Where to Start When Treating a Tricky Shoulder Patient

Posted By: Andy Barker

The shoulder is a pretty complex joint, with many structures that can cause your patient’s pain.

And many of the so called shoulder ‘special’ tests are not that special…

Most having poor sensitivity and specificity, meaning it can be hard for you to nail down a clear shoulder pain diagnosis.

So you might think, given that you do not have a clear diagnosis, there is not much you can do…

Right?

This is why you then struggle to know where to start with your patients hands-on treatments or know what rehab to prescribe.

So you keep it safe.

You give your patient some banded rotator cuff exercises…

Maybe a few stretches to the pec’s or lat’s…

And probably some scapula stability work.

Sound like a programme you have written before?

But does every patient need mobility, rotator cuff AND scapula work?

Most don’t.

The way you find out what your patient actually needs is through your patient assessment.

That is one of the primary goals of your patient assessment [to find the patients problem or problems]…

Because this tells you exactly what you need to do next.

The other goals of your patient assessment are…

To find a patient diagnosis (if you can) and…

Collate the information you need to formulate a treatment plan for your patient.

When I said that one of the primary goals of your patient assessment is to find the patients problem or problems, I am not talking about the diagnosis here, but the issues they have…

Like lost range of movement…

Reduced strength…

The inability to do [x, y or z].

This information is key because…

You treat a patient problems and not their diagnosis.

So it makes sense that you need to be clear when you finish your patient assessment, as to what the patients problems actually are.

Makes sense, eh?

Know the problems and you will know exactly what to focus your efforts on with your hands-on treatment techniques and rehab…

And you will avoid falling into the common pitfall of trying to treat everything like you are probably doing at the moment.

When you get stuck and you do not know what hands-on treatments to use or what rehab exercises to prescribe this is usually the result of a poor assessment.

Get the assessment wrong and you are treating blind.

You throw the kitchen sink at your patient and hope that something sticks.

This strategy rarely works, especially with the shoulder as it can be so easy to flare patient symptoms…

And if it does happen to work…

You don’t really know what worked, as you threw everything at your patient like those cuff, scapula and mobility exercises…

All at the same time!

Wouldn’t it be better if you could clearly identify if your patient had a cuff, scapula or mobility problem in the assessment…

So you could prescribe cuff OR scapula OR mobility based exercises and not prescribe rehab exercises they do not need.

It is hard enough for you to get your patients to do their home rehab as it is, so the less exercises you can give, that actually make a change, the better. 

Want to know how to differentiate between different shoulder pathologies?

How to conduct a simple shoulder assessment that will help you find the patients actual problems?

And be able to link your assessment findings to your treatments and rehab so you know 100% you are treating the right thing?

Then you do not want to miss my next FREE webinar…

Simplifying The Shoulder

This is a LIVE online event and is a happening on… 

Wednesday 19th January 2022 at 19:00 (UK Time).

I have just opened registration for this webinar.

If this like most of my free webinars it will fill up quick so move fast and secure your seat here.

Andy Barker

The New Grad Physio Mentor

PS. There will be NO recording or replay made available after this event so if you miss it, you will miss out. 

Book now and block out 60 minutes of your week to learn everything you need to know about Simplifying The Shoulder to get the patient results you want…

Even with tricky shoulder cases!