When Patient B. came to us at San Marcos Rehabilitation & Health Care with persistent shoulder pain, he was experiencing reduced activity tolerance and participation, a decreased upper-extremity range of motion and a need for assistance with ADLs. His shoulder pain measured 8 out of 10 on his B shoulders; his muscle strength was at 3+ out of 5 for his shoulder flexors, abductors and extensors; and his Shoulder Pain and Disability Index (SPADI) score was 90 out of 100. Needless to say, B. had a lot of work ahead of him, as did our therapists.
Through the collaborative efforts of Physical Therapy and Nursing, we designed a treatment program for B. that would allow us to help the patient progress while also monitoring his pain levels. Using the SPADI score allowed for an objective measure of pain relief as we set to work with various therapies, including a kinesio taping technique, therapeutic exercises to strengthen the shoulders, and scapular mobilization and gentle Grade 3 joint oscillation (inferior glide) of the humerus for two minutes at a time. For the first intervention, we incorporated kinesio taping of the B shoulders based on protocol developed by Kase, Wallis & Kase (2003). The second intervention included preheating the shoulders with a hot pack for 15 minutes, followed by various shoulder and scapular mobilization techniques.
The outcome for B. has been positive, as he now reports an improvement in pain relief, registering at 3 to 5 out of 10 — compared to his initial complaint of 8 out of 10. By week four, His SPADI score had dropped to 80, compared with 90 initially, and although this score did not meet the minimal clinical importance difference criteria where a 13-point difference is required, the patient did have a subjective improvement in pain relief.
Perhaps the most significant takeaway for B. has been the kinesio-taping technique, which has improved his ability to sleep at night and to interact with his environment. All numbers aside, it’s always a pleasure to see patients experiencing a reduction in pain and an improved quality of life as a result of our combined therapy efforts.