JH brought up a good question:
"Get this, I sent a patient back to his Dr. because I believe him to have a nerve palsy preventing him from controlling his arm in ER as wellas scap control. GUess what the Dr. said to do? Yep the Dr. wanted me to work on more scap stability. How can I when the person has a nerve palsy?? "
I see what's bugging you about this. The MD probably went to some workshop where everything was caused by scapular dyskinesis. However, it does come down to one of those chicken or the egg things. Did the nerve palsy cause the scapular control/ER issues you speak of, or did these issues cause a hypermobility in the shoulder that created the nerve palsy? Because either way, exercise is the answer; and his diagnosis gives you plenty of leeway to create a sound program. It could be worse; pigeon holing you into specific treatments that frustrate you and the athlete.
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THis patient had this problem before he was referred to an ortho. I know cause I tretaed him. He progressed but only minimally. After seeing the ortho last year he was dxd with a RC tear and subsequently had surgery. Now that the RC is fixed, he still has the same problem. I'm sure he had a tear but that in my opinion was not the cause of his problem to begin with. I think he had a nerve palsy all along.
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