Patient Referrals
Specialty MSK Physios provide the highest level of rehabilitative care - offering clinical expertise, diagnostic accuracy and specific treatments for a variety of conditions.
Physician referrals are welcome, but not required, to access specialty MSK physio.
SELECT YOUR PROFESSION
Surgical Referrals
General Physician Referrals
Specialist Referrals
Specialist Referrals
General Physician Referrals
Specialist Referrals
General Physician Referrals
General Physician Referrals
Physiotherapy & Allied Health
Physiotherapy & Allied Health
Physiotherapy & Allied Health
Physiotherapy & Allied Health
Clubs, Coaches & Trainers
Physiotherapy & Allied Health
Insurance and Legal Requests
Insurance and Legal Requests
Physiotherapy & Allied Health
Insurance and Legal Requests
PATIENT REFERRAL PROCESS
Surgical Referrals
Expertise in Shoulder Pain & Injury
- Clinical diagnostics - identifying pain sources through comprehensive clinical examination, functional and stress testing
- Therapy review - 2nd opinion / review of the patient's current diagnosis and treatment plan
- Movement disorders - assessment and correction of biomechanics
- Recommendations for strong surgical candidates
- Collaborative support for complex surgeries
Non-Surgical Solutions
- all stages of capsulitis +/- small cuff pathology
- symptomatic calcific tendinopathy & spinal referral (Cx / Tx)
- bursitis & cervical spine referral
- acute and recurrent mild-mod instabilities of the GHJ / ACJ
- scapular dyskinesis - primary and secondary
- complex upper extremity pain presentations
Pre-operative Assessments
A single physiotherapy session is commonly all that is required to set correct post op expectations and ensure they understand their early post op restrictions and movements.
Post-Operative Rehabilitation
Specialty MSK shoulder physiotherapy includes a working knowledge of all standard operative procedures, most surgical variations, and early and late surgical complications for each procedure.
Post surgical protocols incorporate ASES and ASSET guidelines where available with considerable margins for full protection of the surgical site.
Specialty Shoulder Protocols are used for:
- SAD, LHB tendonesis & other pain relieving procedures
- Bankart and Latarjet procedures
- Hemiarthroplasty, TSA and rTSA (LT osteotomy & SSC releases)
- Cuff and various labral repairs
- ACJ resections and repairs
- Post traumatic contractures / post operative stiffness
SURGICAL COMMUNICATION
Operative Report Availability
Surgical information provides a basis for many recommendations and patient answers, including when patients request specific guidance for returning to a variety of home, work and sport activities.
Patients are often very unaware of the surgical process, extended recovery times and pace of return to work, sport and exercise. Compliance and patient satisfaction is higher in post operative care if surgical details are available during rehabilitation for the following reasons:
- Pre-op planning vs intra-op surgical findings / intervention
- Better patient compliance and protection of the surgical site
- Safer manual therapy and exercise progressions
- Management of post operative patient questions and concerns
VIRTUAL POST OPERATIVE CARE
Patient's requiring post operative care from remote locations can contact Cameron for a virtual appointment - please use the online consultation option below or have the patient contact either clinic directly to organize a suitable time.
PATIENT REFERRAL PROCESS
Specialist Referrals
Please scroll below for information specific to your specialty
- SPORTS MEDICINE & PHYSIATRY
- RADIOLOGY
- NEUROLOGY
- RHEUMATOLOGY & PAIN MEDICINE
Sports Medicine & Physiatry
Cameron offers senior clinical expertise in upper extremity disorders including comprehensive assessment, determination of symptomatic vs asymptomatic pathology and primary / secondary complaints.
Expertise in Shoulder Pain & Injury:
- Primary and secondary scapular dyskinesis
- Subacromial and GHJ disorders
- Specific exercise programs for shoulder cuff tears, instabilities, post dislocation or separation, tendinopathies, cuff weakness and post operative care
- Ongoing assessment of injection procedures and recommendations for future standard or novel injection strategies
- Symptomatic differentiation of multiple pathologies including bursal pathology, cuff injury, calcific foci, ACJ pathology and GHJ contracture / instability
- Spinal manual therapy for cervical and thoracic pain drivers
- Cervical spine stretching and stabilization programs for complex pain presentations.
