General, Physical Therapy, Sport Medicine

Shoulder Assessments in Physical Therapy

When it comes to injuries that necessitate physical therapy, shoulder impairment may be one of the most complicated issues to examine. The shoulder region has many structures, movements, and lesions within the joints, all of which require an organized approach when inspecting the shoulder history and key aspects of what’s causing the pain. Here’s some important information that should be gathered when it comes to shoulder assessments in physical therapy.

 

Shoulder History

Before a medical professional or physical therapist comes up with a plan for dealing with a shoulder injury, they must first go through a shoulder history. This sounds exhaustive (how far back does the history of a shoulder go?), but basically it just involves a few factors.

    1. How long has the condition been present? When the condition begins or starts might be the difference between an acute and chronic injury. This might seem like a trivial question, but it might be the most important one. 
    2. What is the pain like? You get to be a creative writer on this one and describe what you’re feeling in graphic detail, being as specific as possible. Where is the pain located, where does it start, what’s the severity, how long does it last? There are many qualities to consider when it comes to pain. 
    3. What kind of symptoms go along with the pain? Do you have a stiff neck? Can you move it? Some associated symptoms could spell nerve injury and help a therapist diagnose it. 
    4. What is the rundown of symptoms? This is where the therapist will take everything you tell them and put it into a story to help figure out what exactly is going on with you. 
    5. What activities are you involved in? Are you a racquetball player? Or a couch potato? Either way, your lifestyle can often be another clue into your diagnosis. 

shoulder injury therapist and patient

The Shoulder Assessment

The medical professional will start with just assessing the patient’s vitals, simply looking at the book by its cover. How does the patient look? Sometimes just looking at a patient will tell a professional what kind of treatment they need. But here are the steps in the assessment process. 

Step One: The physical therapist will inspect the patient, looking at their posture for symmetry, swelling, surgical scars, and any deformities that might suggest fractures or separation.

Step Two: The physical therapist will start at the sternum and palpate the sternoclavicular joint, looking for warmth, tenderness, and stability. Then, they will move across the clavicle, the glenohumeral joint, and the spine of the scapula. They’ll also assess muscles. 

Step Three: The physical therapist will then ask the patient to exercise their range of motion (ROM) — arms crossed in front of the body, arms at the side and elbows flexed, rotation of the arms, as well as reaching overhead. 

Step Four: The physical therapist will also test the power of the patient when it comes to flexion, extension, abduction, and more. 

Step Five: Additionally, there are special tests that might be performed to help a therapist diagnose a rotator cuff tear, impingement, stability, bicep tendonitis, and more. 

 

X-Rays

If the medical professional feels it’s necessary, they might utilize X-Ray tests to look further at the shoulder injury, especially if it suggests a dislocation. There are three views that can be looked at in an X-Ray that might spell dislocation:

  • AP or 45 degree lateral (which would indicate dislocation)
  • The trans-scapular Y view (which demonstrates the direction of a dislocation)
  • Axillary, which might be challenging to get due to a patient’s pain and limited ROM

 

Conclusion

Now that you have an idea of what to expect with shoulder assessments, you can move forward with physical therapy with peace of mind. There’s a lot that goes into shoulder examinations, including learning about the history of injury, how the pain may have started, when the pain started, and what activities (or maybe even lack of activities) could have caused the injury. The physical therapist will then put everything together and come up with a plan to help the patient treat their injury and get back to rolling (their shoulders) with the punches that life throws at them. 

Contact Us

Now that you know what shoulder assessments in physical therapy are like, contact Love Health with any questions or concerns about our one-on-one physical therapy sessions. Whether it’s sports medicine or functional medicine, Love Health has expert physicians and a top-flight staff to support you with whatever medical services you need, providing customized therapy to get you back on your feet or maybe even off your feet. We have locations in North Tampa, St. Petersburg, South Sarasota, North Sarasota, and Brandon. And if you’re in Pennsylvania, we also have a clinic in Philadelphia. 

To schedule an appointment, contact us at 1-800-511-8050 or get in touch via our contact page.

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