When we assess patients with pain and injury we really need to look at how things work as a whole.
Taking an Osteopathic approach to the assessment of shoulder pain means we’ll look at the movement and function of the scapular (shoulder blade), the thoracic spine (rib cage) and the shoulder joint itself. We’ll also look more broadly at how the neck, lower back and hips move and work in relation to these areas.
We do this to identify any factors that might disadvantage the shoulder structures (part of the ‘why’ your shoulder hurts in the first place) but more importantly we do this to identify useful strategies for offloading sensitive shoulder structures … (the much more important, ‘how’ to make it hurt less)..
You see, we hear so much over-simplified nonsense about ideal posture, alignment and movement but the reality is we don’t all need to look and move the same to do things well or to be strong, fit and healthy.
There is wild variation in normal anatomy and neurology (for movement control) so wherever we have physical or functional short comings, we’re usually able to compensate and adapt well to overcome pain and limitation… sometimes we just need to know what helpful or useful compensations to encourage your body to make. And how to introduce them in sensible incremental progressions that allow for nervous system and connective tissue adaptation.
That’s where a more functional style of assessment comes in really handy because we can try on different compensatory strategies to see how they help your pain and function and once we find strategies that work for you we simply train them to build capacity and give you longer term gains.
In the video below you’ll see a shoulder examination that allows us to see what sort of trunk control you have when you load the shoulder, what the shoulders ability to control rotation is like and how the neck contributes to tasks as the shoulder nears the limits of it’s functional capacity.