Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with recurrent episodes of left shoulder instability, describing a sensation of the humeral head "slipping" or "popping out" of the glenoid fossa. Symptoms are exacerbated by overhead activities and external rotation. Patient reports associated apprehension, pain, and occasional numbness during instability events. No history of acute trauma or neurological deficit noted.
Clinical Examination Findings
Left shoulder inspection reveals no gross deformity or atrophy of the deltoid or rotator cuff musculature. Palpation demonstrates tenderness over the anterior glenohumeral joint line. Range of motion is full but guarded. Positive Apprehension test, Relocation test, and Load and Shift test for anterior instability. Sulcus sign is negative. Neurovascular status is intact distally.
Treatment Protocol
Initiate physical therapy focusing on rotator cuff strengthening and scapular stabilization exercises. Activity modification to avoid provocative overhead positions. Prescribe NSAIDs as needed for pain management. Follow up in 6 weeks to reassess stability and functional progress. Consider MRI arthrogram if symptoms persist or if surgical intervention is contemplated.