Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, progressive left shoulder pain, localized to the lateral deltoid region. Symptoms are exacerbated by overhead activities, reaching, and nocturnal positioning on the affected side. No history of acute trauma or instability. Reports associated weakness and stiffness. Pain is described as dull, aching, and occasionally sharp with specific movements.
Clinical Examination Findings
Physical examination of the left shoulder reveals tenderness to palpation over the greater tuberosity and subacromial space. Active range of motion (ROM) is limited by pain in abduction and internal rotation. Positive Neer and Hawkins-Kennedy impingement signs. Empty can test (Jobe test) demonstrates pain and mild weakness, suggesting supraspinatus involvement. No signs of atrophy, erythema, or gross deformity. Neurovascular status is intact distally.
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 control. Consider subacromial corticosteroid injection if symptoms persist despite 4-6 weeks of conservative therapy. Follow-up in 6 weeks to assess progress.