Journal Club 1.3
1.
Shoulder pain and mobility deficits: Adhesive Capsulitis
Journal of Orthopedic Sports Physical Therapy 2013; 43(5) Kelly DPT
Conclusions:
High correlation with type 2 diabetes and thyroid disease
2 year process with 3 stages.
Inra-Articular corticosteroid injections are effective.
Pt education and stretching exercise may be beneficial.
Short wave diathermy, ultrasound, or electrical stim can be beneficial with stretching exercises.
Joint mobilization and joint manipulation is also effective.
Stretching alone was effective. .
WSS conclusions: First step: Blood work to rule out diabetes and thyroid problems. (A1c and thyroid
panel). Also, such strong correlation with female demographic. Female hormones also important. To
secure diagnosis check behind the back internal rotation. Usually, females say “cannot fasten bra
strap”. Differential diagnosis will include rotator cuff rupture. If you have a rotator cuff tear you can
still reach behind back and you will have no strength on empty can test. Someone with frozen
shoulder will usually test strong on empty can test. Heat is important for recovering range of motion.
We recommend specific stretching exercises to be performed every 2 hours of the day. This is crucial.
Acupuncture also has great track record for helping with symptoms. In conclusion, we recommend an
appointment with Dr. Furlano to rule out metabolic problems mentioned previously. We then treat
the adhesive capsulitis with heat, stretching, DNS, acupuncture, and adjustments. In very stubborn
cases we will refer to the orthopedists for manipulation under anesthesia. We do not use
corticosteroid injections although the evidence does support it.
2.
Effect of scapular function training on chronic pain in the neck/shoulder region: A randomized
controlled trial.
J occup Rehab. 2014; 24: 316-324 Andersen
Conclusions: Scapular Functional Training reduces pain intensity and increases shoulder elevation
strength in adults with chronic non-specific pain in neck/shoulder region. The magnitude of
improvement in pain intensity was clinically relevant.
WSS conclusions: We would definitely use a better approach for exercise for scapular stability, as pushup plus is somewhat of an outdated exercise. However, in this study still decreased pain and increase
scapular protraction. In shoulder cases, we are less concerned with the protraction function of the
serratus anterior and more concerned with its stabilizing function of holding the scapula secure on the
rib-cage. The importance of scapular stabilization for shoulder complaints cannot be overstated. We
use Dynamic Neuromuscular Stabilization to achieve this task in the office.
3.
Effect of spinal manipulative therapy with stretching compared with stretching alone on full
swing performance of golf players: a randomized pilot trial
Journal of Chiropractic Medicine (2009) 8, 165-170 Costa
Conclusions: Chiropractic Spinal Manipulative Therapy in association with muscle stretching may be
associated with an improvement of full-swing performance when compared with muscle stretching
alone
WSS Conclusions: Research continues to show that statically stretching muscles won’t only not improve
performance, it will impair performance. It basically takes the spring out of muscles. This study not only
exposed this fact but also highlights the neurologic benefit of an adjustment. Having spinal segments
that can move freely is a prerequisite for a good golf swing. Adjustments not only improve the spine
biomechanically but also neurologically. Said another way, the brain has a better perception of where
the spine is in time and space when the vertebrae are able to move freely. Not surprisingly, just about
every tour player will see their chiropractor regularly for adjustments to maintain this spinal freedom.
The gut-brain barrier in major depression: Intestinal mucosal dysfunction with an increased
translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory
pathophysiology of depression
Neuroendocrinology Letters 2008; 29(1): 117-124 Maes
Conclusions: It is suggested that patients with MDD should be checked for leaky gut by means of IgM
and IgA panel used in the present and accordingly should be treated for leaky gut.
WSS conclusions: Any patient on a depression medication or that is clinically depressed should have
their GI permeability assessed. Research continues to point at this correlation. Many times Selective
Seratonin Reuptake Inhibitors are not getting to the actual cause of the problem. “Leaky gut” is a
common problem that Dr. Furlano sees on a daily basis. We also have simple ways to blood test for
leaky gut. Some depressive cases have no issues with the gut and then of course other treatments
would be implemented.