January 26, 2019

Shoulder Pain Information and Resources

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Here are some links to articles about shoulder pain that I hope you will find useful.
If you find links that don’t work, or have any links you wish to share, please use the comment form at the Bottom of the page. Thanks.
These links are from my workshop on Assessment and Treatment of Shoulder Pain. Workshops are listed at
https://massagelibrary.com/events/
High Prevalence of Superior Labral Tears Diagnosed by MRI in Middle-Aged Patients With Asymptomatic Shoulders
Orthop J Sports Med. 2016 Jan 5;4(1):2325967115623212. doi: 10.1177/2325967115623212. eCollection 2016.
https://www.ncbi.nlm.nih.gov/m/pubmed/26779556/

Diagnosing and Treating People with SLAP tears of the Glenoid Labrum –  Avoid Shoulder Surgery!

https://www.doctorschierling.com/blog/shoulder-pain-and-tears-of-the-glenoid-labrum-the-dreaded-slap-tear-how-to-avoid-surgery
Patterns of motion loss in subjects with idiopathic loss of shoulder ROM
The internal rotation less than abduction less than external rotation pattern was demonstrated in 14 of 25 (56%) involved shoulders.
Clin Biomech (Bristol, Avon). 2004 Oct;19(8):810-8.
https://www.ncbi.nlm.nih.gov/pubmed/15342153  
The Effect of Anterior Versus Posterior Glide Joint Mobilization on External Rotation Range of Motion in Patients With Shoulder Adhesive Capsulitis
“the individuals in the posterior mobilization group had a mean improvement of 31.3°”
J Orthop Sports Phys Ther 2007;37(3):88–99. doi:10.2519/jospt.2007.2307
http://www.aptei.ca/library-article/shoulder-mobilizationmulligan-or-kaltenborn-who-is-right/  
Don’t Blame the Rotator Cuff – Erik Dalton
Working with the sternoclavicular joint to relieve impingement at the acromioclavicular joint.
https://erikdalton.com/blog/dont-blame-the-rotator-cuff/
I’m Blaming it on the AC Joint – Erik Dalton

I’m blaming it on the AC joint!

