with progressions

3:00 – Short break

3:15 – Co-contraction protocol

3:30 – Case summary

4:00 – Finish

VENUE: Pro-Health Physio / Pioneer Performance, 5, 5 Hawick Cres, Newcastle upon Tyne NE6 1AS, United Kingdom

Goals for Day One: Shoulder Instability

• 1.    To be able to undertake a thorough and comprehensive assessment of a patient with shoulder instability.

• 2.    Clinicians will be able to differentiate directions of instability and identify key clinical signs of shoulder instability

• 3.    To design a progressive rehabilitation plan for patients with shoulder instability, targeting subscapularis and infraspinatus / teres minor and differentiate from the scapula

• 4   Use co-contraction protocols to address shoulder instability in more than two directions

Learning Outcomes: Managing Shoulder Instability

Clinical Assessment

1.    Perform a comprehensive clinical examination of the shoulder, including specific tests for instability.

2.    Interpret the results of special tests such as the apprehension test, relocation test, and load-and-shift test.

Diagnosis

1.    Differentiate between various types of shoulder instability (e.g., anterior, posterior, multidirectional).

2.    Identify key clinical signs and symptoms indicative of shoulder instability in athletes.

Management Strategies

1.    Design a progressive rehabilitation program for acute shoulder instability.

2.    Implement appropriate manual therapy techniques for managing subacute shoulder instability.

Subscapularis and Infraspinatus Protocols

1.    Demonstrate specific exercises targeting the subscapularis muscle in shoulder instability rehabilitation.

2.    Apply progressive resistance techniques for infraspinatus strengthening in the subacute phase.

Scapula Assessment and Treatment

1.    Conduct a thorough assessment of scapular position and movement.

2.    Develop a tailored exercise program to address scapular dyskinesis in athletes with shoulder instability.

Co-contraction Protocols

1.    Explain the importance of co-contraction in shoulder stability.

2.    Design and implement exercises that promote optimal co-contraction of shoulder musculature.

Case Study Analysis

1.    Apply theoretical knowledge to real-world clinical scenarios involving shoulder instability.

2.    Formulate evidence-based treatment plans for complex cases of shoulder instability in athletes

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