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On this episode of the Healthy Wealthy and Smart Podcast, Jo Gibson is featured to discuss physical therapy treatment of the unstable shoulder. Jo is a Clinical Physiotherapy Specialist working at the Liverpool Upper Limb Unit at the Royal Liverpool Hospital and a Consultant in private practice. She has worked as a Shoulder Specialist since 1995 and lectures nationally and internationally about assessment and rehabilitation of the shoulder complex. Jo has co-developed Masters modules with Liverpool University for the diagnosis and treatment of upper limb pathology and has co-authored national guidelines for the management of different shoulder pathologies. She has presented original research at many National and International conferences, published in peer-reviewed journals and written several book chapters. In addition she is an Associate Editor of the British Shoulder & Elbow Journal.
In this episode, we discuss:
-Using patient history to classify shoulder pathology
-Factors to consider when deciding whether to treat with surgery or rehabilitation
-The nervous system’s role in shoulder instability
-How to use language and metaphors to develop buy-in
-Jo’s takeaways from the British Elbow and Shoulder Society Conference
-And so much more!
Jo prioritizes learning about a patient’s history during the initial evaluation because it can serve as a roadmap for treatment. Jo has found that, “The biggest investment of my time is hearing how everything started and what the story has been from there.” Jo believes patient history to be more valuable than other evaluation method as she states, “The history tells me far more than any clinical test.”
Symptom modification can be an important psychological tool to encourage more confidence in a patients shoulder capabilities. Jo stresses, “It is very empowering for the patient because it shows them that if we make their muscles work differently they are stable.”
Jo’s treatment protocol includes a variety of functional exercises which utilize external cues to promote motor learning and neuroplasticity. Jo believes there is room for physical therapists to get creative with these treatments and that sometimes, “We kind of undermine the artistry of what we do.”
Jo has found that improving her communication skills has led directly to improved physical therapy treatment outcomes. Jo reminds us that, “This is about being human. Communication underpins everything we do… Patients are just the biggest source of information and actually they give us all of the clues and give us the language to use.”
For more information on Jo:
Jo Gibson Grad.Dip.Phys MSc.(Adv.Pract) MCSP. Jo Gibson studied physiotherapy at the Salford College of Technlogy and qualified in 1987. Her physiotherapy career started in Nottingham in 1987 at Queen’s Medical Centre where an encounter with Professor Angus Wallace fuelled her interest in the shoulder.
Jo moved to Liverpool in 1989 and after completing several years of rotational experience she joined forces with Professor Simon Frostick and in 1996 she became one of the first specialist Upper Limb Physiotherapists in the UK.
In order to increase her subspeciality knowledge and expertise, Jo completed travel fellowships in the UK, Europe and the USA sponsored by the British Elbow and Shoulder Society and Royal Liverpool University Hospital Trust Charities Board.
Since that time the Liverpool Upper Limb Unit has gained an International reputation as a centre of Excellence in Shoulder and Elbow surgery and it was here that Jo started working with Peter Brownson.
Jo has a passion for education and since 1996 she has lectured nationally and internationally on rehabilitation of the shoulder and she runs her own courses all over the World.
Internationally, in 2004 she was a co-founder of the International Congress of Shoulder and Elbow Therapists, a meeting which now runs tri-annually. In addition, Jo has served as Vice president and Chair of the education committee on the EUSSER board (European Society of Shoulder & Elbow Rehabilitation).
Nationally, Jo has been the AHP representative on the British Elbow and Shoulder Society (BESS) Council and in addition she has served as a member of the BESS Research and Education Committees. She is an associate lecturer at the University of Liverpool and has co-developed tailormade masters modules to support physiotherapists working in or towards specialist Upper Limb appointments.
Jo completed her Masters in Advanced Practice at Liverpool University in 2012 and completed her dissertation on the Biopsychosocial model cementing her belief in tailoring treatment to the individual and the importance of communication skills.
She continues to be involved in upper limb research, has presented original research at many National and International conferences winning three Best Paper prizes. She has published in peer-reviewed journals and written several book chapters. Jo has also co-authored BESS Care Pathways for the British Elbow and Shoulder Society.
Jo’s recognized expertise in the assessment and management of shoulder pathology has resulted in consultancy work with many elite sports teams in a variety of sports including football, rugby, cricket, gymnastics, swimming, boxing and tennis. In addition she is regularly sought out by other clinicians to help problem solve more challenging presentations.
Her close working relationship with Peter Brownson has been pivotal in the opportunity to develop postoperative rehabilitation regimes facilitating early return to sport or function and has resulted in a publication of results in an elite football population.
Resources discussed on this show:
Sham surgery versus labral repair or biceps tenodesis for type II SLAP lesions of the shoulder: a three-armed randomised clinical trial
British Elbow and Shoulder Society
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