from the doctor’s office: shoulder program design BTS

Treating shoulder pain is literally the thing I do most during the average work week. Shoulder pain, specifically due to impingement syndrome, is the most frequent diagnosis I make in my clinical practice, making up about 40% of my total caseload. I have plenty of clinical experience (with lots of success) in treating this condition, but good physical therapy has to be rooted in scientific evidence. 

I took the time to review dozens of relevant research articles on shoulder impingement to see what the current best practices are, and found 14 studies worth citing. Through this process, some clear patterns emerged:

  • Exercise is the most effective intervention.
  • Specific exercises are more effective than general exercises.
  • Addressing stiff/tight/painful muscles in the shoulder complex can make exercise more effective.
  • Mobilizing the upper back in addition to exercise yields better results.
  • Targeted stretching can improve results. 

All of the above is great news for anyone who wants to try to deal with his or her own shoulder pain. Why? Because you can watch some videos to learn how to do specific shoulder exercises and stretches. You can use a foam roller or ball to identify and address your stiff spots and mobilize your own thoracic spine. 

The next step in building the program was to map out a plan that incorporates all of the above as well as my clinical experience. This meant outlining fifty-two different strengthening, stretching, and mobility exercises that fit the paradigm outlined above. With all of the “reading” picked out, now I have to build an actual syllabus: organizing those exercises into a plan that users can easily navigate: “week one, day one, do these 3 things.”

When that structure is in place, the next step will be planning, shooting, editing, and producing videos that have everything you need to learn and do the exercises on your own and nothing you don’t. This will take some time, but when it’s finished, we want the end product to be something that anyone who has shoulder pain can use to diagnose where they’re at, get a rehab plan that meets them where they are, and has everything they need to get back to full, pain-free function. 

– Sam