Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, progressive right shoulder pain, exacerbated by overhead activities and reaching behind the back. Pain is localized to the subacromial region, often interfering with sleep when lying on the affected side. No history of acute trauma or instability. Symptoms are consistent with primary subacromial impingement syndrome.
Clinical Examination Findings
Right shoulder inspection reveals no atrophy or deformity. Active range of motion is limited by pain in abduction and internal rotation. Passive range of motion is preserved but painful at terminal degrees. Positive Neer and Hawkins-Kennedy impingement signs. Rotator cuff strength is 5/5, though limited by pain. No neurovascular deficits noted in the right upper extremity.
Treatment Protocol
Initiate conservative management including activity modification, avoidance of overhead activities, 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.