While doing bench presses in the gym, Alex McEwen heard a loud snap, and he knew instantly that something was wrong. 

McEwen went to the emergency room but found little guidance around the nature of his injury and the possible treatments. That barrier is something the University of Calgary’s Sports Medicine Centre is hoping to break down.

Through personal research, McEwen figured his injury was likely a ruptured or torn pectoralis major tendon, an injury that requires an MRI to diagnose.  

McEwen struggled with finding availability for a specialist. 

“I had learned during my research that a ruptured pectoralis major tendon typically is irreparable if it takes more than a month or two to have surgery,” he said. 

“People may never have to navigate the healthcare system until there’s a crisis.” 

The new Shoulder Care Access Project clinic, located at the University of Calgary, aims to optimize shoulder injury diagnosis and recovery, all beginning with an online tool. The tool allows patients to self-diagnose through a questionnaire, without leaving home. 

Patients are then admitted to see a doctor within four weeks of completing the survey.

Traditionally, those with shoulder or knee injuries would see a primary physician or family doctor, go through diagnostic measures, and then potentially be sent to a specialist or surgeon. 

Accurate initial diagnosis with new SCAP tool

The new tool offered through the Shoulder Care Access Project, or SCAP, allows patients to better understand their injury and potential care options before seeing a doctor. 

The tool accurately diagnoses patients up to 75 per cent of the time, according to Dr. Nick Mohtadi, the co-Medical Director of the Sport Medicine Center, faculty of Kinesiology, and the principal investigator in the Shoulder Care Access Project with the University of Calgary. 

Mohtadi said that traditionally, before seeing a specialist, patients may head down a pathway that “might have multiple loops in it.” 

These processes can include unnecessary examination and uninspiring wait times.  

“We’re seeing people sooner, we can help them sooner,” Mohtadi said.  

So far, the clinic has found that many patients do not require surgery, upwards of 90 per cent, said Mohtadi.  

Throughout his experience in the 1990s, Mohtadi saw that patients were not able to see specialists in a reasonable amount of time. Mohtadi was then involved in developing a proposal to investigate knee and shoulder procedures. 

Over the next five years, Mohtadi’s team conducted research projects and found that a knee injury clinic could function as a direct access point for healthcare delivery and that the service could be cost-effective. 

“We’ve been running our knee injury clinic for 16 years, and the Shoulder Care Access Project clinic is a spin-off from that,” he said. 

“We can save significant costs in the system, from avoiding expensive investigations and unnecessary visits to the emergency room.” 

Traditionally, injured patients see a primary care provider and then are referred to a surgeon, Mohtadi said.  

Some patients, like McEwen, may even go to the emergency room 

“If people avoid the emergency rooms, the cost is saved. If we avoid unnecessary tests, particularly expensive ones, we save money there, and if we only need to see an individual once or twice, then we save on the number of visits,” Mohtadi said.  

The SCAP clinic has been built on managing patients’ understanding through clarity and information. 

Generally, patients want to know what’s wrong with them and the potential avenues toward recovery. Through the online questionnaire, some patients can better understand their injury without seeing a doctor, Mohtadi said.