Selecting Tests to Diagnose Shoulder PainDoctors and physical therapists often see patients with shoulder pain. Treatment gets better results when there is a known diagnosis. In this study, selective tissue tension (STT) is evaluated as a reliable way to make that diagnosis.
STT includes tests of movement and muscle control of the neck and shoulder. It's a logical way to examine the shoulder. One expert and three other examiners (doctors and physical therapists) used the STT to evaluate 56 shoulders. All four examiners came up with a diagnosis based on the results of the STT.
There was overall good agreement among them. But a closer look at the data showed there wasn't agreement for all diagnoses. Agreement was only fair-to-moderate for shoulder bursitis. Shoulder capsulitis seemed to have the best agreement.
The authors suggest the STT can be used to diagnose shoulder problems when the examiner is experienced. Competence in the use of the STT can't be taken for granted. The test may be more reliable than the examiner using the test. For this reason, training in the use of the STT is needed before using it to diagnose shoulder problems.
Nigel C. A. Hanchard, MSc, et al. Diagnosis of Shoulder Pain by History and Selective Tissue Tension: Agreement Between Assessors. In Journal of Orthopaedic & Sports Physical Therapy. March 2005. Vol. 35. No. 3. Pp. 147-153.
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