Shoulder Lecture Flashcards
4 Main questions every patients wants answered before the end of their appointment
- What is wrong with me (patient)?
- How long will it take to resolve?
- What can I (the patient) do?
- What can you (provider) do for me?
*US: How much is it going to cost?
Shoulder Pain Red Flags
-Constant pain, that doesn’t fluctuate with positional change
-Swelling and tenderness w/o obvious MOI
-Recent increase in swelling
-Worsening pain at night
-Fever or chills
AC joint test w/ a sensitivity (16-100%) and specificity (90-97%)
O-Briens test
An over-arching term that encompasses a spectrum of shoulder conditions, rotator cuff tears
Rotator cuff related shoulder pain (RCPSP)
Studies have demonstrated ________ in clinical outcomes after rotator cuff repair with or without acromioplasty at 2 years postoperatively
No difference
In the arthroscopic repair of full thickness rotator cuff tears, neither acromioplasty, coracoacromial ligament loosening nor bursectomy were
determined to have _______ on the results
No effects
Do we have a valid standardized criteria for returning the athlete to play after having a shoulder pain experience?
Yes, but they are of poor validity. The goal is, and always will be individualized function.
Is there a superior way to treat shoulder issues?
No. Manual therapy (including manipulation and mobilization) have mild benefits in pain control but currently aren’t believed to change structure.
Applying simple loading principles to sensitized tissues in a progressive fashion is ________ for improving function, with low grade evidence to support the decrease of pain and is most
consistently recommended.
Moderately effective
Can we identify what structure in the shoulder is causing pain?
Not often. The history is our best guide into what may be causing pain. Imaging and orthopedic tests have some value, but often are of little significance, and in fact can have a negative impact on
outcomes due to catastrophization
