30/05/2019 (Clinical Hours)

The day began with a follow-up female patient complaining of left upper trapezius tightness and bilateral forearm niggling. We performed a ULTT A, C and D along with C6, C7, C8 Dermatome tests to clear any neurological issues that could have come into play. At the end, the DDx was purely muscular tightness in her trapezius due to bad sitting posture with the added forearm pain being caused due to pre-symptoms of lateral epicondylitis. This patient has a reputation of refusing to do any type of home-based exercises. I showed her active STRs for distal lateral epicondylitis (Anderson et al 2017) that she could do at home, but for the trapezius she onlyrequested a massage. The stretching routine can be seen in the link below.

It was hard to give a DDx for the second patient of the day. Their symptoms, sex and age bracket suggested early stage of frozen shoulder but upon conducting PROM, their symptoms mimmicked something more within the realm of a rotator cuff tendinopathy. After consulting my supervisor, an Early stage protocol was devised to return ROM within the soulder girdle and after two weeks have passed we can clarify if the condition points more towards a forzen shoulder or a tendinopathy (Favejee et al 2010). Again, this protocol can be seen through the link below.

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🇧🇬🇬🇧 Ранно тренировъчно лечение при диагностицирано Замръзнало Рамо: •Пасивни раменни свличания 3 серии 10-16 повторения •Пасивни раменни флексии 3 серии 10-16 повторения *Целете да повишите разтоянието на движение с всяко следващо повторение, използвайки прага на болка като еталон •Махало •Паяци *Преминете през всички посоки на движение на раменната става и спрете при прага на болка Early exercise intervention for Frozen Shoulder: •Passive Shoulder Abductions 3 sets 10-16 reps •Passive Shoulder Flexion 3 sets 10-16 reps *Try to increase the range of motion with each repetition, the benchmark being your point of pain •Pendulums •Wall Crawlers *Go through the ranges of motion of the shoulder, not going any further where pain becomes unbearable Източници/References: Favejee et al 2010 Jones et al 2019 #shoulderrehab #frozenshoulder #adhesivecapsulitis #shoulderpain #sportrehab #pendulum #shoulderflexion #shoulderabduction #earlyrehabilitation #рамене #рамо #болка #замръзналорамо #физиотерапия🏥 #рехабилитация #лечение #рамо

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The follwing two patients requested a back masage. They complained of low back pain after sitting for a prolonged period of time. After conducting an Observational Assessment, palpation and gluteal firing test, symptoms of atrophy and poor gluteal firing were indicated. Although both cases required only a  massage, I still prescirbed them a couple of gluteal exercises that they could perfrorm at home (Cavaliere et al 2017).

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