Shoulder joint

Shoulder injuries

Dr. Vic Weatherall
June 2015

Treating shoulder injuries and pain are common challenges encountered by chiropractors and other health care professionals. Typical examples are rotator cuff tears and impingement syndromes. The following article is based on the Ontario Workplace Safety and Insurance Board (WSIB) Shoulder Program of Care Reference Guide, October 2012.

Contact Dr. Weatherall if you have any questions or to see if he can help you with a problem.

Initial assessment

Initial assessment includes

  • Obtaining patient health history and history of the presenting complaint to obtain a thorough understanding of the mechanism of injury
  • Completing standardized symptom and abilities questionnaires
  • Performing a physical and functional examination and objective evaluation

The objectives of the initial assessment is to rule out “red flags” (indicators of potentially serious problems and to identify “yellow flags” (psychological risk factors that may have an impact on behaviour, expectations, and recovery from injury).

Red flags

Red flags include the following potentially serious signs and symptoms:

  • Any clear indicators for immediate surgical intervention.
  • Acute inflammatory arthropathy (joint conditions).
  • Advancing or unexplained neurological or sensory deficits.
  • Infection or fracture at site of injury.
  • major tears.
  • Dislocation.
  • Neoplasms (tumours).
  • Significant weight loss.

 Yellow flags

Yellow flags help to identify people who are at potentially greater risk for chronicity (slow recovery or recurrence) and to ensure appropriate monitoring and intervention during treatment.

Yellow flags include the following:

  • Believes hurt equals harm
  • Fears or avoids activity
  • Low mood or social withdrawal
  • Prefers passive treatments
  • Home environment concerns
  • Work environment concerns

 Treatment

Treatment focuses on evidence-based treatment interventions, including

  • Patient education about condition.
  • Pain and self-management strategies.
  • Treatment (targeted exercises, mobilization, and massage).
  • Transition to work and activities of daily living.

Image citation

By OpenStax College [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons.