Continuing Education Bits for PTs & PTAs

Treating patients with shoulder issues? Then this article is for YOU!



OneIf you want to activate the Rhomboids in an exercise program, it is best to be done isometrically at the end range (and usually toward the end of the exercise program).


twoThe supraspinatus, while one of the rotator cuff muscle, functions mostly to pull the deltoid head into the glenoid.If the supra shows any signs of weakness, it should be strengthened early in the exercise program, and at the lower (first 30 degrees) of elevation.


ThreeEvery sport is unique, and requires unique motor control. As Physical Therapist, we all know which muscles function at each phase of the gait cycle.  Similarly, as therapists, we need to understand the muscle activity during each phase of the sporting activity, and know the substitution patterns so that we can most accurately treat the athlete.


FourSpecific stretches can be good for a patient, or they can be bad. When they are our patients, we can see that rationale and appropriate select the correct stretch.  What do you do, however, if you are advising a team on warm up stretches?  What do you take into consideration in selecting Team Warm-Ups and Cool Downs?


FiveThe serratus anterior functions as an ‘endurance’ muscle during the freestyle swim stroke.  Thus, it needs special attention for team exercises and, if the swimmer is your patient, definitely check for any signs of weakness in the serratus. Typically, the serratus in one of the first muscles to fail: therefore it is commonly one the basis for early subtle signs.

To hone your knowlege and skills on the shoulder, check out two of our courses, taught by Marilyn Pink, PT, Ph.D., a sports rehab expert who worked closely with such luminaries as Dr. Frank Jobe and Dr. Jaqueline Perry to develop innovative orthopedic techniques that are widely used today.

 Shoulder-1-thumb  Plus  Shoulder-2-thumb

These courses examine the anatomy, mechanics and pathomechanics of the shoulder complex in amazing depth and detail. You will learn how these factors apply to specific sports, such as golfing, swimming, and playing baseball and tennis.

PURCHASE THEM TOGETHER AND RECEIVE A 15% DISCOUNT! If you are interested in this offer, send an e-mail to to receive your coupon code.


Comments on: "Top 5 Things a PT Should Know About Treating the Shoulder" (2)

  1. Hi Michael! If you go to and login — you can go to this research article:

    This was a fine wire EMG study that looked at the scapular muscles during 16 exercises. Consistently the rhomboids proofed they were more of a ‘tonic’ muscle — which makes sense, they are short muscles and closer to the skeletal frame. The position the recruited the most muscle activity for the rhomboids was end-range, isometric.

    Oh, and in the clinic, I found that if I positioned the patient on his/her back, and asked them to squeeze their shoulder blades together as I gave a quick stretch opposite the direction of the rhomboids muscle fibers, voila! They very quickly ‘got it’.

    As a matter of fact, a pro golfer came to me after he’d completed a shoulder rehab program, said “it just doesn’t feel right” – and his game was off. I did one trial of that rhomboid exercise with a quick stretch and he jumped up, danced around and shouted “That’s it! That’s what I was missing!” Obviously, we had to do lots more of that exercise until it automatically fired when needed during his game — but he got his swing back!

    Does that help Michael?? Let me know if you have any thoughts!


    PS (the course on the shoulder will give you this, and many more tips)

  2. said:

    Thank you for the post. In regards to #1, why isometrically, and why toward the end range? Thank you.

    Michael Knox PT, OCS, PA-C

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