This seems to becoming a typical occurrence in my practice.
Long time pain/dysfunction patient gives me the deadline of 2 weeks to “Fix” her.
“You’ve got one chance to figure this out! I’ve got to get back to work within 2 weeks!”
She’s a patient who has been everywhere, seen everyone and had everything done to them. I’m sure you have these in your practice.
Long story made short, my new female patient has had 30yrs of shoulder pain post MVA. She’s a laborer in the movie industry and lifts heavy items all day typically working 12-18hrs. She’s now on a 2-week vacation, taking the time to get “fixed!” She complains of 30yrs of lateral GH pain, discomfort and has dysfunctional AROM and PROM with some tingling/numbness in some fingers.
I typically like to find out what everyone before me has done so not to retrace their steps. It’s nice to know what’s worked and what hasn’t. As it turns out, no one investigated thoroughly how the MVA 30yrs ago happened and so therefore treated tissues that were not the primary tissues injured. They treated where she complained!
Was there dysfunction where she complained? Yes, but it was being caused by some other dysfunction that had been there since the MVA. Specifically assessing and treating in series throughout the treatment affords you the perception of seeing the whole picture of the injury and whether you are being effective or not.
We determined that she had severe dysfunction at her sternochondral joints 1-5 and forced coupling dysfunction at her SC joint. Multiple level of tissue protection involvement in the cervical, thoracic and shoulder were determined. By the end of the 2 weeks (4 treatments) the dysfunctions were near inexistent, full AROM and PROM had returned to normal and she commented on increased strength and endurance.
It’s been 6mos since the final treatment and she hasn’t needed to return.
No this isn’t a magical treatment. It’s a precise and specific approach that when applied appropriately has the ability to change someone’s life dramatically.
This is why we are here…Right?!
Great example regarding potential masquerades. This really illustrates that all shoulder pain is not rotator cuff or DJD. I am interested in techniques you have use in balancing scalenes and first rib and assessing clavicular function/coupling. Any references? Great video…thanks.