Скачать или смотреть Shoulder Complaints Usually Resolve With 1-2 Repeated Movements

According to mainstream orthopedics, shoulder complaints are usually diagnosed as rotator cuff tendinopathies, subacromial impingement, arthritis, and various structural lesions such as tears in the muscles, tendons, or labrum. There are less frequent diagnoses as well like frozen shoulders, fractures, and dislocations.

These diagnoses are made via clinical tests called orthopedic special tests (OSTs) and imaging (mostly MRI).

While I use OSTs and imaging when needed, the most important test I use for diagnosing is repeated movement testing, developed by Robin McKenzie. By using repeated movement testing of the spine and shoulder, I find at least 70% of shoulder complaints are caused by a mechanical problem - either in the spine or in the shoulder joint itself. This diagnosis of joint derangement which is resolved by finding the direction the joint needs does NOT exist in mainstream orthopedics since most clinicians have not learned McKenzie's work. (I was not taught about his ideas in school, for example.)

Repeated movement testing (an algorithm that is based initially on the verbal history, the orthopedic baselines, and knowledge of prevalence and patterns) will, in my mind, more accurately diagnose the root cause. If the diagnosis is a joint derangement, the matched treatment is repeated movement into the direction that resolves the symptoms and restores normal mechanics. For spinal joint derangements (which can easily refer pain to the shoulder, scapula, head, face, and upper extremity), the movement is a spinal movement. For shoulder joint derangements, the movement is a shoulder movement. Functional internal rotation is commonly the movement that is therapeutic.

Repeated movement testing reveals, of course, if the problem is not a derangement. If the diagnosis is indeed a tendinopathy, a structural lesion, etc., I apply the appropriate matched treatment. I argue that the diagnosis of impingement does not exist as clinicians typically refer to it.

In conclusion, a diagnosis is only as good as the tests it's based on. By including repeated movement testing in my orthopedic evaluation, I find I can better diagnose disorders (most are joint derangements) and better apply the matched treatment, resulting in better outcomes.

Study 1: “Rapid resolution of chronic shoulder pain classified as derangement using the McKenzie method: a case series,” Aytona & Dudley, PMID: 24421633

Study 2: “Treatment of shoulder pain utilizing mechanical diagnosis and therapy principles,” Kidd, PMID: 24421628

Study 3: “Shoulder pain: differential diagnosis with mechanical diagnosis and therapy extremity assessment - a case report,” Menon & May, PMID: 22795390

Study 4: “Shoulder Pain of Spinal Source in the Military: A Case Series,” Hathcock, Boyer, & Morris, PMID: 33591318

Dr. Laura Mannering DPT, OCS, Dip MDT
Doctor of Physical Therapy
Board-certified in Orthopedic Physical Therapy
Diploma in MDT (Mechanical Diagnosis and Therapy)

My website: https://www.drlauramannering.com
My Instagram:   / drlauramannering  

Clinic located in Dupont Circle in downtown Washington, DC.

#orthopedics #shoulder #shoulderpain #shoulderpainrelief #physicaltherapy