Exercise Is As Effective As Surgery in Rotator Cuff Shoulder Pain

FUNCTIONAL F1RST

"Shoulder special tests are not that special"

"For the vast majority of [shoulder] conditions...its probably impossible to be certain exactly where the symptoms are coming from"

We speak with Dr. Jeremy Lewis (PhD, FCSP, Consultant Physiotherapist, Professor of Musculoskeletal Research) about rotator cuff shoulder pain, including issues relating to shoulder special tests, medical imaging, and research which reports that, for most people, exercise is as effective as surgery.

To connect with Jeremy, visit his website http://www.londonshoulderclinic.com or follow him on twitter @JeremyLewisPT

00:25 Can you give us a brief background?

01:33 Can you describe each of the following hypotheses, how they started, and what the research supports?:

01:42 - Shoulder impingement

06:22 - Rotator cuff tears

07:23 - Shoulder special tests

09:56 - Shoulder imaging and pain

12:32 - Shoulder surgery

14:14 - Posture and shoulder pain

16:24 Why do you think that all of these hypotheses are still prevalent despite the research?

18:13 How did you come to question these hypotheses and how have they changed your practice?

19:10 Do you think that clinicians should change their practice based on the research?

20:37 Do you think that we should abandon the traditional shoulder special tests in assessments?

22:01 Do you think there is such thing as a bad shoulder exercise?

23:05 What about exercises people do in the gym that aren’t considered functional positions? (E.g. Behind the neck military press)

25:06 Can you explain your shoulder symptom modification procedure and how you incorporate it into an assessment?

28:18 Does the shoulder symptom modification procedure drive your management decisions?

29:10 How do you explain a shoulder issue to a patient who wants a specific diagnosis?

30:47 Do you feel is the biggest mistake that clinicians make when dealing with the shoulder?

31:39 Are there any specific kinetic chain factors you assess that may influence the shoulder?

33:29 What are some psychosocial factors that contribute to shoulder outcomes?

35:27 Can you share one interesting and little known fact about the shoulder?

36:51 What are some unknowns about the shoulder that you hope will be answered in future research?

38:57 How can people learn more about you?