All pathologies and movement disorders can be assisted. Rehabilitation can be paced to match any post injection effects or typical response time of many procedures (steroid, HA, PRP).
- Conservative rehabilitation of rotator cuff tears - including complex partial and small to medium (<3cm) full thickness tears
- GH dislocation management and all ACJ separations including grade V exercise management.
- Scapular dyskinesis - combined movement principles to address primary and secondary disorders
- Calcific tendinopathy - all subtypes and sizes +/- barbotage
- Adhesive capsulitis - non-stage dependent accelerated recovery - typically 8-10 weeks for 90% movement recovery.
- Cuff tendinopathy and all bursal / bicep pathology (SASD / acromial / scapular / tenosynovitis)
- Shoulder OA - effective conservative management for mild / mod OA and active patients mod/mod-severe OA changes. Rehab for post operative hemi, interpositions,TSA and rTSA recovery.
- Contracture recovery - highly tested methods for contracture recovery in 80-90% of GHJ cases.
Collaboration with MSK physiotherapy is recommended for all injection candidates and successful post injection management.
MSK Radiologists
Recommendations for specialty MSK physio can be noted in the clinical summary of your imaging report. Clinician evaluation is aided by detailed radiology reports and patients should be assessed in a clinical setting prior to surgical evaluation.
Complex cases and mixed MSK diagnoses normally require a thorough physical examination in collaboration with current films. For this reason, it is generally recommended that most patients be examined before or shortly after imaging studies to determine the relevance of multiple findings found on x-ray, US and MRI studies.
Good candidates for referral are:
- Restricted US examinations likely due to capsulitis or 'impingement'
- All bursal and tendinopathy dominant findings on US or MRI
- Calcific tendinopathy - conservative management is effective in almost all cases
- Rotator cuff tears under 3cm in AP length (PT and FT)
- All labral disorders including reverse Bankart / Bankart / SLAP variations
- Mild through to mod-severe GH OA changes on plain film / CT
- Complex or chronic shoulder pain disorders
Neurologists
Cameron can assist with complex upper extremity pain, cervicogenic headache and chronic concussion complaints through examination of upper spine and shoulder pain drivers.
Cervical stability protocols and specific rehabilitation / injection work can be very effective for these patient groups. This includes patients with inconclusive findings on soft tissue imaging or neurodiagnostic exams.
Successful outcomes are seen in those presenting with upper extremity pain post MVA and specific peripheral neuropathies (accessory, axillary, SSP and LTN palsies) and spinal nerve root disorders causing shoulder / cervical dysfunction. Correct exercise strategies are very important for these patients.
Excellent functional outcomes have been achieved in many complex cases by careful in treatment, correct sequencing of physiotherapy treatment and specific MSK strategies.
Patients with severe brachial plexus or dystrophic disorders may also find additional support through neurological physiotherapy.
Rheumatology & Pain Medicine
Patients requiring expertise for shoulder, neck and upper back rehabilitation can be referred for specialty MSK physio in collaboration with any pain intervention specialties.
Progressive manual and exercise therapy, ongoing clinical diagnostics and pain education are routinely employed when working with complex injuries.
Cameron has significant expertise in solving complex and chronic MSK shoulder disorders. He has worked for many years with leading MSK practitioners in Australia alongside sports medicine, MSK medicine, osteopathy, pain specialties, interventional radiology, spinal surgery and rheumatology.
Expertise in Shoulder Pain & Injury:
- Primary and secondary scapular dyskinesis
- Subacromial and GHJ disorders
- Specific exercise programs for shoulder cuff tears, instabilities, post dislocation or separation, tendinopathies, cuff weakness and post operative care
- Ongoing assessment of injection procedures and recommendations for future standard or novel injection strategies
- Symptomatic differentiation of multiple pathologies including bursal pathology, cuff injury, calcific foci, ACJ pathology and GHJ contracture / instability
- Spinal manual therapy for cervical and thoracic pain drivers
- Cervical spine stretching and stabilization programs for complex pain presentations.
