Week 4 Day 1

I had the strangest experience today...one of my patients came in that I had seen once before with a shoulder impingement. He said to me during the subjective assessment that he didn't feel like he had made any improvement during the week and that he didn't feel the HEP I had given him had helped at all. He also said he wasn't any worse luckily! I was a little worried that I had been completely off the mark with him and hadn't really found the root of his problem which seemed strange as he presented as a typical impingement with terrible scapula posture.

So I did the full objective assessment on him and straight away I could see a massive inprovement just in the muscle bulk of his rhomboids and that he was now activating lower traps. So I got him to do his active movements but didn't really take much notice and just wrote it down and moved on through the rest of the assessment. When I eventually looked back at the results he had from the week before he had moved from 90 degress of active flexion and abduction to 180 degrees. When I went back in and told him he was very casual about it and said that he hadn't really noticed. I felt like I was banging my head against a brick wall trying to explain to him that because he was so diligent with his HEP he had made a HUGE improvement that is so rare to see and that if he kept going like this he would be better in no time. But it didn't really sink in. Its amazing that you can give someone an extra 5 degrees of knee flexion and they rave about it because now they can go down stairs but something as big as a 90 degree gain of shoulder flexion and they barely notice, because its just not functional...