Technology helps our diagnosis
At Melbourne Shoulder Physiotherapy, technology helps our diagnosis. We use real-time ultrasound to visualise what is happening inside your shoulder. Ultrasound can determine if the rotator cuff is torn, or whether there is tendinopathy causing the pain. It can inform us of a distended subacromial bursa, which occurs with inflammatory bursitis.Ultrasound takes the guess work out of our assessments and provides greater confidence in our diagnoses.
However, ultrasound should not be used in isolation. At Melbourne Shoulder Physiotherapy, we are looking for harmony between the story that the patient tells, the physical examination and the ultrasound results. All three elements of the examination need to be consistent.
Testing the strength of the shoulder muscles is a critical element of shoulder assessment.To ensure that we have accurate and reliable results from our strength testing, we use dynamometry. This utilises a portable, hand held device and provides accurate results for the strength of various shoulder movements. Again, it takes the guess work out of assessment and allows for meaningful evaluation of the patient’s progress in rehabilitation.
We have developed a reliable protocol for strength testing at Melbourne Shoulder Physiotherapy. Through a long period of strength testing around the shoulder, we have developed expected readings for different “healthy” populations. This allows us to better understand your strength readings and establish realistic goals for your recovery.
Dr. Phillip Hughes
What has my shoulder blade got to do with my shoulder pain?
The way your shoulder blade (scapula) moves can be responsible for your shoulder pain.
When the shoulder blade is not moving as it should, it’s called scapular dyskinesis.
When the arm is moved upwards, the shoulder blade moves in a way to assist that upward movement. When the shoulder blade is not moving correctly, the rotator cuff tendons can be irritated or compressed, leading to shoulder pain. This is because the roof of the shoulder is an extension of the shoulder blade, called the acromion. If the shoulder blade is not moving correctly, and scapular dyskinesis is occurring, the distance between the acromion and the top of the humerus (the arm bone) may be reduced, which then compresses the rotator cuff and the subacromial bursa.
At Melbourne shoulder physiotherapy, when we assess your shoulder movements we pay close attention to the way the shoulder blade is moving, to diagnose any scapula dyskinesis that may be in operation.
Part of your treatment routine for rotator cuff pain or bursitis may involve re-education of your shoulder blade movements. It may also involve strengthening and stretching certain muscles around the shoulder blade.
The shoulder blade can be seen as the base of the shoulder, as well as the roof of the shoulder, because it contains the shoulder socket (glenoid fossa), so you can see how important the shoulder blade is for normal shoulder functioning, and how critical it is to a successful rehabilitation of the shoulder.
Dr. Phillip Hughes
We can’t leave it up to guesswork
Measuring strength of the muscles surround the shoulder is critical when assessing shoulder pain.
Often, weakness around the shoulder provides vital information about which tendons of the rotator cuff may be damaged.
It also provides important information about which muscles need to be strengthened for a full recovery.
At Melbourne Shoulder Physiotherapy, we take the guesswork out of assessing muscle strength by using a manual dynamometer. When we measure rotator cuff muscle strength, this device accurately measures the strength of certain movements, and is a critical piece of equipment to get your shoulder, moving pain-free again, in the shortest possible time.
By using a dynamometer, we can target specific muscles and movements that are in need of strengthening, which will promote a full recovery. It provides an objective measure of a patient’s strength.
Using the dynamometer allows us to accurately track your progress, during your rehabilitation.
Shoulder pain location
The location of your pain can sometimes tell you about where it’s originating.
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