Why the other options are wrong:

• Managing the pain primarily through medication.: The physiotherapist says short-term pain medication is fine but should not replace rehab.
• Getting imaging done as soon as possible.: The physiotherapist says imaging like MRI is usually not needed before starting treatment.
• Stopping all physical activity until the pain is gone.: The physiotherapist recommends modifying hockey, not stopping all activity completely.

Correct Answer: Physiotherapy is tried first unless treatment fails or a tear is suspected.

Why this is correct: MRI is usually reserved for non-improvement after conservative care or a suspected tear. The physiotherapist says current symptoms do not suggest a tear; symptoms worsening is not substituted as the exception.

Why the other options are wrong:

• MRIs are only useful for desk-related injuries.: The source does not limit MRI usefulness to desk-related injuries.
• The injury is already clearly diagnosed by imaging.: No completed imaging is described.
• MRIs are not available in Guelph clinics.: No claim is made that MRI is unavailable in Guelph.

Correct Answer: Strengthening exercises, mobility work, and manual therapy.

Why this is correct: The physiotherapist describes the programme as including targeted strengthening, mobility work, and some manual therapy. These three components form the initial treatment plan. The physiotherapist would also adjust the patient's workstation to reduce shoulder strain.

Why the other options are wrong:

• Primarily cortisone injections and rest.: Cortisone injections are discussed separately and are not part of the core programme.
• Daily massage therapy and acupuncture.: Daily massage therapy and acupuncture are not mentioned at all.
• Only home exercises with no clinic visits.: Home exercises are included, but clinic visits are also part of the plan.

Correct Answer: His frequent work travel.

Why this is correct: The patient mentions that he travels for work about once a month. He asks if this will slow down his recovery. The physiotherapist addresses this by saying a home exercise plan can work around his travel schedule.

Why the other options are wrong:

• His inability to stop playing hockey.: The patient asks about hockey but does not say he cannot stop playing.
• His lack of insurance coverage.: Insurance information comes from the provider; the patient raises work travel as a concern, not lack of coverage.
• His previous shoulder surgery.: The patient asks about travelling for work. Previous shoulder surgery is not discussed.

Correct Answer: They can help in certain cases but should be used cautiously.

Why this is correct: The physiotherapist says cortisone injections are better for severe inflammation, but warns that overuse can weaken the tendon. This shows they have a role in certain situations but should not be used too freely. The approach is cautious and limited.

Why the other options are wrong:

• They are required before physiotherapy can begin.: The physiotherapist does not say injections are required before rehab can start.
• They are fully covered by OHIP.: OHIP coverage for cortisone injections is not discussed.
• They are the best long-term solution for tendon injuries.: The physiotherapist warns about overuse, so they are not called the best long-term solution.

Correct Answer: The patient's progress will be reassessed.

Why this is correct: The physiotherapist promises reassessment after four weeks. A change to the plan is not promised.

Why the other options are wrong:

• He will be referred immediately for surgery.: Surgery is described as a last resort after months without restored function, not an immediate four-week referral.
• He will begin weekly MRI scans.: Weekly MRI scans are not part of the stated plan.
• He will be discharged regardless of progress.: Discharge regardless of progress is not stated; the planned action is reassessment.