Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with localized left shoulder pain, insidious in onset, exacerbated by overhead activities and abduction. Reports nocturnal pain when lying on the affected side. Denies history of trauma, numbness, or radiating paresthesia. Pain is described as a dull ache with sharp episodes during specific range of motion.
Clinical Examination Findings
Left shoulder examination reveals tenderness to palpation over the subacromial space. Neerβs impingement sign and Hawkins-Kennedy test are positive. Active range of motion is limited by pain in abduction and internal rotation. Passive range of motion is preserved but painful at terminal arc. Rotator cuff strength is 5/5, neurovascular status is intact distally.
Treatment Protocol
Initiate conservative management: Activity modification to avoid overhead lifting, NSAIDs for inflammation control, and a structured physical therapy program focusing on rotator cuff strengthening and scapular stabilization. Consider subacromial corticosteroid injection if symptoms persist despite initial conservative measures.