Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with right shoulder pain localized to the subacromial region, exacerbated by overhead activities and reaching behind the back. Onset is insidious, characterized by a dull ache with intermittent sharp pain during abduction. No history of acute trauma or instability. Symptoms are worse at night, particularly when lying on the affected side.
Clinical Examination Findings
Right shoulder inspection reveals no atrophy or deformity. Palpation demonstrates focal tenderness over the subacromial space. Range of motion is limited by pain during active abduction and external rotation. Neer and Hawkins-Kennedy impingement tests are positive. Rotator cuff strength is 5/5, though limited by pain. Neurovascular status is intact distally.
Treatment Protocol
Initiate conservative management including activity modification, avoidance of overhead lifting, and a structured physical therapy program focusing on rotator cuff strengthening and scapular stabilization. Prescribe NSAIDs for inflammation control. Consider subacromial corticosteroid injection if symptoms persist despite 4-6 weeks of conservative therapy.