I always have had chronic pain in my right shoulder.
I frequently pose my shoulder like this
when I do ultrasound scanning or interventional procedure.
Furthermore, I enjoyed martial art training and active exercises when I was young.
Would you please guess the pathology of my shoulder pain?
Today, I will share my clinical experience of extracorporeal shock wave treatment.
It is an excruciating treatment. But I wish this treatment would help me to heal.
I am right-hand dominant and forced to overuse my shoulder in an inappropriate position.
I checked the MRI scan. Let me show you my MRI scan.
I found a focal labral tear with a ganglion cyst in the anterior capsule
and focal high signal intensity of the coracohumeral ligament.
I understood why my shoulder pain did not improve well for long.
and tried to inject steroids into my shoulder several times.
I can not afford to close my clinic and get an operation.
so, I tried to inject a steroid into my shoulder several times,
but it did not improve the pain and limited mobility
Let me receive a physical exam first
I am not sure it will cure my shoulder. I hope I can give you good news soon.
Please fix the shoulder before checking the glenohumeral joint mobility.
I feel pain at the passive abduction test, and there is a limitation of motion.
The external rotation movement is also limited.
Let me show you internal rotation.
Please use your left hand to show my arm to the audience
I have a capsular limitation and pain, according to an orthopedic examination.
Let me show you my left glenohumeral joint mobility.
I have no pain and limitations in my left shoulder.
Passive abduction.
Please observe the scapula's fixation technique to prevent compensatory movement.
I would pay attention to the glenohumeral joint movement only.
Passive external rotation
Passive internal rotation
Let me show you my external rotation in a supine position.
She put a towel under my shoulder to prevent compensatory movement of the scapula.
I feel intense pain in the passive external rotation.
This position would remove the compensation more effectively.
Please compare both shoulder movements.
Let's start extracorporeal shock wave treatment.
I will use an EMS doloclast extracorporeal shock wave machine.
Like an ultrasound scanning, I need a gel to make the probe contact with the skin.
The first target is the anterior and inferior joint capsules.
According to Cyriac's orthopedic examination, the pathology is located at this place.
It is a radial type.
I will introduce you to the kind of machine, mechanism,
and clinical application of shock wave treatment in the feature.
Today, you enjoy watching my receive of treatment.
The sound is loud, so I will put down the noise.
Actually, it is an excruciating treatment.
The target from this position is the anterior capsule
and subscapularis muscle and tendon.
She said it would be more effective when tightly compressed the probe.
But it provokes more pain.
The gliding probe would release the tight muscle.
The stretching of my shoulder would extend the anterior capsule and increase mobility.
It is a rolling technique. It will release the pectoral muscle.
Next, move on to the inferior capsule.
She put the probe at my axillary fossa toward to inferior capsule.
The skin of the axilla is soft and highly sensitive.
Consequently, I feel pain in the deep tissue and skin.
This position intends to focus on the coracohumeral ligament.
I feel more intense pain when she stretches my shoulder more.
It will be boring so. I will make it fast.
Let me sit on the stool.
She placed the probe to focus the shock wave in the supraspinatus muscle and tendon.
The rolling technique on the suprascapular fossa will release the supraspinatus muscle.
Internal rotation of the shoulder will expose the supraspinatus tendon to the shock wave.
I will take more repeated treatment. It is painful.
Some patients refuse to get treatment because of excruciating pain.
Let's move on to the coracohumeral ligament
My primary diagnosis is the anterior labral tear.
I realized that several pathologies are mimicking frozen shoulder.
The SLAP and anterior labral tear are one of them.
It is an excruciating treatment.
But I wish this treatment would help me to heal.
I am done.
Please compare the glenohumeral joint mobility.
Passive abduction
Passive external rotation
Passive internal rotation
Transiently. It increases my shoulder mobility and reduces my pain.
I hope it will cure my shoulder.
Thank you for watching. See you in the following videos.
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