Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic left shoulder pain, localized to the lateral deltoid region. Pain is exacerbated by overhead activities, reaching, and sleeping on the affected side. No history of acute trauma. Reports associated weakness and stiffness. Pain intensity is rated at [X]/10, characterized as dull, aching, and intermittent.
Clinical Examination Findings
Left shoulder examination reveals tenderness over the greater tuberosity and subacromial space. Active range of motion (ROM) is limited by pain in abduction and external rotation. Positive Neer and Hawkins-Kennedy impingement signs. Rotator cuff strength testing demonstrates weakness in abduction (supraspinatus) and external rotation (infraspinatus/teres minor) with pain. No evidence of instability or neurovascular deficit.
Treatment Protocol
Initiate conservative management including activity modification, avoidance of overhead lifting, and application of cryotherapy. Prescribe NSAIDs for inflammation control. Referral to physical therapy for rotator cuff strengthening and scapular stabilization exercises. Consider subacromial corticosteroid injection if symptoms persist despite 4-6 weeks of conservative therapy.