108. Cervical spine referred shoulder pain assessment, diagnosis & treatment with Jo Gibson
Release Date: 12/07/2020
Physio Edge podcast
Patellofemoral pain (PFP) rehabilitation doesn’t end when your patient gets stronger. The real challenge is getting them back to running, training and racing without triggering another flare-up. In this final episode of the four-part series, Tom Goom (Running Physio) and David Pope explore the fourth pillar of successful PFP rehabilitation: a planned return to running. Continuing Alice’s journey from the previous episodes, a HYROX athlete preparing for competition, Tom and David break down exactly how to rebuild running volume, progress training safely, and help runners hit their goals,...
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Strengthening exercises are a key part of successful patellofemoral pain (PFP) rehabilitation. Squats, lunges and single leg squats are often painful early on and can aggravate your patients pain, but on the flip side, we want to build up their tolerance and confidence with these movements. If you introduce an exercise your patient isn’t ready for, progress too quickly, or overload the knee too early, you’ll often flare your patients pain and set their rehabilitation back. In this episode, Tom Goom (Running Physio) and David Pope explore the third pillar of successful PFP treatment:...
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When is your patient's shoulder pain from their neck? Are you missing a cervical spine component in your shoulder patients? After a day in clinic reviewing patients with years of unresolved shoulder pain, Shoulder Specialist Physiotherapist Jo Gibson breaks down the five most common mistakes clinicians make when ruling in — or out — the neck. In this podcast, Jo covers: Why you don't need neck pain to have neck-driven shoulder pain (and which pain locations are most pathognomonic) Why referred symptoms below the elbow don't automatically point to the cervical spine Why active range of...
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Anterior hip pain is often blamed on the hip flexors, but in runners, that’s rarely the diagnosis. So how can you identify the real cause and guide patients to a safe, effective recovery? In this episode, Tom Goom (Running Physio) explores the function of the hip flexors in running, key differentials for anterior hip or groin pain, and practical rehab strategies you can use right away. You’ll discover: Why true hip flexor tendinopathy is uncommon in endurance runners Red flags and key tests to identify bone stress fractures and intra‑articular pathology Early‑stage loading strategies...
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Your patient presents with shoulder pain, and straight away you need to identify: Is it rotator cuff related shoulder pain, frozen shoulder, instability, or something else entirely? Is it rotator cuff related shoulder pain, frozen shoulder, instability, or something else entirely? Is the pain actually coming from the shoulder? Could it be the cervical spine? Is there a tear that needs urgent referral? Should you order imaging? Refer to a surgeon? Or confidently continue with rehab? In this podcast, Jo Gibson (Upper Limb Rehabilitation Specialist Physio) guides you through a simple,...
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Your patient is running, playing sport, or jumping or lunging forward - an activity with fast eccentric or concentric activity in dorsiflexion,and suddenly they feel like they’ve been kicked in the back of the leg. They might hear a snap and have difficulty weightbearing, walking and pushing off. What’s your likely diagnosis? You picked it - an Achilles tendon (AT) rupture. AT ruptures are a devastating injury that can drastically impact a patient’s ability to walk, run, or return to sport. Despite their frequency, there’s a lot of uncertainty among clinicians, patients, and even...
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When is shoulder pain from the C/sp? When a patient presents with shoulder pain and stiffness, how can C/Sp referral be identified? If a patient has full neck range of movement, and neck movements don’t reproduce shoulder pain, can their pain still be from the C/sp?
Recent research shows that including treatment of the C/sp can improve results in up to ⅓ of shoulder pain patients. In this video with Jo Gibson (Clinical Physiotherapy Specialist) discover how to identify, assess and treat patients with cervical referral, including:
- What history and pain features will patients with cervical referred shoulder pain report?
- What assessment tests can be performed to diagnose or rule out the C/Sp involvement in shoulder pain?
- What information does palpation and repeated movements in the objective assessment provide?
- What does the research reveal about cervical referred shoulder pain?
- What biopsychosocial factors may be involved in cervical referred shoulder pain?
- How can manual therapy to the C/Sp improve shoulder range of movement?
- What education can be provided to patients with cervical spine referral?
- What exercises and exercise variations may be used to improve cervical referred shoulder pain?
- Are upper muscle fibres of trapezius “overactive” or are these muscles actually weak?
- What exercises can be used for upper traps in C/sp referred shoulder pain?
- What manual therapy can be used for C/sp referred shoulder pain?
- Does the thorax get “stiff”, and what exercises help improve thoracic range of movement?
Podcast handout
The handout for this podcast is articles referenced in the podcast. There is no additional transcript or handout available.
Free webinar “5 common mistakes therapists make with shoulder pain, and what to do about them” with Jo Gibson
Register now for the free webinar "5 common mistakes therapists make with shoulder pain, and what to do about them" with Jo Gibson (Upper Limb Specialist Physio)
Frozen and stiff shoulder assessment & treatment with Jo Gibson
Shoulder: Steps to Success online course with Jo Gibson
Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess
Links associated with this episode:
- Improve your assessment and treatment of frozen and stiff shoulders now with Jo Gibson’s online course at clinicaledge.co/frozenshoulder
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Articles associated with this episode:
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- Download the podcast handout to receive the articles associated with this podcast.
- Alonso-Perez JL, Lopez-Lopez A, La Touche R, Lerma-Lara S, Suarez E, Rojas J, Bishop MD, Villafañe JH, Fernández-Carnero J. Hypoalgesic effects of three different manual therapy techniques on cervical spine and psychological interaction: A randomized clinical trial. Journal of Bodywork and Movement Therapies. 2017 Oct 1;21(4):798-803.
- Hauswirth J, Ernst MJ, Preusser ML, Meichtry A, Kool J, Crawford RJ. Immediate effects of cervical unilateral anterior-posterior mobilisation on shoulder pain and impairment in post-operative arthroscopy patients. Journal of back and musculoskeletal rehabilitation. 2017 Jan 1;30(3):615-23.
- Katsuura Y, Bruce J, Taylor S, Gullota L, Kim HJ. Overlapping, Masquerading, and Causative Cervical Spine and Shoulder Pathology: A Systematic Review. Global Spine Journal. 2020 Apr;10(2):195-208.
- Vicenzino B, Collins D, Benson H, Wright A. An investigation of the interrelationship between manipulative therapy-induced hypoalgesia and sympathoexcitation. Journal of manipulative and physiological therapeutics. 1998 Sep 1;21(7):448-53.






