title: Manipulative assessment and treatment of the shoulder complex: case reports.
abstract: OBJECTIVE
  To describe a unique method of evaluation and a conservative management plan for patients with shoulder dysfunction of mechanical origin. Possible causes for this clinical presentation and a brief review of the literature are offered.
  
  
  METHODS
  In the 3 cases described here, symptoms included acute shoulder pain, limitation of movement, positive orthopedic tests, palpable tenderness, muscle spasm and muscle weakness. The 3 cases all resulted in differing diagnoses.
  
  
  RESULTS
  Following the use of a proposed joint dysfunction isolation test, thrusting forms of manual adjusting procedures, electrical modalities and soft tissue therapy were applied. Three cases representing different common shoulder problems (an acute episode of a chronic problem, a progressive problem resulting in capsulitis, and a occult problem associated with a motor vehicle accident) responded favorably to treatment.
  
  
  CONCLUSIONS
  There is the need for a non-surgical, conservative approach to treatment of shoulder problems before considering the more aggressive treatment approaches that carry greater iatrogenic risks. The patients' signs and symptoms responded to a unique method of evaluation and manipulative therapy when other approaches had failed. The risk/benefit ratio suggests that conservative care be considered a potential option for similar conditions.
authors.affiliation: Private Practice of Chiropractic, Montana.
authors.forename: Thomas
authors.initials: T
authors.lastname: Donahue
authors.forename: Thomas
authors.initials: T
authors.lastname: Bergmann
authors.forename: Sara
authors.initials: S
authors.lastname: Donahue
authors.forename: Michael
authors.initials: M
authors.lastname: Dody
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