PATIENT REFERRAL PROCESS
General Physician Referrals
Clinical Tips:
- Imaging or Treatment First?
- Early Treatment Effects
- Discharge vs Ongoing Care
Imaging or Treatment First?
Patient examination and initial treatment can be offered prior to any imaging studies. A provisional clinical diagnosis will normally be made at the first session, with treatment initiated for pain relief and early recovery. Diagnostic signs will be reviewed on followup, along with treatment response.
Should a patient require early imaging, communication will be sent back with the patient, with recommended imaging and a short clinical summary for radiology.
Patients ideal for referral include:
- patients seeking clinical expertise in upper extremity disorders
- patients who request additional help or opinion in solving their shoulder disorder or pain
- patients experiencing chronic or treatment resistant shoulder pain
Initial and followup appointments can include:
- a comprehensive shoulder questionnaire / history / examination
- clinical assessment and interpretation, including imaging studies
- provisional diagnosis for primary and secondary sources of the patient's complaint
- in-house therapy protocols developed through high case load and clinical audits of patient diagnosis and outcomes
- medical and surgical communication to assist imaging recommendations, surgical assessment or injection procedures
Early Treatment Effects
Most patients should experience improvements within the first one-three sessions, with more permanent improvements as effects accumulate. Emphasis on pain education, acute pain management and diagnostically driven rehabilitation are the keys to early successful treatment.
Very occasionally, patients may experience temporary worsening of their symptoms due to physical assessment or soft tissue reactions to some treatments. While every effort is made to avoid these reactions, please reassure your patient these will normally settle quickly and adjustments to treatment made as necessary.
For complex or chronic conditions, patients should be aware that some foundational work (1-4 weeks) may be required prior to significant treatment effect.
Treatments are carefully monitored for expected outcomes based on regular diagnostic reviews and special tests. Ongoing examination is used in complex cases to confirm sources of skeletal pain, alter treatment options and monitor for signs of medical pathology.
Discharge vs Ongoing Care
Patient discharge is normally triggered by recovery from injury and appropriate self management, however a patient may elect to continue with physiotherapy for additional gains beyond rehabilitation, including high performance activities and skill development.
PATIENT REFERRAL PROCESS
Physiotherapy & Allied Health Professionals
SECTION 1 - FOR PHYSIOTHERAPISTS
SECTION 2 - OTHER HEALTH PRACTITIONERS
- Occupational Therapists
- Osteopaths, Chiropractors & Manual Therapists
- Athletic Therapists & Kinesiologists
- Sports Scientists & Exercise Physiologists
- Naturopaths, Acupuncturists & TCM Practitioners
- Massage Therapists
Physiotherapists
Second opinion, advanced practice and advice on treatment pearls & pitfalls.
Some patients may require diagnostic support, case review or additional expertise for solving a shoulder or upper extremity problem. If you require this assistance, we are very happy to support further learning and development of physiotherapy professionals.
Diagnostic Support & Treatment Direction
If your patient is seeking expertise in this field or has not had success with current therapy, a referral to sub-specialty MSK physio is encouraged. A comprehensive history, physical examination and special test combinations are matched to symptom patterns, imaging studies and current physical and medical interventions.
We can assist with recommendations for further investigation and specialist referral.
A two session review is sometimes required to confirm the diagnosis and provide advice on the treatment direction for your patient.
Clinical Physiotherapy Guides
Regularly updated clinical information is available including diagnostic criteria, research outcomes, special tests and recommended rehabilitation progressions for a variety of shoulder and upper extremity disorders.
Our regularly updated treatment protocols will become available soon:
- Adhesive capsulitis, contractures and diabetic capsulitis
- ACJ injuries - grades I,II,III,IIIb and V - foundations of treatment and progressions.
- GH osteoarthritis - defining symptomatic OA and treatment plans
- Solving Impingement Signs in the Shoulder
- Conservative & Post-Op Management of Rotator Cuff Tears
- Calcific Tendinopathy - Shockwave vs barbotage vs physio only.
- Tendinopathy and Bursitis - Solving persistent problems.
