The shoulder is the most mobile joint in the body and is comprised of an intricate complex of muscles, tendons, and ligaments. Due to thismobility and heavy reliance on arms, shoulder injuries are one of the most debilitating and common disorders afflicted in the workplace. They have been categorized as a high impact injury by the workplace safety and insurance board (WSIB) of Ontario due to the long recovery and return to work (RTW) times. Difficulty diagnosing shoulder injuries due to similar clinical presentations and variability withrange of motion (ROM) testing has led to uncertainty when administering proper treatment and an over reliance on diagnostic imaging. Current standards emphasize taking a thorough patient history, using basic physical examination tests to examine ROM, stability, and strength, and using specialized tests to help determineearly prognostic indicators. Physiotherapy is the first-line treatment for most non-traumatic shoulder injuries as it addresses most repetitive overload disorders commonly found in occupational settings. Analgesics and injections have a role for pain relief but should only be used as a temporary measure. A surgical approach can be considered if there is a specific pathology without red flag indicators but an initial trial of physiotherapy should be recommended. In conjunction with treatment, a patient tailored RTW plan should be developed with information about the injury and preventative measures with an emphasis on early RTW as there is evidence that regular work life promotes positive health benefits.
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