Dr Angela Cadogan - Physiotherapy Specialist

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Dr Angela Cadogan - Physiotherapy Specialist

Specialist Physiotherapist (MSK) and Director of Physio Academy.

🎓PhD Specialist Physiotherapist | Shoulder Diagnostics and Imaging | Orthopaedic Triage & Secondary Care | Clinical Governance | Advanced Practice Education 🎯 | Free tools & courses 👉 https://linktr.ee/drangelacadogan Special interest in the diagnosis and management of shoulder pain, professional competency training and career development pathways. 'Like' this page to receive notification of lates

t research, clinical guidelines, links to podcasts and notification of relevant courses and CPD events.

31/08/2026

After an AC joint injury, should we focus on rehabilitating the joint, or the entire scapular suspensory system?

The AC joint is part of the mechanical link between the clavicle, scapula and upper limb. When that relationship is disrupted in high-grade AC joint injury the consequences include effects on scapular suspension, stability, movement control and force transmission from the upper limb.

This is the focus of our next Shoulder Academy Live Q&A:

Restoring Scapular Function After AC Joint Injury
📅 16 September 2026

We’ll look at assessment of the scapula after AC joint injury including assessment of active and passive instability, reducibility, altered scapular control and deltotrapezial function and examine how each of these can influence rehabilitation.

Exclusive to Shoulder Academy members.
Already a member? Registration details are inside Shoulder Academy.

Not yet a member? Join via the link in bio or check comments below.

25/08/2026

Subgrouping in rotator cuff-related pain is not just about pathology.

Two people can have a similar rotator cuff diagnosis on imaging and still have very different clinical presentations and impairments.

When we are considering prescribing rotator cuff exercises for rotator cuff-related pain we first have to understand what role the rotator cuff is playing in the clinical presentation. It may be acting primarily as:

➡ A symptom generator
Pain and irritability may dominate. The priority may be improving load tolerance rather than simply adding more resistance. More load is not always better.

➡ A force producer
If the cuff is intact and innervated, and weakness is limiting function, improving force capacity may be appropriate.

➡ A dynamic stabiliser
If movement control and muscle coordination are impaired, sensorimotor rehabilitation may be the more relevant target.

➡ A structurally or neurologically compromised system
With a denervated cuff or a massive/irreparable tear, simply trying to “strengthen the rotator cuff” is not realistic. Rehabilitation may need to focus more on restoring useful movement (elevation and external rotation) and function than on attempting to normalise specific cuff strength.

And of course, psychosocial factors can modify all of these presentations.

The sequence I find most useful is:
Diagnosis → role of the cuff → key impairment → rehabilitation target → intervention

Subgrouping is only useful when it changes what we do. The aim is to identify the dominant impairment, then choose an intervention that is actually targeting it.

(Slides from the Auckland Tendon Symposium 15/8/2026).

23/08/2026

One of my main takeaways from the Auckland Tendon Symposium (15/8/2026):

❗ We need better subgrouping in rotator cuff rehabilitation, not more debate about “the best exercise”.

Two people can both present with rotator cuff-related pain and have very different rehabilitation needs and respond very differently to the same exercise.

For one, the main issue may be load tolerance. For another, it may be sensorimotor function, force capacity, functional compensation, or fears, beliefs and expectations that are limiting movement and participation.

We know that improvements in pain and function are not consistently explained by improvements in strength, and comparable long-term tendon adaptation to exercise has not been established in the rotator cuff in the way it has for some lower-limb tendons. So "strengthening" exercises and high load or eccentric training may not change pain and function. What are we missing?

Rather than starting with "Which exercise should I prescribe?” A better first question may be, "What needs to change in this patient?”

Peter Malliaras used the example of activity-dominant, psychosocial-dominant and structure-dominant presentations. In my rotator cuff presentation, I broke this down further into rehabilitation targets:

load tolerance ▫️ sensorimotor function ▫️ force capacity ▫️ functional compensation ▫️ psychosocial factors

Identifying specific impairments and targeting intervention (including exercise) at the specific mechanism behind that impairment may lead to better outcomes for people with rotator cuff-related pain (and probably all tendon pain!).

05/08/2026

🤔Clinical question: what are we actually rehabilitating after a high-grade AC joint injury?

The injury is usually described according to the AC joint deformity and radiographic classification. However, in persistent presentations, the more important functional consequence may be loss of the stable relationship between the clavicle and scapula.

This raises several questions:
• Are we assessing the AC joint, the scapula–clavicle relationship, or both?
• Why do some patients fail repeated rotator cuff and generic scapular programmes?
• Does successful return to sport necessarily mean the injury has recovered well?

I recently explored this in an article for MSK Mag, "Beyond the Bump: Reframing High-Grade AC Joint Injury".
https://open.substack.com/pub/mskmag/p/beyond-the-bump-reframing-high-grade?utm_source=share&utm_medium=android&r=2c4jgz

I would be interested in how others assess and manage these persistent cases.

29/07/2026

TENDONS!
Join us for the 2026 Tendon Symposium.

Hear from internationally recognised and New Zealand experts as they share the latest evidence and practical clinical strategies for managing tendon pain.

https://pnz.org.nz/Event?Action=View&Event_id=4357

22/07/2026

Wrapping up the Frozen Shoulder podcast series with Margieolds.com in the Glenohumeral Gurus Podcast. We summarise key insights from her guest speaker series & discuss where to next in Frozen Shoulder.

🔗Podcast link in post 👇

20/07/2026

⭐Q&A Highlights | Rotator Cuff Series
Does increasing strength actually explain why patients recover?

It's a question that has generated plenty of discussion.

This short clip is taken from a recent Shoulder Academy member Q&A exploring the relationship between strength, pain and function in rotator cuff-related pain.

The full recording is now available for Shoulder Academy members.

🤔Have you changed the way you use strength testing in practice?

13/07/2026

Practice Point: Does strength drive recovery in rotator cuff-related pain?
Not necessarily.....

Patients with rotator cuff-related shoulder pain often report meaningful improvements in pain and function without large measurable improvements in strength. Strength also improves as soon as pain improves (e.g immediately after a subacromial anaesthetic injection). So are we really measuring 'strength', or simply pain tolerance?

That doesn't mean strength testing has no value - it does in circumstances where strength is a major part of the pathway to recovery. This article highlights that this may not be the case for everyone with RCRP and reminds us that strength testing is only one piece of the clinical reasoning puzzle.

This month's Research in Practice explores the evidence behind this concept in more detail.

💬 Has this changed the way you think about strength testing?

09/07/2026

🆕New Research in Practice is now available inside Shoulder Academy.

This month's review explores a thought-provoking editorial questioning one of the most common assumptions in shoulder rehabilitation:

Do improvements in strength actually explain improvements in pain and function?

Inside the review you'll find:
✅ Key findings from the paper
✅ What changes clinically
✅ What doesn't change
✅ Where caution is needed
✅ Specialist commentary on what this means for practice

Available now exclusively to Shoulder Academy members.

Not a member? Learn more via the Shoulder Academy website.

28/05/2026

Great chat with Prof. John Cronin - food for thought from the master of S&C for anyone using force tech in rehab. Free recorded webinar now available- link 👇

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http://www.drangelacadogan.co.nz/

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