Innovation in Advanced Management of the Post Stroke Spastic Hemiplegic Shoulder, from Early Intervention to Contracture

Wednesday, May 20, 2026

10:00 AM - 11:00 AM PT

Location: 118

Ideal Audience:Physician or Surgeon. Residents. Medical Students

Course Director(s)

Paul J. Winston, MD

Physiatrist and Researcher
Vancouver Island Health Authority

Speaker(s)

Mahdis Hashemi, MD

Researcher
Vancouver Island Health Authority
Eve Boissonnault, MD, FRCPC (she/her/hers)

Assistant Professor, Division of Physical Medicine and Rehabilitation
University of Alberta
Fraser A. MacRae, BS (he/him/his)

PhD Candidate
Western University
Romain David, MD

MD
University of Poitier

Faculty(s)

Guynn Clay, DO

Physiatrist
Northside Hospital

Brief Session Description : Hemiplegic shoulder pain (HSP) is the most common pain disorder after stroke, affecting 30–70% of patients and often arising within the first week. It reduces function, interferes with rehabilitation, and diminishes quality of life. Causes are heterogeneous, ranging from spasticity and capsular stiffness to glenohumeral pathology or complex regional pain syndrome. With contracture developing in up to half of patients, careful assessment is essential. Diagnostic nerve blocks can help distinguish spasticity from contracture and other causes. This program will provide scientific background, clinical evidence, case discussions, and skills demonstrations, welcoming professionals, advocates, and the public to explore effective management.

COI
Unless noted below there are none.
Paul J. Winston, MD – Disclosed honoraria and advisory board roles with Merz; payments to institutions
Mahdis Hashemi, MD – Disclosed research support (Pacira)
Eve Boissonnault, MD, FRCPC – Disclosed speaking role and grant support to institution (Merz, Pacira)
Fraser A. MacRae, BS – Disclosed travel support and investigator role in clinical trial (Pacira)

Session Objectives:

1. Recognize the urgency of early identification and treatment of hemiplegic shoulder pain following stroke. 2. Identify the clinical features and diagnostic considerations of complex regional pain syndrome (shoulder-hand syndrome). 3. Evaluate indications for early intervention, including botulinum toxin and cryoneurolysis, in the management of hemiplegic shoulder pain
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