Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic left shoulder pain, exacerbated by overhead activities and reaching behind the back. Reports nocturnal pain when lying on the affected side. No history of acute trauma. Pain is localized to the subacromial region with associated weakness in abduction.
Clinical Examination Findings
Left shoulder inspection reveals no atrophy or deformity. Palpation demonstrates tenderness over the subacromial space. Range of motion is limited by pain in abduction and internal rotation. Positive Neerโs sign and Hawkins-Kennedy test. Rotator cuff strength is 4/5 in abduction; neurovascular status is intact distally.
Treatment Protocol
Initiate conservative management: activity modification, avoidance of overhead lifting, and non-steroidal anti-inflammatory drugs (NSAIDs). Prescribe a structured physical therapy program focusing on rotator cuff strengthening and scapular stabilization. Consider subacromial corticosteroid injection if symptoms persist.