Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic right shoulder pain, localized to the subacromial region, exacerbated by overhead activities and reaching behind the back. Reports nocturnal pain when lying on the affected side. No history of acute trauma or instability. Symptoms are consistent with subacromial impingement syndrome.
Clinical Examination Findings
Right shoulder inspection reveals no atrophy or deformities. Palpation demonstrates tenderness over the greater tuberosity and subacromial space. Range of motion is limited by pain in abduction and internal rotation. Positive Neerโs and Hawkins-Kennedy impingement signs. Rotator cuff strength is 4/5 due to pain, with intact neurovascular status.
Treatment Protocol
Initiate conservative management including activity modification, avoidance of overhead lifting, and a structured physical therapy program focusing on rotator cuff strengthening and scapular stabilization. Prescribe NSAIDs for pain and inflammation. Consider subacromial corticosteroid injection if symptoms persist despite 6 weeks of conservative therapy.