Pаtient Prоblem: A 38 yeаr оld femаle is referred tо the outpatient clinic with left anterior shoulder pain. She reports developing focal L anterior shoulder pain after cleaning "all the windows in my house" about 3 weeks ago. She noticed reaching the top of the cabinets has become painful and has anterior shoulder burning type symptoms when carrying heavier items with her L elbow flexed. X-rays of the shoulder were taken and both the GHJ and ACJ were ‘unremarkable’ per the report. Pain: (0-10 VAS) rest 4/10, activity 6/10. Described ache in the shoulder region that is worse in the front of the shoulder. PMH: unremarkable, works out 2 x per week cross fit, 1 x per week yoga DASH: 38% Examination Findings: Posture: LUE held close to body with elbow alternating between flexion & extension due to discomfort, rounded L shoulder A/PROM: AROM PROM Left shoulder flexion 0-160 0-170 capsular mild pain at end ROM Left Shoulder Abduction 0-160 0-170 capsular mild pain at end ROM Left Shoulder External Rotation 0-50 0-55 moderate anterior shoulder pain at end of ROM Left Shoulder Internal Rotation 0-70 0-80 blocked by abdomen Left Shoulder Extension 0-20 0-25 degrees moderate anterior shoulder mild pain at end range Strength Left Right Shoulder flexion 4/5 mild anterior shoulder pain 5/5 Shoulder abduction 4/5 mild anterior shoulder pain 5/5 Shoulder extension 4/5 (mild pain anterior shoulder) 5/5 Shoulder ER 4/5 (mild anterior shoulder pain) 5/5 Shoulder IR 5/5 5/5
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