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scapular stability, as push-up plus is somewhat of an outdated exercise.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
wont 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.