Shoulder Flashcards
(112 cards)
what is the issue with the medical model?
- no reliable correlation with symptoms
- does not guide rehab clinical decision making
what does the medical model exam/treatment consist of?
- take history
- perform exam
- assign a diagnosis
- prescribe treatment based on that diagnosis
T or F: there are special tests that are 100% sensitive and specific
F
special tests are most useful for ruling _______ conditions
out
T or F: treatment based on the medical model works well for most rehab patients
F: patients with the same medical diagnosis can present very differently and therefore need different treatments
two cases in which the medical model is valid
fracture management
surgery
you have a patient with subacromial pain syndrome suffering an exacerbation (9/10 pain) after painting. what is the optimal management for this patient
rest, NSAIDs, isometrics, education on prevention
you have another patient with SA pain syndrome who only experiences intermittent pain, especially with elevation. he has 0/10 pain at rest. what is the optimal management for this patient?
sleeper stretch
eccentric posterior RC exercises
long term endurance training depending on goals
what are two major things that guide intervention?
impairments and SINS
SINS (acronym)
- Severity (how functionally limiting)
- Irritability
- Nature (trauma/overuse)
- Stage (acute/chronic)
what are the two most important questions to ask during subjective
age and onset
examples of common overall impairments
- motion restriction
- strength
- endurance
- fear avoidance
- central sensitization
ultimate goal of PT is to identify the most relevant _________- and apply the optimal ________ for it
impairment
intervention
T or F: the rehab model can include a medical diagnosis
T: patients want a label and other medical providers are familiar with them
the main focus of the rehab model is…
impairments
T or F: most atraumatic MSK pain is linked to a pathoanatomical (medical) diagnosis
F
what are two approaches to always avoid with atraumatic MSK pain?
1 - linking image finding to pain presentations
2 - linking interventions to a “fix”
T or F: imaging findings are common without symptoms
T: disk degeneration, cuff tears, etc.
you want patients to have an _________ locus of control. What does this mean?
internal
they are in control of the situation *image findings can shift them to external
it is important to talk about lifestyle changes with your patients. these can include… (3)
tobacco use
weight loss
managing pain
screening determines what?
if a patient is appropriate for PT?
your pt is a 71 y/o who c/o R shoulder pain. there was not MOI. he has weakness with RC muscle testing. is this pt appropriate for PT?
yes, based on how rehab goes he may benefit from imaging or surgical eval
your pt is a 23 y/o who c/o R shoulder pain after falling down the stairs and catching himself on an outstretched hand. he is very guarded and you were not able to complete a full exam due to pain. is this pt appropriate for PT?
no, you need an ortho opinion first, he may be appropriate after
you pt is a 50 y/o male complaining of L shoulder pain that also radiates to the jaw. he is short of breath. you are unable to reproduce the pain with shoulder testing. is this patient appropriate for PT?
no - these are red flags. 911
