Physio Edge podcast with David Pope

172. Shoulder pain assessment & clinical reasoning. Physio Edge Shoulder Success podcast with Jo Gibson

22 snips
Jul 16, 2025
Jo Gibson, a Consultant Shoulder Rehabilitation Specialist, shares her extensive knowledge on effectively assessing and treating shoulder pain. She emphasizes the importance of distinguishing between various conditions like rotator cuff issues and frozen shoulder. Jo presents a structured clinical reasoning framework to navigate complex diagnoses, covering key questions to ask patients and how to identify red flags. She also discusses the crucial role of imaging, when to make referrals, and effective rehab strategies tailored to individual needs.
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INSIGHT

Subjective History Drives Diagnosis

  • Most shoulder diagnoses rely heavily on subjective history, about 80% from patient interviews.
  • Key factors include age, pain location, mechanism, aggravating factors, and sleep impact.
ADVICE

Rule Out Cervical Spine Involvement

  • Rule out cervical spine if cervical extension-rotation is full and pain-free.
  • Medial scapula or posterior-lateral shoulder pain suggests cervical involvement.
ADVICE

When to Refer for Surgery

  • Consider referral for surgery if patients under 55 have traumatic onset, immediate pain, and persistent loss of function.
  • Imaging is more useful in traumatic dislocations and instability to guide management decisions.
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