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shoulder impingement assessment treatment examination physical therapy

Shoulder Impingement – 3 Keys to Assessment and Treatment

Shoulder impingement is a really broad term that is used too often. It has become such a commonly used junk term, such as “patellofemoral pain.”

Unfortunately, the use of such a broad term as a diagnosis is not helpful to determine the treatment process. There is no magical “shoulder impingement protocol” that you can pull out of your notebook and apply to a specific person.

I wish it were that simple.

To make the treatment process for shoulder impingement a little more simple, there are 3 things that I typically consider to classify and differentiate shoulder impingement.

Does Subacromial Decompression Surgery Really Do Anything?

Subacromial decompression surgery is a very common procedure performed for people with shoulder pain. The procedure is often recommended for people with “impingement syndrome” and was originally theorized to open up the subacromial space and help reduce biomechanical impingement. But recent research has challenged the effectiveness of the procedure, and even the diagnosis of “subacromial impingement” itself.

Special Tests for Rotator Cuff Tears

Rotator cuff tears are one of the most common injuries we see in orthopedic physical therapy. During the clinical examination of the shoulder, we want to perform special tests designed to detect a rotator cuff tear. In this article, I’ll share my 4 favorite special tests for rotator cuff tears that I perform during my clinical examination of the shoulder. These 4 tests do a good job detecting larger tears that are causing dysfunction.

Should We Delay Range of Motion After a Rotator Cuff Repair Surgery?

Based on a recent systematic review, I would continue to recommend performing control range of motion following rotator cuff repair surgery as it appears to be safe and effective at restoring motion and function sooner than if we delay rehabilitation.

Should We Perform Immediate Range of Motion After a Total Shoulder Replacement?

Should We Delay Range of Motion After a Total Shoulder Replacement?

Total shoulder replacements are becoming more common, especially in younger patient populations that want to stay active. There is some conflicting information regarding the safety and efficacy of immediate range of motion following total shoulder arthroplasty.

6 keys to shoulder instability

6 Keys to Shoulder Instability Rehabilitation

Shoulder instability is a common pathology encountered in the orthopedic and sports medicine setting.

But “shoulder instability” itself isn’t that simple to understand.

Would you treat a high school baseball player that feels like their shoulder is loose when throwing the same as a 35 year old that fell on ice onto an outstretched arm and dislocated their shoulder? They’re both “shoulder instability,” right?

There exists a wide range of symptomatic shoulder instabilities from subtle recurrent subluxations to traumatic dislocations. Nonoperative rehabilitation is commonly utilized for shoulder instability to regain previous functional activities through specific strengthening exercises, dynamic stabilization drills, neuromuscular training, proprioception drills, scapular muscle strengthening program and a gradual return to their desired activities.

I’ve had great success rehabilitating dislocated shoulders and helping people return back to full activities without surgery. But to truly understand shoulder instability, there are several key factors that you must consider.

clinical examination of SLAP tears

Clinical Examination of Superior Labral Tears – What is the Best Special Test for a SLAP Tear?

What is the best test for a SLAP tear? That is a pretty common question that I hear at meetings. Clinical examination to detect SLAP lesions is often difficult because of the common presence of concomitant pathology in patients presenting with this type of condition. Here are some of the more popular special tests that I prefer.