Manual therapy + movement for the masses

Shoulder Pain

Shoulder Pain
December 14, 2016 Phillip Snell

1. Identify provocative movement
2. Consider involved neurology for potential neuropathic component
3. Assess for neural sensitivity
4. Apply treatment to improve mechanical interface of the involved neuro
5. Re-test provocative movement
6. Apply homecare and perform regularly until sensitivity to movement normalizes

Common Diagnosis

  • Rotator cuff impingement
  • Rotator cuff tear
  • Labral tear (glenohumeral)
  • Acromioclavicular arthritis
  • Glenohumeral arthritis
  • Thoracic outlet syndrome

Target Neurology

  • Suprascapular nerve
  • Supraclavicular nerve
  • Radial nerve
  • Median nerve
  • Ulnar nerve
  • Posterior ramii nerves

Shoulder arthritis and rotator cuff tears are often a “garbage can” diagnoses that can give a person a notion that a linear process of “degeneration” is in place and the end result might need to be surgery. We frequently have major success in managing chronic shoulder pain with DTM and very quickly re-work those limiting thought processes. Given the mixed motor and sensory capacity of many of these nerves, be sure to evaluate motor function and rule out a nerve root compression using McKenzie protocols. From a functional perspective, we find value in assessing the scapulo-thoracic and thoracic vertebral articulations to assure that coordinated movement of the entire shoulder girdle is available.

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Head/NeckShoulderArmUpper BackLower BackAbdomenHipLegFoot