Struyf Filip. Shoulder Pain. Clinical Assessment of a Complex Joint

Translation from the Dutch language edition: “Over de schouder” by Filip Struyf. — Springer, 2024. — 167 p. — ISBN 978-3-031-82228-5.For more than two decades, I have immersed myself in unraveling the mysteries nestled within our shoulders. Ironically, the term “shoulder complex” perfectly captures its intricacy. The shoulder, composed of interconnected joints and bone structures, operates as a harmonious system to execute specific tasks. Typically, these involve positioning our hands—whether bringing food to our mouths, discarding items, retrieving something from a shelf, or opening a door. Our hands are linked to our torsos through the elbow and further to the shoulder. Therefore, the shoulder plays a crucial role in enabling our hands to perform their functions in the right place and at the right time.
As you hold this book, imagine your hand, elbow, shoulder, and even your entire body maintaining equilibrium under the weight of the book. Muscles around your shoulder work to stabilize your upper arm, allowing the elbow to position your hand correctly and keeping the book at the appropriate height and distance from your eyes. In essence, the shoulder enables you to fully enjoy the book—how fitting. In other words, our shoulders are integral to our daily lives, providing a stable foundation for handshakes and requiring the necessary mobility to throw a ball or wave to a neighbor.
Our shoulder serves as the link between the hand and torso, directed by our brains. While our entire body is undoubtedly complex, it is the combination of stability, mobility, and the substantial force our shoulders can generate that renders them unique and complex. Furthermore, even our hormonal and metabolic systems impact how our shoulders feel.Epidemiology of Shoulder Pain.
Anatomy.
The Glenohumeral Joint.
The Acromioclavicular and Sternoclavicular Joints.
The Scapulothoracic Joint.
Neuroanatomy of the Shoulder Region.
Motion Analysis.
The Glenohumeral Joint.
The Sternoclavicular and Acromioclavicular Joints.
The Scapulothoracic Joint.
Muscle Functioning Around the Shoulder.
Problem-Solving.
The Hypothetico-Deductive Approach.
Pattern Recognition.
The Algorithm.
The Gathering Method.
Questionnaires, PROMS, and PREMS.
Questionnaires Focusing on Shoulder Pain.
Visual Analog Scale.
Numeric Pain Rating Scale.
Brief Pain Inventory.
Combined Scoring Systems.
Constant-Murley Score.
Questionnaires Focusing on Functioning of the Shoulder or Upper Limb.
Shoulder Pain and Disability Index.
Simple Shoulder Test.
Western Ontario Rotator Cuff Index.
Disabilities of the Arm Shoulder and Hand Questionnaire.
Western Ontario Shoulder Instability Index.
Oxford Shoulder Instability Score.
The Western Ontario Osteoarthritis of the Shoulder Index.
Oxford Shoulder Score.
The American Shoulder and Elbow Surgeons Standardized Assessment.
Questionnaires Focusing on Psychosocial Experience.
Fear-Avoidance Beliefs Questionnaire.
Tampa Scale of Kinesiophobia.
Pain Catastrophizing Scale.
Questionnaire Focusing on Quality of Life.
EuroQol 5 L-5D.
Short-Form Health Survey 36.
Screening.
Yellow Flags.
Red Flags.
When Is Medical Advice Required.
The Patient History.
In the Waiting Room.
The First Meeting.
The Story of the Patient.
How Do We Let the Patient Tell Their Story.
What Questions Should I Ask.
Administrative Patient History.
Specific Patient History.
Pain History.
Social Patient History.
Additional Patient History.
Clinical Examination.
Visual Assessment.
Brief Palpation.
Active and Passive Movement Assessment.
Anteflexion ROM.
Abduction ROM.
External Rotation ROM.
Internal Rotation ROM.
Resistance Testing.
Manual Muscle Testing.
Handheld Dynamometry.
Isokinetic Muscle Strength Testing.
The Role of Special Tests.
Properties of a Clinical Test.
Sensitivity and Positive Predictive Value.
Specificity and Negative Predictive Value.
Likelihood Ratios.
Inter-rater Reliability.
Tissue Irritability.
Multidimensional Load-Capacity Model.
