Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a history of recurrent anterior instability of the right shoulder. Reports multiple episodes of subluxation/dislocation, typically occurring with overhead or abducted/externally rotated arm positioning. Patient describes a sensation of the shoulder "slipping out" or "giving way," associated with apprehension, pain, and subsequent reduction. No neurological deficits noted.
Clinical Examination Findings
Right shoulder inspection reveals no gross deformity or atrophy of the deltoid or rotator cuff musculature. Palpation demonstrates tenderness over the anterior glenohumeral joint line. Range of motion is full but guarded. Provocative testing: Apprehension test is positive; Relocation test is positive; Sulcus sign is negative; Load and shift test reveals increased anterior translation compared to the contralateral side. Neurovascular status is intact distally.
Treatment Protocol
Initiate physical therapy focusing on rotator cuff strengthening, scapular stabilization, and proprioceptive training. Activity modification to avoid provocative positions (abduction/external rotation). Consider anti-inflammatory medications as needed. If conservative management fails or if recurrent instability persists, surgical consultation for arthroscopic Bankart repair or capsular shift procedure is recommended.