Hi everyone, here's another patient I just saw that we can go through together.

I'm leaving the FAQs in at the bottom for a little while. Glad they're helpful.

Patient is a 50-year-old male with intermittent pain: R interscap pain, R UT, R deltoid, R upper arm. Onset date: about 4 weeks ago. Method of onset: nothing specific, just woke up with it, possibly 188+ push-ups and 20+ pull-ups per day (push/pull-up challenge, one more every day). General Symptom Trend: staying the same. Worse: push-ups, mornings, carrying a backpack on the R, sleeping on the R side, and reaching up to grab something. Better: naproxen, m. relaxers, avoidance. Otherwise, he's healthy, no imaging, no surgeries. He wants to get back into the gym and needs to sleep better. His wife notes he's started snoring since his shoulder has affected his sleep.

-R Shoulder ROM: Min-Mod loss of IR (not new), otherwise no changes

-UE Strength: R arm generally feels weak, but MMT is 4+ abduction w pain, 4+ tricep extension

-UE Neural Tension: + R Radial, + R Median

-Cervical ROM: Mod loss of R rotation and R SB

Repeated Movement Testing (I'm going to the cervical spine):

• Retraction: no effect
• Ret/Ext: improved neck rotation
• Cervical Ext over chairback: normalized rotation and improved SB
• Cervical Ext w patient overpressure: decreased neural tension and improved strength w R shoulder ABD and tricep

The video of his HEP is below.

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TAKEAWAY: The history hinted at a shoulder etiology, but further digging revealed that he has not experienced NEW shoulder stiffness since the onset of symptoms, and his location of pain seemed too diffuse. I went to his cervical spine first and felt comfortable with escalating his force progression rapidly, given his response and general health.

It's looking good, but we'll see how this turns out in the future!

Until next time,

Ryan Tauzell, PT, Cert. MDT

ryan@atlashealth.io

​atlashealth.io​

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