Expert: Dr. Paul Newhart - 9/15/2009

Question
Hi Dr. Newhart. I am am currently an under grad at a Chiropractic school and will be moving on to the D.C Program shortly. About three months ago I was in the gym doing dumbell presses and I felt a sharp pain in my right shoulder. Specifically in the front deltoid. I also had a feeling of the shoulder being out of place in general. I have not lifted for three months, I have just stuck to running and swiming. Swiming does not seem to bother it. I was sure that it would but it does not. My shoulder was only adjusted twice. And the Chiropracter who did it, did not take any time evaluating it. Now that I am back on campus I was able to have a full examination. The intern and doctor who looked at me tested my range of motion. Everything was good except for one thing. He sat me down on the table, stood behind me to my right, then put his foot on the table. He placed my elbow on his leg and pointed my finger tips to the cieling. Like an L shape. He attemted to roll my shoulder back by pushing my for arm and hand. I know that it is not supposed to go very far but it hardly moved at all. It strayed in the L sahpe. He massaged the front of my shoulder some and then it moved a little but still not much. He thinks it is related to my injury but then my left shoulder reacted the same way. Is this just my personal bodymechanics? My other shoulder does not hurt. Yet I felt both shoulders tug when he tried to pull them back. I know my question is winded and I hope it makes sense. We still have not began treatment yet. Most likely in a few days. Do you have any advice for me. The pain is not to bad but I feel like it prevents me from doing some things I like to do. Any advice or strengthening exercises would be great!!

Answer
First, congratulations on your career choice!!!  You will find it very rewarding when a patient enters, just as you present now, and you are able to help.  It can be anything from a simple strain to a tear to a misalignment.  Without an actual hands on it is difficult to diagnose.  A good approach would be to use some ice and estim, myofascial release, and range of motion exercise within tolerance.  If there is no or little change in a short period of time, an xray or MRI may be called for.  The test you are describing sounds like it may be the Apprehension test.  Having both shoulders limited in motion is probably normal for your mechanics.  As a side not, we have had ortho tests show positive with no tears, and negative with tears...they are just a guide.