- Scapular Dyskinesis - Primary and Secondary Solutions
- Hemi, TSA and rTSA - How good are they and what level of function can be achieved?
- Dislocation Management - Our best treatment plans for pre and post surgical management
SHOULDER PT - Fast track your clinical expertise
SHOULDER PT is a specialty MSK professional development program that offers physiotherapists advanced working knowledge for all shoulder disorders and related upper extremity problems.
This service offers regularly updated information and resources covering:
- Diagnostic Examination and Special testing of the Shoulder
- Combination Testing for stronger diagnostic accuracy
- Understanding and Interpreting Imaging of the Shoulder
- Examination and Clinical approaches to Solving Scapular Disorders
- Detailed clinical understandings for injection work, clinical problem solving and radiology interpretation / pitfalls
- Combined upper extremity remedies to solve complex and chronic upper extremity pain disorders
- Key spinal treatment techniques and treatment plans
This subscription is available to all physiotherapists that would like to have direct access to specialty clinical practice information, quarterly updates to our current clinical work along with carefully curated research information and conditioning protocols.
Fees, requirements and online registration coming soon.
Allied Health, Professional & Alternative Healthcare
Referral Guidelines for Specialty MSK Shoulder Physiotherapy
All allied health, professional and alternative healthcare professionals may refer directly for specialty MSK physio.
Please provide a short clinical summary of the patient concern and any investigations relevant to the patient's condition. This can be via fax to either clinic.
We can provide full diagnostic support, treatment recommendations and collaboration with sports medicine and other specialties including neurology, surgery, interventional radiology, rheumatology and physiatry.
PATIENT REFERRAL PROCESS
Clubs, Coaches & Trainer Referrals
This section covers the following:
- Head Coaches
- Assistant Coaches
- Strength & Conditioning Coaches
- Trainers - Club & Personal
Head Coaches
We can offer expertise in managing upper limb and shoulder injuries for a variety of club, national and international athletes.
If you require team support, please contact Cameron through either clinic or via the contact form to determine availability and your exact requirements.
Sports we have considerable experience with include -
- Swimming sports (ocean, competitive, waterpolo, free diving)
- Paddling sports (kayak, rowing, outrigger and dragon boating)
- Climbing sports (recreational, speed including national competitors).
- Throwing sports (baseball, softball, football)
- Combat sports (striking, grappling and boxing sports)
- Racquet sports (squash, badminton and tennis)
- Golf (recreational, amateur and professional)
We can assist with acute, chronic and difficult to treat injuries, determine suitability of screening programs and injury prevention methods for your athletes.
Assistant Coaches
If you are responsible for a junior or senior team and require assistance with your athletic group, or would like to discuss any specific concerns, please ensure the Head Coach is included in this request.
Referral can be made through either Clinic or online (preferred). Paper referrals can also be made by screenshot of the online form and faxed to the closest Clinic location.
Strength & Conditioning Coaches
If you are working as an independent Strength & Conditioning Coach, Cameron can accept referrals directly and will be in contact with the client or athlete.
If you are working in a team environment please initially direct your concerns to the Head Coach. Should the athlete already be undergoing treatment and require a second opinion, please advise and we can discuss directly with the patient or Head Coach.
A short introduction and discussion is sometimes required prior to attendance at the first appointment. This can be done via the Athlete Referral Form (below).
Club & Personal Trainers
Many individuals have concerns leading up to an important event, whether returning from injury or pushing for high performance results.
If your client or athlete is having difficulty performing their exercise or sports conditioning routine due to injury, pain or other concern, please recommend your patient contact us directly for clinical assessment and treatment / advice.
Clients or athletes under 18 will need a parent or guardian to make direct contact with the Clinic.
PATIENT REFERRAL PROCESS
Health and General Insurers
Cameron offers an array of expertise for health and general insurers that may need further opinion on disability for upper extremity disorders.
Personal Injury & Legal Assistance
Cameron is available for legal reviews related to any complex or chronic upper extremity disorders. Case reviews include diagnostic and prognostic evaluations, together with recommended treatment strategies.