The one thing is understanding how anatomy gets applied.
When it comes to shoulder cases, and you’re thinking through the process of what you may know or not know instead of jumping from one thing to another, “Oh, I need to know testing,” or “I need to get better at hands-on stuff,” I think it’s key to get down to the basics of what you know about shoulders.
So, what do you know about the shoulders?
The basics of a shoulder are that it is an unstable joint, and it’s unstable so that we can have mobility. So we’re sacrificing stability for mobility.
When someone comes to you, and they ask, “Why? Why is this happening to my shoulder?” I usually start with, “Well, you know, your shoulder is a really unstable joint so that you can get a lot of movement.” And that’s why we tend to develop problems over time with our shoulders, which can be painful.
Then you can understand a little bit of the anatomy. So, what makes the shoulder complex? What are the three bones that make the shoulder complex?
We’ve got the humerus (the upper arm bone), the scapula (the shoulder blade), and the clavicle (the collar bone).
While It is very important to know the correct terminology, at the end of the day, you also want to know what the common terminology is to increase your chances of the likelihood that your patients are going to understand what you’re saying. If they understand why something is happening, they will have a better chance of understanding why we, as shoulder specialists, as occupational therapists, can help them.
So, when you’re explaining to people why they have pain, they have pain because those three bones have to support the whole arm via this one little itty-bitty point to your sternum. That’s the only way that shoulder complex, which bears the weight of the whole arm is attached to the rest of the bones in your body. No other ones float like that, everything else is attached to other big parts, and that’s why we all tend to have shoulder problems. After the age of 40, it increases.
So, if you understand that, it’s a great way to help your patients understand why they tend to have shoulder problems. And then, once you know the bones, you can understand the muscles. And then, once you know the muscles, you can get into understanding all the observational things that you’re going to be looking at, like how it should work normally. And then, once you understand how it normally works, you can understand how abnormalities work.
Once you understand abnormalities, you can go into testing. And then, the testing will really help you pinpoint those key problems. And when you can identify and find those key problems, you will develop problem-solving skills to fix those problems.
Helping them get rid of their pain, be more active, and just get back to what they may want to do with their arms. Outside just your typical Activities of Daily Living (ADL), people want to go to the gym, they want to be able to drive to and from work, they want to be able to sleep without pain, they want to play sports, etc.
So, when you bring it back to that and why they want to fix your shoulder, it comes back to understanding the basics. And when you can explain those basics, it will make it easier for them to understand their problem and how to fix it.
If you are working alone or even if you are working with others but want that extra guidance…attention to help you critically think through a case, and make decisions about what to do next.
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