Hi guys,

@tonywoodall...i can certainly appreciate your experience and insight but i wouldn't rush to be so definitive of where referred shoulder pain comes from. I have helped many a T4 syndrome patient by fixing their hips...hip dysfunction leading to all sorts of issues ending up with overactive external obliques which lock down the ribs from 5 - 8 and so the T4 moves over a basically immobile T5 causing T4 syndrome. But i would certainly encourage physios to go look further afield than the classic innervation/dermatonal maps

As for the original poster (c.falco), your patient is a golfer who doesn't get symptoms with his golf swing but during classic shoulder testing of ABD and FF and HzF? HzF is usually an AC problem for me, esp if ABD is involved. Test his ABD or HzF with different glides of his AC joint to see what is happening. If there is no structural issue with the AC joint (no laxity etc) then start looking to see why his shoulder motor control is off...support his ribs - the ones which are moving during shoulder motion (none of them should move if he is below 90deg), test his C/S segments - again none of them should move below 90deg. The movement in the joints failing load transfer could be moving during the movement initiation so make sure you are monitoring before the patient even BEGINS to think about moving!!

Cheers!