Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, deep-seated left shoulder pain, exacerbated by overhead activities and throwing motions. Reports mechanical symptoms including clicking, popping, and occasional catching sensations. No history of acute dislocation, though patient recalls repetitive overhead strain. Pain localized to the superior aspect of the glenohumeral joint.
Clinical Examination Findings
Left shoulder inspection reveals no atrophy of the supraspinatus or infraspinatus fossae. Tenderness to palpation at the bicipital groove. Range of motion is full but painful at end-range abduction and external rotation. Positive OโBrienโs test, positive Crank test, and positive Biceps Load II test. Neurovascular status intact distally.
Treatment Protocol
Initiate conservative management: activity modification, avoidance of overhead sports/lifting, and physical therapy focusing on rotator cuff strengthening and scapular stabilization. Prescribe NSAIDs for inflammation. If symptoms persist >3 months, consider MRA of the left shoulder and orthopedic surgical consultation for potential arthroscopic repair.