Ask a PT

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Posted - 02/06/2007 :  20:45:24  Show Profile  Reply with Quote
Our user asked: "Mainly we find pain on anterolateral aspect of shoulder joint.WE apply ultra sound and perform all active and passive movement.Also tried theraband and Mulligan technique and it is not give result.Patient give less response. But after few days condition again deteriorates.So what to do now? "

Ask a PT Response: "First of all, I'll admit that I am not very familiar with Mulligan's technique in treating the shoulder. From what I know the technique involves mobilization of the GH and ST joints with movement. An article which I found useful for more information on this technique is at http://www.physiotherapy.org.nz/index02/Publications/JournalPDF/31 - http://www.physiotherapy.org.nz/index02/Publications/JournalPDF/31 3 Nov03p140-142.pdf
When I perform treament I treat the patient and not just the injury. I develop a problem list and address these issues. It sounds like what you are doing is only working somewhat as you are not achieving lasting results with your patient. If your patient has a biomechanical, postural or instability issue, kinesiotaping and further postural/functional training may help with this situation. Training and neuromuscular reeducation in a pain free or minimal pain zone may be beneficial for your patient as well, as this could eventaully lead to training throughout the range at the GH joint. Activities such as PNF techniques are an example of one approach to accomplish this.

Definitely continue to reassess your patient and his/her problems and address them. Develop other treatment approaches based on the problems that you discover. Should your patient continue to have less than optimal results I would recommend you refer your patient back to the doctor for further medical intervention, if appropriate, such as an MRI or medications such as anti-inflammatories or a steroid injection. Good luck with your patient and thanks for using CyberPT."