Symptoms of Pain Do Not Correlate with Rotator Cuff Tear Severity
J Bone Joint Surg Am. 2014 May 21; 96(10): 793–800.
Published online 2014 May 21. doi:  10.2106/JBJS.L.01304
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4018774/
Structure is not Destiny
http://www.greglehman.ca/blog/2012/07/22/structure-is-not-destiny-please-dont-rush-to-freaking-out-about-your-x-ray-mri-or-ultrasound
What is Shoulder Impingement and why it is important to address it
https://www.doctorschierling.com/blog/what-is-a-shoulder-impingement-and-why-its-important-to-address-it-before-it-affects-the-rotator-cuff-or-labrum-causes-a-slap-tear
Tennis Serve
54% of the power comes from the legs and trunk
Kibler, W.B. 1995. Biomechanical analysis of the shoulder during tennis activities.
Clin Sports Med, 14:79-85
http://europepmc.org/abstract/med/7712559
Baseball Pitching
24% energy decrease from hip and trunk
requires 34% increase at the shoulder
to deliver the same amount of force
WB Kibler – The role of the scapula in athletic shoulder function
The American journal of sports medicine, 1998 – ajs.sagepub.com
http://journals.sagepub.com/doi/abs/10.1177/03635465980260022801
Surgery or Physiotherapy
For people diagnosed with atraumatic partial thickness tears of the supraspinatus tendon involving less than 75% of the tendon, a graduated physiotherapy exercise program has been found as beneficial as surgery involving acromioplasty, or acromioplasty and rotator cuff repair.
Kuhn, J. Exercise in the treatment of rotator cuff impingement. A systematic review and synthesized evidence based rehabilitation protocol. 2009, J shoulder Elbow Surg, Jan. – Feb.
http://www.jshoulderelbow.org/article/S1058-2746(08)00476-X/abstract
Can you have a Rotator Cuff Tear and No Symptoms?
https://mikereinold.com/can-you-have-a-rotator-cuff-tear-and-no-symptoms/
Headstand for Rotator Cuff Tear: Shîrshâsana or Surgery
International Journal of Yoga Therapy: 2006, Vol. 16, No. 1, pp. 39-47.
http://iaytjournals.org/doi/abs/10.17761/ijyt.16.1.l3p3u261u8522451?code=iayt-site 
Yoga-Based Maneuver Effectively Treats Rotator Cuff Syndrome
Topics in Geriatric Rehabilitation April/June 2011 – Volume 27 – Issue 2 – p 151–161
http://journals.lww.com/topicsingeriatricrehabilitation/Abstract/2011/04000/Yoga_Based_Maneuver_Effectively_Treats_Rotator.10.aspx
Shoulder Health: an Overview of Anatomy and Injury
http://www.otpbooks.com/shoulder-health/
Muscle Energy for Sterno-Clavicular Joint
Tom Ockler, PT
https://www.youtube.com/watch?v=o7NQsO8nry0&t=11s
New Paradigms in Rotator Cuff Retraining
Bahram Jam, MPhty, BScPT, FCAMT
http://www.aptei.ca/wp-content/uploads/New-Concept-in-Rotator-Cuff-Retraining-Final-Sep-04-3-column.pdf
Gentle Thawing of the Frozen Shoulder
a prospective study of supervised neglect versus intensive physical therapy in seventy-seven patients with frozen shoulder syndrome followed up for two years.
Diercks RL, Stevens M., J Shoulder Elbow Surg. 2004 Sep-Oct;13(5):499-502.
http://www.jshoulderelbow.org/article/S1058-2746(04)00082-5/abstract
Manipulation Under Anaesthesia
http://www.aptei.ca/library-article/frozen-shoulder-is-manipulation-under-anaesthesia-a-good-option/ 
Isometric Shoulder Exercises
http://www.aptei.ca/library-article/novel-isometric-shoulder-exercises/
Massage for Shoulder Dysfunction
Massage Therapy Journal – Nov. 2016
https://www.amtamassage.org/articles/3/MTJ/detail/3592
Rotator Cuff Pain and Sleepless Nights
Here is a very simple technique to help your shoulder pain clients get a good nights sleep.
https://goo.gl/i6L7pF
Pain Medial to the Scapula
This may be from the Dorsal Scapular Nerve
http://massageofferings.com/index.php/2017/08/04/shoulder-blade-pain-everyones-bane/
Shoulder Arthroscopy – 1893
https://link.springer.com/article/10.1007/s11999-015-4659-1?fbclid=IwAR07OM_XxnZZ5eVXm_PQY9C49jBg0uw8NKTWfrNH67HcUnJUrwh-O1t88Sw
Reliability of MRIs
Variability in diagnostic error rates of 10 MRI centers performing lumbar spine MRI examinations on the same patient within a 3-week period
R Herzog, DR Elgort, AE Flanders, PJ Moley – The Spine Journal, 2017 – Elsevier
The Spine Journal, April 2017 Volume 17, Issue 4, Pages 554–561
http://dx.doi.org/10.1016/j.spinee.2016.11.009
MRI study of 31 asymptomatic subjects
Age 50+        72% had rotator cuff disorder
Age 40 – 49   48%
Age 30 -39    43%
Frost, P. Anderson, J.H and Lundorf, E. 1999.
Is supraspinatus pathology as defined by MRI associated with clinical sign of shoulder impingement?
http://www.jshoulderelbow.org/article/S1058-2746(99)90090-3/abstract?cc=y=
Abnormal Findings on Magnetic Resonance Images of the Cervical Spines in 1211 Asymptomatic Subjects
87.6% of subjects presented with disc bulging
Spine: 15 March 2015 – Volume 40 – Issue 6 – p 392–398
http://journals.lww.com/spinejournal/Abstract/2015/03150/Abnormal_Findings_on_Magnetic_Resonance_Images_of.11.aspx
Ultrasound study on 51 men, aged 40 – 70, asymptomatic for shoulder pain.
96% had some degree of moderate to severe shoulder pathology.
Sub acromial bursa thickening 78%
Acromio-clavicular joint degeneration 65%
Supraspinatus tendinosis 39%
Subscapularis tendinosis 25%
Partial thickness tear supraspinatus 22%
Posterior glenoid labral anomaly 14%
Girish, G., Lobo, L.G., Jacobson, J., Morag, Y, Miller, B. and Jamadar, D.
Ultrasound of the shoulder: Asymptomatic findings in men.
American Journal of Roentgenology, 2011;97, 713-9.
http://www.ajronline.org/doi/abs/10.2214/AJR.11.6971
Self Care Exercises
Videos and pdf handouts of self-care exercises for the shoulder are available at
https://massagelibrary.com/Free+Section/Self+Care/ 
Pectoralis Doorway Stretch
https://massagelibrary.com/video/pectoralis-doorway-stretch/
Rotator Cuff Exercise
https://massagelibrary.com/video/rotator-cuff-exercise-2/
Rounded Shoulder Exercise
https://massagelibrary.com/video/rounded-shoulder-exercise/
Shoulder Impingement Stretch
https://massagelibrary.com/video/shoulder-impingement-stretch/