Shoulder Diagnosis

Rotator Cuff Tear

Subjective
- Pain at night
- Severe pain at time of injury
- Pain overhead
- Positive painful arc
- Weakness of involved muscle
- Painful symptoms radiating down the arm
Objective
3 things to look for
- Active / Passive ROM
- Strength
- Palpation
3 Special tests
- Subscapularis: lift off test
- Supraspinatus/infraspinatus: ER lag sign , Drop arm test
- Infraspinatus manual muscle test
Interventions
- Scapular protraction / retraction
- Scapular depression
- Shoulder shrugs
- Sidelying External rotation
- 90-90 ER
-

Shoulder Diagnosis
Subjective
Objective
3 things to look for
3 Special tests
Interventions

Shoulder Diagnosis
Subjective
Objective
3 things to look for
3 Special tests
Interventions

Back Diagnosis Scoliosis

Subjective
- Mild back pain discomfort
- Idiopathic scoliosis showed diminished pulmonary function, difficulty breathing/endurance
Objective
3 things to look for
- Active ROM of spine (Flexion/Ext/Side Flexion)
- Curvature
3 Special tests
- Adam Forward Bend test – distinguish between structural scoliosis / non structural
scoliosis
Interventions
- Breathing techniques
- Depression/Anxiety Relaxation techniques
- Muscular endurance / strength
Lumbar Spinal Stenosis
- Subjective
o Pain with prolonged ambulation, standing
o Relieved with forward flexion
o Neurogenic claudication
o Symptoms bilateral – asymmetric
o N&T  involve usually entire leg
o Walking upstairs easier than downstairs
- Objective
o Muscle tenderness
o Posture
o Reflexes
o Straight Leg Raise Test
o Bicycle Stress Test
- Interventions
o Core musculature strengthening
o Flexion based exercises

Lumbar Spondylolisthesis
- Subjective
o Intermittent localized LBP
o Exacerbated by flexing/extending affected segment
o Lying in supine helps pain *instability of spondylolisthesis* reduces in supine
o Hamstring muscle spasms
o Difficulty walking (coordination and balance)
- Objective
o Step off sign
o SLR test – causes pain
o Muscle strength
o AROM
o Lumbar vertebral mobility
- Treatments
o Core stability
o Antilordotic
o Isometric exercises
o Stretching hip flexors/lumbar paraspinals
o Balance training