Mobility Docs LLC Physical Therapy and Performance

19/01/2026

🤯 Mindset Monday

🚨 Shoulder Impingement Often times doesn’t need surgery

🚨 Subacromial Arthroscopic Decompression Surgery doesn’t get better outcomes consistently across systematic reviews and meta analysis

✅ High-quality systematic reviews and meta-analyses consistently show no clinically meaningful advantage of SAD surgery over structured physical therapy for pain or function.

✅ Sham-controlled trials demonstrate that outcomes after SAD are similar to placebo surgery.

✅ PT (with or without injections) performs as well as surgery for most patients.

✅ Surgery carries higher cost and risk, without superior long-term benefit.

AMA References

1. Lähdeoja T, Karjalainen T, Jokihaara J, et al.
Subacromial decompression surgery for adults with shoulder pain: a systematic review with meta-analysis.
BMJ Sports Med. 2020;54(11):665–673. doi:10.1136/bjsports-2019-100882

2. Karjalainen TV, Jain NB, Heikkinen J, Johnston RV, Page CM. Surgery for rotator cuff disease.
Cochrane Database Syst Rev. 2019;1(1):CD005619. doi:10.1002/14651858.CD005619.pub3

3. Saltychev M, Äärimaa V, Virolainen P, Laimi K.
Conservative treatment or surgery for shoulder impingement: systematic review and meta-analysis.
Disabil Rehabil. 2015;37(1):1–8. doi:10.3109/09638288.2014.907364

4. Ketola S, Lehtinen J, Arnala I.
Does arthroscopic acromioplasty provide any additional value in the treatment of shoulder impingement syndrome? A two-year randomized controlled trial.
J Bone Joint Surg Am. 2009;91(6):1326–1334. doi:10.2106/JBJS.H.00540

5. Paavola M, Malmivaara A, Taimela S, et al.
decompression versus diagnostic arthroscopy for shoulder impingement: randomized, placebo-surgery controlled clinical trial. BMJ. 2018;362:k2860. doi:10.1136/bmj.k2860

6. D**g W, Goost H, Lin X-B, et al.
Treatments for shoulder impingement syndrome: a systematic review and network meta-analysis.
PLoS One. 2015;10(10):e0139324. doi:10.1371/journal.pone.0139324

7. Våberg R, Evensen A, Larsen J, et al.
Effectiveness of surgical vs conservative interventions for subacromial pain syndrome: an overview of systematic reviews. J Rehabil Med. 2022;54:jrm00273. doi:10.2340/jrm.v54.2414

16/05/2025

Key Points for Risk Factors for Shoulder Injury for Athletes and Lifters

1) Range of motion (ROM), strength, previous injury, and training load were found to be the primary risk factors for shoulder injury in athletes

2) Many of these factors (especially ROM and strength) are modifiable and can be targeted through screening and injury prevention programs

3) Interventions should be sport and or task position-specific due to differing demands on the shoulder across athletic populations

👉 This is a simplistic overview as to why imaging alone SHOULD NOT dictate or justify surgical intervention

👉 This is also why often times you can’t just go to the and do plate external rotation exercises alone and expect that the shoulder pain will resolve

👉 This is also why the “paper exercises your physician gave you” will only get you so far, especially if we are talking higher level tasks such as lifting

👉 The shoulder is a complex and dynamic joint with many contributing factors that often times needs to be stressed in task specific ways so that it translates into whatever your goal or desire is

👉 This is also why Rehab and Physical Therapy can work very well with helping people over pain, injury, and dysfunction because 3/5 risk factors above can be modified or addressed through conservative means without needing medications, injections, and or surgery

07/05/2025

What We Did for Quick Results 💰

✅ Assessed for his specific deficits

✅ Developed Individualized Program For His Goals

✅ Integrated Lifitng and Gym Activities WITH Rehab

✅ Progressively Increased Load Tolerance with Consistent Action on His End

💰 Led to Bench Pressing 225 pain free (previously 135 lb was painful)

💰 Led to pain free Golfing

💰 Led to pain free DB and Machine Shoulder Work

What we Didn’t Do 🛑

❌ Rest or RICE for weeks on end

❌ Stop Lifting all together

❌ Catastrophize and assume worst

❌ Wait 3 months to get into Orthopedic Surgeon

❌ Wait for “Imaging” before starting Rehab

❌ No unnecessary medications or injections (I.e. band-aids)

💰💰 All we do is get Results ✅

29/04/2025

👉 At the end of the day, sometimes we just need help or someone to show us the way

👉 It’s okay to not know the answer or how to resolve the problem, that’s why we have experts in the field to help guide you or direct you

👉 It’s okay to be scared or unsure of what to do

🛑 The problem truly lies with not investing time, energy, and or money into your health because one day, at one point in time, you will have to pay

🤔 The choice is yours

15/04/2025

Rehab is Change and Change is necessary to get from point A to point B

Sometimes it’s changing range of motion, strength, stability, volume, load, movement modifications, etc

But a lot of times it’s breaking down misconceptions, misinformation, and changing perspective and mindset

We break these into digestible steps that allow you to get from Point A to Point B

The most important part is that you show up and take action

So are ready to take action?

