Physical Therapist's 'Quick Assessment' Enters Second Hour as Patient's Dysfunction List Grows

What was scheduled as a thirty-minute initial assessment at Apex Physical Therapy entered its second hour Wednesday as physical therapist Dr. Corinne Glenohumeral continued to identify previously unknown dysfunctions in patient Michael Tensor, who had presented with what he described as 'a bit of a sore shoulder.'

'I came in because my shoulder hurts when I reach overhead,' Tensor said, now standing shirtless while Dr. Glenohumeral photographed his scapular positioning from six angles. 'That was ninety minutes ago. Since then I've been told my glutes are inhibited, my thoracic spine doesn't rotate, my hip flexors are "in crisis," and my ankles lack what she called "adequate dorsiflexion for the demands of being a biped."'

Dr. Glenohumeral's assessment notes, which Tensor glimpsed briefly, included the phrases 'global motor control deficit,' 'significant scapulohumeral rhythm disruption,' 'bilateral femoral anterior glide syndrome,' and, underlined twice, 'this man's serratus anterior is essentially decorative.'

'Your shoulder pain is not a shoulder problem,' Dr. Glenohumeral explained. 'It's the final expression of a kinetic chain that has been compensating for dysfunctions from the ground up. Your feet pronate, which internally rotates your tibiae, which alters your femoral alignment, which anteriorly tilts your pelvis, which—'

'Can you just fix the shoulder?' Tensor asked.

'There is no shoulder,' Dr. Glenohumeral replied. 'There is only the chain.'

Tensor's treatment plan, presented at the end of the assessment, recommends three sessions per week for twelve weeks, totaling thirty-six visits. His sore shoulder is addressed in session twenty-eight.

'I'm going to try ibuprofen first,' Tensor said.