Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic left shoulder pain, localized to the lateral deltoid, exacerbated by overhead activity and night pain. Reports weakness in abduction and external rotation. No history of acute trauma. Symptoms are refractory to conservative management including NSAIDs and rest.
Clinical Examination Findings
Left shoulder examination reveals tenderness over the greater tuberosity. Active range of motion is limited by pain in abduction. Positive Neer and Hawkins-Kennedy impingement signs. Strength testing demonstrates 4/5 weakness in supraspinatus (empty can test) and infraspinatus (resisted external rotation). Neurovascular status is intact distally.
Treatment Protocol
Initiate physical therapy focusing on rotator cuff strengthening and scapular stabilization. Prescribe NSAIDs for inflammation control. Consider subacromial corticosteroid injection if symptoms persist. Patient advised to avoid overhead activities. Follow-up in 6 weeks to reassess functional status.