26/03/2025

✅ Key Takeaways

👉 Start with load management and rehab – most cases improve without surgery

👉 Injections are temporary solutions – PRP may be better than steroids for long-term relief

👉 Surgery is a last resort and should only be considered if conservative management fails

Painful movements often include:
🔹 Pressing – Bench press, dips, overhead press
🔹 Olympic lifts – Sn**ch, clean & jerk
🔹 Cross-body movements – Pec flys, heavy carries
🔹 Direct pressure – Back & front squats

Painful movements with modification include:
😩Bench Press & Dips → ✅ Neutral Grip Dumbbell Press
😩 Overhead Press → ✅ Landmine Press
😩 Pec Flys → ✅ Cable or Band Flys (Avoid Cross-Body)
😩 Sn**ch & Clean → ✅ Slow Tempo DB Variations
😩 Back & Front Squats (Bar Pressure) → ✅ Safety Bar Squat or Goblet Squat

17/03/2025

👉 Get in faster

👉 Get results quicker

👉 Get pain resolved for good

👉 Start today, don’t wait

07/03/2025

Always remember imaging is only one piece to the puzzle 🧩

Just because you have tear doesn’t mean you need surgery and many research studies, coupled with anecdotal experience, and social proof all show that 💪

There are many variables to consider that are involved with your pain experience; although imaging can be related, it SHOULD NOT be the main reason for surgery ❌

First line of defense is a solid rehab program tailored towards goals/desires to get your strength and mobility back and getting your pain to go away ✅

24/02/2025

Let’s be real, in today’s world there’s a lot of information out there and it’s hard to know what applies to your specific situation or circumstance.

That’s totally understandable, which is why you have experts in the field to help guide you. Experts in the field help guide and inform you what information applies to your specific situation or circumstance and what doesn’t.

But continuing to wait to for the “right time”, “after _____ (insert excuse) i’ll do it”, or “until I do ______ (insert excuse)”, your also just prolonging your own pain and spending more time away from what you love to do.

DM me “Pain” and start with a free phone call that should take 10 mins or less to begin your journey back to what you love to do!

21/02/2025

1: Imaging is not necessarily needed to treat shoulder pain, primarily should be used if it’s traumatic onset

2: Imaging findings don’t always correlate with pain you are experiencing, there’s a lot of factors that play a role

3: Just because you have a tear or abnormality on imaging doesn’t mean you need surgery to “fix it”. Our bodies can adapt often times with conservative means

4: Don’t need imaging to diagnosis what’s going on. A good clinician with expertise in musculoskeletal system can often times clinically diagnosis without imaging

5: Don’t wait for imaging to seek treatment, start today, you are only prolonging the process of being in pain and or having limitations form the stuff you want to be able to do

02/02/2025

👉 This is provide a quick overview of the treatment road map from least invasive to most invasive and

👉 This is the order in which you should treat this condition

👉 Often times, conservative care including proper rehab program with short term activity modification combined with slow reintegration of previously painful or limited activities or lifts gets people back to what they love to do

👉 Diagnostic imaging is NOT needed to effectively treat this unless conservative management has failed and possible surgery is being considered

👉 Corticosteroid Injections should only be used if it’s too painful to participate in rehab program! Then, as soon as you get the injection, you should begin rehab program (they are only effective if used in conjunction with rehab)

👉 Not all rehabilitation care is equal, so if one rehab program failed, and you don’t want surgery or more invasive options, seek out help from someone else

👉 Don’t assume that just because you are diagnosed with this means you have to have surgery, rehabilitation compared to surgery have equal outcomes long term when it comes to pain and function

23/06/2024

http://mobilitydocsllc.com/2024/06/23/understanding-subacromial-impingement-syndrome-and-its-impact-on-weightlifters/

By: Dr Christopher Schroeder PT, DPT, BRM Subacromial impingement syndrome (SIS) is a prevalent condition contributing to shoulder pain, commonly seen among individuals engaged in repetitive overhe…