A 15 year old girl developed R shoulder pain one year ago after sleeping on it weird. Pain is constant and unable to raise hand above shoulder height (for instance raising her hand in school to ask a question).
3 months after the onset she had a diagnostic ultrasound which found a small supraspinatus tear (rotator cuff muscle). She then had 24 physical therapy visits over 12 weeks with no improvement. 2 months later she had a shoulder MRI - this did NOT show a supraspinatus tear.
11 months after initial onset the patient was referred to me. Pain was still constant (10/10 on VAS) EXSTORE exam was as follows:
•unable to flex shoulder above 90 deg on R
•scapular stability (serratus anterior) on R is inhibited
•during testing of serratus anterior upper trapezius is in spasm
•c spine ROM to the left is 45 deg
•patient cannot do any pushup or modified pushup in school gym class.
•Patient is afraid of needles.
TREATMENT
•the patient agrees to only one needle with some convincing from her mother but does NOT agree to Pointer Plus stimulation.
•I insert needle into serratus anterior with a twitch response - and leave for 30 seconds then follow up with some manual fascial release to the mid axillary line.
RESULT
The patient was off for Christmas for 2 weeks and when she returned she reported her shoulder was 80% less painful (2/10 of VAS)
•shoulder flexion improved to 170 degrees and the scapular stability was 100% stable on EXSTORE re-exam. Her c spine ROM was now 80 deg rotation bilateral.
DISCUSSION
Being specific with your assessment will pay dividends. Take diagnostic imaging into consideration but do not lean on it - do a functional exam. For a joint to move you need two things: muscles to stabilize the joint being moved and muscles to do the moving. This is why learning to assess and treat the serratus anterior is non-negotiable when aspiring to become consistently proficient in treating shoulder and neck dysfunction. This girl had 24 visits with another therapy. 24 visits! Clearly those therapists didnt know what they didnt know. We have the tools and its easier than you think folks.
Assessment & Treatment of 12 Peripheral Nerve Entrapments Using Electroacupuncture
This question came up at the December EXSTORE seminar. When does Anthony use the Pointer versus the ITO? (Or other longer-use estim device)
In this webinar Anthony goes over assessment and understanding of the major scoliotic curves. This includes how to base rehab prescriptions and how to select acupuncture treatment protocols for major scoliotic curves. We also review scoliotic curves on Xray and review what muscles are affected and the structural implications.
🚨 Two-Part Webinar + Live Lab Alert! 🚨
We’re hosting two live webinars this month—each followed by a live lab, so you can immediately apply what you learn and ask all your burning questions in real time.
🦵 June 21 @ 3:30pm EDT: Treating the Paratendon
🐴 June 28 @ 3:30pm EDT: Intro to Assessment & Treatment of Equestrian Riders
Both sessions are open to the public and packed with clinical gems. Bring your curiosity, your questions, and maybe a notebook. Stick around for the live lab and pick Anthony’s brain while he’s still caffeinated.
🧠 Come curious. Leave a better practitioner.
🔗 You must register for both events using the link provided.👇🏽
June 21: https://us02web.zoom.us/meeting/register/yTNyZIlfSNq8UqiI-tXQSQ
June 28: https://us02web.zoom.us/meeting/register/uPOhkp3MTMWP3ycVPN3pGQ
Here is the list of webinars in the library.
This does not include the recorded labs or the other webinars annual members get.
