Hi everyone, here's a follow-up to this patient.

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

RECAP: 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.

UPDATE: Significant improvement with cervical extension. Feels like he's back to normal. Pain is not a limiting factor, just a feeling of deconditioning compared to previous.

Baseline Rechecks:

-R Shoulder ROM: Min-Mod loss of IR (not new), unchanged-not relevant

-UE Strength: R arm generally feels stronger now, but MMT is 5 abduction w/o pain, 5 tricep extension

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

-Cervical ROM: Slight loss of R rotation persists

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

• Cervical Ext w patient overpressure: good technique

The video of his HEP stayed the same.

I recommended that he resume his push-up and pull-up challenge in earnest to determine the effect.

​
TAKEAWAY: Looks like his neck was the source of his pain. However, his minimal loss of IR persisted after all other baselines normalized.

QUESTION: Since his problem was his neck and his shoulder was good, how would you progress his functional restoration? Do you agree with me recommending that he resume his push-up and pull-up challenge?

I'm always happy to hear your thoughts!

Until next time,

Ryan Tauzell, PT, Cert. MDT

ryan@atlashealth.io

​atlashealth.io​

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