The Virtual Shoulder Physical Exam
The COVID-19 pandemic has increased the use of remote telehealth evaluations of sports medicine injuries and shoulder injuries [30,35]. The improvement of web-based videoconferencing platforms has allowed for more user-friendly, face-to-face interactions between patients and clinicians . Both patients and providers have been forced to welcome telehealth as an alternative because of recent required social distancing and restrictions on in-person visits. There have been several studies across various medical specialties that have shown telehealth visits have similar patient satisfaction levels compared with in-person visits. In addition, telehealth visits have shown decreased overall visit times, wait times, and health care costs [2,29,32,42,43]. While the use of telehealth had increased in some medical specialties, before the COVID-19 crisis, it had not had a significant role in most orthopedic surgery or sports medicine practices . As we return to a new normal, most musculoskeletal care providers recognize telehealth as an alternative. This becomes particularly relevant because patients and providers have an increasing demand for convenience and proficiency [25,27,30,35]. A common belief among musculoskeletal clinicians is that telemedicine has a limited ability to provide accurate and through physical examination—the keystone of clinical orthopedic evaluation [8,9,17,18,38,39]. Specifically, many providers feel that in a telehealth visit, it is too difficult to perform exam maneuvers that require manual motor testing for strength, motion assessment, and provocative testing for pain. There is a recent study describing basic physical examination components ; in addition we have recently pubilshed an overview of the telehealth examination of the shoulder and knee elsewhere . Here, we provide a basic overview.