What drew you to focus on shoulder pathology?

There’s a line in a John Lennon song that quotes ‘Life is what happens when you’re busy making other plans’.

My original plan was to research foot biomechanics and their impact locally and throughout the kinetic chain.

At the same time, I started questioning the validity of the subacromial impingement theory, as well as upper body posture, and these two issues became the focus of my PhD.

The shoulder has long been my focus for research in clinical practice and it has also been a stepping stone for a much greater challenge—improving musculoskeletal healthcare for the communities we serve.

Who would benefit most from attending ‘The shoulder theory and practice—online delivery’ and what does the course cover?

The focus of the course is musculoskeletal conditions involving the shoulder.

However, the content goes considerably beyond that.

It reframes musculoskeletal healthcare and embraces a biopsychosocial approach that includes an understanding of environmental and lifestyle factors.

I’ve had the privilege of teaching this course across the world for many years, in both live face-to-face formats and, because of the restrictions imposed by the pandemic, live online events.

The course is now in its 22nd edition and this new version is based on a recently published book of the same name, which I edited and wrote for.

It was something I had wanted to do for a long time and the changes imposed by COVID-19 provided an opportunity to work on it.

I was delighted that over 100 authors from around the world contributed and that the first print run, which was planned to last two years, in fact sold out after two weeks and four days.

The second print run sold out in under three weeks and currently is only available as an eBook.

I have taught this course to physiotherapists, chiropractors, osteopaths, sports and exercise medicine doctors, general practitioners, orthopaedic surgeons, rheumatologists and psychiatrists.

The ethos of both the book and the course is how to place the most important person in healthcare—the patient—at the centre of the clinical encounter.

Why is it important to take a biopsychosocial approach to patient treatment and management?

We must end the era of paternalistic healthcare.

Although we talk about improvements in our health systems, a lot more needs to be done by all stakeholders, including politicians, healthcare providers, educators, the media, insurers, commissioners and patient groups.

There is considerable unnecessary waste in most healthcare systems and as we emerge from this horrible pandemic that has changed all our lives, we must be certain that we are providing the best care to all those in need across our societies.

Physiotherapist Jeremy Lewis, focusing here on the shoulder, advocates for the benefits of a biopsychosocial approach.

The biggest waste arguably relates to elective procedures designed to fix the pathoanatomical structures believed to be causing patient symptoms.

We know today that this is simply not correct and wastes precious healthcare resources.

A biopsychosocial approach focuses instead on the unique individual and the condition that the individual is living with.

During the pandemic, many of the UK physiotherapists who give injections participated in the vaccination program.

I was involved in a program for people who were unable to attend clinics and instead received injections in their own homes.

This reinforced for me that not everybody lives in similar environments and has access to the same facilities and healthcare education and that it is wrong for us to think that one size fits all.

It’s easy to say to a person seeking care for a musculoskeletal shoulder problem that a formal exercise program is the best management.

This may be the case for many people.

However, a single parent working two jobs to make ends meet may not have the same ability to participate as someone else.

Taking a biopsychosocial approach allows us to understand that individual and to adapt our management of their condition to their unique circumstances.

What can participants expect to take away with them for use in everyday practice?

I hope that participants will feel more confident in the assessment and management of musculoskeletal shoulder problems and that the philosophy I present also contributes to improving musculoskeletal healthcare generally.

‘The shoulder theory and practice—online delivery’, presented by Jeremy Lewis, will run virtually from 3 pm until 7.30 pm, 25–27 August. Click here for more information and to register. Participants will be able to watch three hours of pre-course theory videos and at the end of the online course will have one month’s access to all the theory lectures (about 20 hours) and all the practical videos (about 120 in total). 

>> Jeremy Lewis is a consultant physiotherapist and Professor of Musculoskeletal Research at the University of Limerick, Ireland. He has taught more than 500 workshops in over 45 countries on his favourite clinical subject, the shoulder. Jeremy’s main areas of research interest are rotator cuff related shoulder pain, frozen shoulder, injection therapy and exercise therapy self-management. He has been awarded a Fellowship of the Chartered Society of Physiotherapy and is a special features (Viewpoint) editor for the Journal of Orthopaedic and Sports Physical Therapy. He edited and wrote for a recently published book, The Shoulder: Theory and Practice.