Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with right shoulder pain, insidious in onset, exacerbated by overhead activities and reaching behind the back. Pain is described as a dull ache, localized to the lateral deltoid region, with occasional nocturnal exacerbation. No history of acute trauma, numbness, or paresthesia.
Clinical Examination Findings
Right shoulder inspection reveals no atrophy or asymmetry. Palpation demonstrates tenderness over the greater tuberosity and subacromial space. Active range of motion is limited by pain in abduction and internal rotation. Neer and Hawkins-Kennedy impingement tests are positive. Strength testing of supraspinatus (Jobe test) and infraspinatus is 4/5 due to pain, with no evidence of gross motor deficit.
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.