The E3 Rehab Podcast

87. Putting Special Tests for Rotator Cuff-Related Shoulder Pain out to Pasture w/ Paul Salamh

Mar 14, 2023

Paul Salamh, shoulder/upper extremity specialist, joins the podcast to discuss putting special tests for rotator cuff-related shoulder pain out to pasture. The topics covered include common shoulder special tests, imaging findings, pre and post test probabilities, limitations of gold standards, the importance of a comprehensive interview, and Paul's current research on frozen shoulder and pitcher fatigue.

01:06:33

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Episode guests

Paul Salamh

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Episode notes

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Quick takeaways

Special tests for rotator cuff-related shoulder pain lack convergent validity with gold standards like MRI.

The correlation between imaging findings and pain/function challenges the assumption that special tests isolate specific structures.

A comprehensive examination, including a patient interview, screening for red flags, and shared decision-making, is crucial when examining rotator cuff-related shoulder pain.

Deep dives

The podcast explores the limitations of special tests for rotator cuff-related shoulder pain

The podcast episode discusses the viewpoint titled 'It is time to put special tests for rotator cuff-related shoulder pain out to pasture' by Paul Slom and Jeremy Lewis. The episode delves into the decision to write the piece, the most common shoulder special tests, the validity of special tests, and the correlation between imaging findings and pain/function. It also examines the recommended examination elements for rotator cuff-related shoulder pain and delves into the research project involving frozen shoulder.

Introduction

2min

Weather, Background, and a Comparison between Indiana and North Carolina

3min

Advancing Shoulder Practice Based on Current Evidence

11min

Convergent Validity and the Limitations of Gold Standards in Rotator Cuff-Related Shoulder Pain

10min

Understanding Pre and Post Test Probabilities and Likelihood Ratios for Shoulder Special Tests

5min

The Limitations of Special Tests for Shoulder Pain

32min

Current Research and Area of Interest: Frozen Shoulder and Pitcher Fatigue

5min

Chris and Sam sat down with Paul Salamh to discuss his 2020 JOSPT Viewpoint titled, "It Is Time to Put Special Tests for Rotator Cuff-Related Shoulder Pain out to Pasture." Paul is a researcher, professor, and clinician at the University of Indianapolis who specializes in shoulder / upper extremity related conditions. We dive into Paul and Jeremy Lewis' decision to write this piece, identifying the most common shoulder special tests, convergent validity and reference / gold standards, imaging findings and their correlation (or lack thereof) with pain / function, and pre and post test probabilities. We then talk about the recommended examination elements for rotator cuff-related shoulder pain. Lastly, we discuss Paul’s current research project with Jeremy Lewis involving frozen shoulder.

More about Paul:

2020 JOSPT Viewpoint on Shoulder Special Tests

Paul’s Twitter

Paul’s ResearchGate

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Watch the full episode: https://youtu.be/fqLSj3Deg9Y

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