Shared Decision-Making.
Did the Patient Understand.
A Schematic Overview of Shoulder Examination.
Rotator Cuff-Related Shoulder Pain.
What Is Rotator Cuff-Related Shoulder Pain.
How Do You Recognize Rotator Cuff-Related Shoulder Pain.
Step 1 Rule Out a Frozen Shoulder.
Step 2 Rule Out Shoulder Pain of Cervical Origin.
Step 3 Rule Out Trauma-Related Pain.
Step 4 Eliciting the Typical Pain in RCRSP.
Biceps Tendon Pathology.
What Are the LHBT Pathologies.
How Do You Recognize an LHBT Pathology.
The Yergason Test.
The Uppercut Maneuver.
Labral Injury.
What Is a Labral Injury.
Labral Tears in Sector 1 SLAP Lesions.
Labral Tears in Sector 2 and Sector 6.
Labral Tears in Sector 3 and Sector 4.
Labral Tears in Sector 5.
How Do You Recognize a Labral Injury.
The Biceps Load I Test.
The Biceps Load II Test.
Rotator Cuff Tears.
What Is a Rotator Cuff Tear?
How Do You Recognize a Rotator Cuff Tear?
The Drop-Arm Sign.
The External Rotation Lag Sign.
The Internal Rotation Lag Sign/Lift-Off Test.
The Hornblowers Test.
Calcific Rotator Cuff Tendinopathy.
What Is Calcific Rotator Cuff Tendinopathy?
How Do You Recognize Calcific Rotator Cuff Tendinopathy?
Frozen Shoulder.
What Is a Frozen Shoulder?
How Do You Recognize a Frozen Shoulder?
Glenohumeral Instability.
What Is Glenohumeral Instability?
Glenohumeral Shoulder Instability Type 1.
Glenohumeral Shoulder Instability Type 2.
Glenohumeral Shoulder Instability Type 3.
How Do You Recognize Glenohumeral Instability?
Glenohumeral Instability Type 1/Anterior Shoulder Dislocation.
Glenohumeral Instability Type 2.
Glenohumeral Instability Type 3.
The Apprehension, Relocation, and Release Test.
The Load and Shift Test.
The Sulcus Sign.
Acromioclavicular, Sternoclavicular, and Clavicular Conditions.
What Is an Acromioclavicular Disorder?
How Do You Recognize an Acromioclavicular Disorder?
The Paxinos Test.
The O’Brien Test.
What Is a Sternoclavicular Disorder?
How Do You Recognize a Sternoclavicular Disorder?
What Is a Clavicular Disorder?
How Do You Recognize a Clavicular Disorder?
Glenohumeral Osteoarthritis.
What Is Glenohumeral Osteoarthritis?
Nonspecific General Risk Factors for Glenohumeral Osteoarthritis.
Nonspecific Local Risk Factors for Glenohumeral Osteoarthritis.
Specific Local Risk Factors for Glenohumeral Osteoarthritis.
Specific Systemic Risk Factors for Glenohumeral Osteoarthritis.
How Do You Recognize Glenohumeral Osteoarthritis?
Neurologically Related Shoulder Conditions.
What Is a Neuropathy?
How Do You Recognize Neuropathy?
What Is Cervical Radiculopathy?
Risk Factors and Prognosis.
How Do You Recognize Cervical Radiculopathy?
Spurling Neck Compression Test.
Shoulder Abduction Test.
Arm Squeeze Test.
What Is Hemiplegic Shoulder Pain?
How Do You Recognize Hemiplegic Shoulder Pain?
What Is Parsonage-Turner Syndrome?
How Do You Recognize Parsonage-Turner Syndrome?
The Role of Imaging.
Rotator Cuff-Related Shoulder Pain (RCRSP).
Biceps Tendon Disorders.
Labral Injuries.
A Rotator Cuff Tear.
Calcific Tendinopathy.
Frozen Shoulder.
Glenohumeral Instability.
Acromioclavicular, Sternoclavicular, and Clavicular Conditions.
Glenohumeral Osteoarthritis.
Communication with the Patient.
Validating Versus Reassurance.
Listening as Therapy.
References.
Index.