Patients with atraumatic sternoclavicular joint (SCJ) instability may have pain during overhead activities, throwing or playing sport. How can you diagnose and successfully rehabilitate SCJ instability? Find out in this podcast with Jo Gibson (Clinical Physiotherapy Specialist), and explore:

Assessment & diagnosis

• Which bony surfaces, ligaments and muscles provide stability at the SCJ.
• Why do patients develop SCJ instability, and what are the risk factors?
• What the research reveals about SCJ instability.
• Common symptoms that help you identify SCJ instability.
• Questions you need to ask that help with diagnosis.
• Posterior instability - Common symptoms & anatomical structures that can be impacted.
• How to identify clavicular epiphyseal plate injuries in young athletes.
• When closing of the proximal clavicular epiphyseal plate occurs, and why this is important to know.

Rehab & recovery

• Rehab exercises you can use to develop muscular support for the SCJ.
• How and why you can add C/Sp exercises into SCJ rehab.
• How long recovery will take your patients.
• When patients are likely to start noticing improvements in symptoms.
• Will SCJ instability patients continue to experience instability and pain after rehab?
• Is this condition self-limiting?
• How can involvement of the SCJ disc be identified?
• What imaging can be helpful?
• When should you request SCJ imaging?
• When is SCJ surgery indicated?

Jo also answered these questions from FB Live listeners:

• Does hypermobility change with age?
• Can asymptomatic SCJ instability occur in weightlifters that do not have hypermobility, and do we need to treat it?
• Which SCJ patients benefit from injections?
• When should SCJ injections be avoided?
• What autoimmune inflammatory conditions may result in SCJ swelling?

Podcast handout

The handout for this podcast consists of articles referenced in the podcast. There is no additional transcript or handout available.

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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
• Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson
• The Hypermobility Syndromes Association (HMSA)
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• Infographics by Clinical Edge

Articles associated with this episode:

• Download the podcast handout to receive the articles associated with this podcast.

• Castori M, Tinkle B, Levy H, Grahame R, Malfait F, Hakim A. A framework for the classification of joint hypermobility and related conditions. InAmerican Journal of Medical Genetics Part C: Seminars in Medical Genetics 2017 Mar (Vol. 175, No. 1, pp. 148-157).

• Malfait F, Francomano C, Byers P, Belmont J, Berglund B, Black J, Bloom L, Bowen JM, Brady AF, Burrows NP, Castori M. The 2017 international classification of the Ehlers–Danlos syndromes. In American Journal of Medical Genetics Part C: Seminars in Medical Genetics 2017 Mar (Vol. 175, No. 1, pp. 8-26).

• Martetschläger F, Warth RJ, Millett PJ. Instability and degenerative arthritis of the sternoclavicular joint: a current concepts review. The American journal of sports medicine. 2014 Apr;42(4):999-1007.

• Sewell MD, Al-Hadithy N, Le Leu A, Lambert SM. Instability of the sternoclavicular joint: current concepts in classification, treatment and outcomes. The bone & joint journal. 2013 Jun;95(6):721-31.