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JOSPT Insights

Ep 11: Are we overcomplicating the shoulder? Tips for assessment and treatment, with Prof Jeremy Lewis and Dr Paul Salamh

Nov 2, 2020
Prof Jeremy Lewis and Dr Paul Salamh discuss the overcomplication of shoulder assessment and treatment, emphasizing the limitations of imaging and special tests. They highlight the importance of patient education, shifting away from structural diagnoses, and adapting treatment based on presentations rather than specific structures. The podcast also covers the significance of subjective evaluation, functional movement assessment, and patient-driven treatment for shoulder issues.
27:07

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Quick takeaways

  • Special tests for rotator cuff-related shoulder pain are not effective in identifying the source of pain and can lead to harmful interventions.
  • Physical therapists should prioritize patient goals, provide tailored rehabilitation programs, and exceed patient expectations in the treatment of shoulder pain.

Deep dives

Moving away from structural diagnosis in shoulder pain

The podcast discusses the viewpoint of Dr. Jeremy Lewis and Paul Salom, which argues for moving away from a structure-specific model in the diagnosis and treatment of rotator cuff-related shoulder pain. They propose categorizing patients based on a Venn diagram framework that considers overlap with other shoulder conditions, kinetic chain factors, and psychosocial factors. The aim is to shift focus from identifying specific structures to addressing functional problems and reducing disability.

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