Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, deep-seated shoulder pain, exacerbated by overhead activities and throwing motions. Reports mechanical symptoms including clicking, popping, and occasional catching sensations. Pain is localized to the superior aspect of the glenohumeral joint. No history of acute dislocation, but notes repetitive microtrauma or a specific inciting event involving an eccentric load on the biceps tendon.
Clinical Examination Findings
Physical examination reveals tenderness to palpation over the bicipital groove and superior glenohumeral joint line. Positive OโBrienโs active compression test, positive Crank test, and positive Speedโs test. Range of motion is preserved but painful at terminal overhead abduction and external rotation. Neurovascular status is intact distally. No evidence of gross instability or rotator cuff atrophy.
Treatment Protocol
Initial management includes activity modification, avoidance of overhead activities, and a structured physical therapy program focusing on scapular stabilization and rotator cuff strengthening. NSAIDs prescribed for pain and inflammation management. If symptoms persist beyond 3-6 months, consider MRI arthrogram to confirm lesion grade and evaluate for surgical intervention (arthroscopic debridement or labral repair).