|
Subjective
|
Time
|
|
History
|
Pain now at rest with meds
/
|
|
Pain Initially
/
|
Edema
• • •
|
|
Increased Pain
• • •
|
Body Diagram
|
|
Objective
|
|
|
ROM: Shoulder flexion LEFT
|
ROM Flexion RIGHT
|
|
ROM Abduction LEFT
|
ROM Abduction RIGHT
|
|
ROM External rotation LEFT
|
External rotation RIGHT
|
|
ROM internal rotation LEFT
|
ROM internal rotation RIGHT
|
|
Strength: Shoulder flexion LEFT
|
Strength Flexion RIGHT
|
|
Strength Abduction LEFT
|
Strength Abduction RIGHT
|
|
Strength External rotation LEFT
|
Strength External rotation RIGHT
|
|
Strength Internal rotation LEFT
|
Strength Internal rotation RIGHT
|
|
Palpation
• • •
|
Special Tests
• • •
|
|
Joint Mobility
• • •
|
Labrum
• • •
|
|
Scapulohumeral rhythm
• • •
|
GIRD
|
|
Objective Notes
|
|
|
Assessment
|
|
|
Assessment
|
Rehab Potential
|
|
Goal 1
|
Goal 2
|
|
Goal 3
|
Goal 4
|
|
Goal 5
|
|
|
Plan
|
Treatment Plan
|
|
Treatment Duration
• • •
|
Treatment Frequency
• • •
|
|
Today's STM
• • •
|
Today's Joint Mobs
• • •
|
|
Manual therapy
|
Self care
|
|
Exercises
|
HEP
|
|
MD Signature
|
|
