Establish a baseline
We discuss your history and goals, measure movement and strength, and identify a task that reproduces your difficulty, such as reaching to a shelf.
Shoulder Pain & The MDT Method
Understand your shoulder symptoms. Find a treatment direction.
Pain with reaching, lifting, dressing, or lying on your shoulder can make everyday tasks difficult. At Nick Rinard Physical Therapy in Portland, shoulder care starts with Mechanical Diagnosis and Therapy (MDT), also known as the McKenzie Method.
We examine how your symptoms and movement respond to testing. Those findings guide the treatment choice, the home program, and how we measure progress.
How an MDT shoulder assessment works
Test symptom behavior
We assess whether the neck or upper back contributes, then examine the shoulder. Repeated movements, sustained positions, or resisted testing may be used when appropriate.
Retest and classify
We compare symptoms, movement, and your difficult task after testing. The pattern helps us classify the presentation and decide what to do next.
Why we assess the neck with shoulder pain
The neck or upper back can contribute to pain felt around the shoulder. A local shoulder problem and a spinal contribution can also occur together.
We check whether spinal movements change your shoulder symptoms or movement. This helps determine which region needs treatment and whether more than one area should be addressed. Learn about our neck pain assessment and care.
Your findings determine the treatment
MDT is an assessment and classification system for spinal and extremity problems. Shoulder treatment is selected according to the presentation and adjusted as we reassess your response.
A useful movement direction
If testing identifies a direction that improves symptoms and movement, we may use that movement as a self-treatment strategy and teach you how to monitor its effect.
Stiffness or tendon-loading symptoms
When findings fit joint-related stiffness or a tendon-loading problem, treatment may involve gradually restoring motion or applying progressive resistance, matched to the classification and your tolerance.
A different management need
Some presentations require a different approach or further medical evaluation. We consider your history, symptom irritability, examination findings, and response over time.
Self-treatment with a clear purpose
Your home program follows the assessment. We explain which movement or activity to use, how often to do it, and what response to look for. We then reassess the plan as your symptoms and function change.
Hands-on procedures may help when appropriate. The goal is to give you useful tools for managing symptoms and returning to the tasks and activities that matter to you.
Common questions about shoulder care
Does MDT apply to shoulders?
Yes. The McKenzie Method includes assessment and management of extremity problems, including the shoulder. It uses the examination findings to guide care.
What if my MRI shows a tear?
Bring your report and any medical instructions. Imaging is considered alongside your history, examination, and function. We can coordinate with your medical provider when further assessment is needed.
Will I receive strengthening exercises?
That depends on your classification and goals. Progressive loading can be appropriate for a tendon-related presentation or later recovery. Your examination determines when and how it is used.
When shoulder pain needs medical attention
Seek urgent medical assessment for severe pain after an injury, inability to move your arm, deformity, major swelling, loss of sensation, or shoulder pain with fever or feeling unwell.
Tell your clinician about persistent tingling or changing weakness. An evaluation should help determine whether physical therapy is appropriate or medical care is needed first.
Related resources from NRPT
The MDT / McKenzie Method →An NRPT shoulder case: why reassessment matters →How Treatment Works →All Conditions We Treat →
Learn more: The McKenzie Institute: the MDT approach. Case discussions describe individual experiences; your care is based on your own findings.
Southwest Portland
Schedule a shoulder physical therapy evaluation
Visit Nick Rinard Physical Therapy at 9700 SW Capitol Hwy, Suite 140, Portland, OR 97219.
Questions about starting care? See our referral information and insurance and payment information.