Atypical Cause Of Shoulder Pain In A Collegiate Softball Player - Page #1
 

Author: Michael Slesinski, DO
Co Author #1: Mathew Saffarian, DO
Editor: Christian Verry, MD

Patient Presentation:
20 year old female softball player presented with left shoulder pain. No injury prior to onset of pain. The left shoulder pain started last year with painful "catching" in the subscapular region, which improved over the summer. The following winter, the pain returned. The pain was worse with throwing activities and repetitive use of the involved arm. She was having night pain. She was taking Motrin with minimal relief. She was pursuing rehab with her athletic trainer, including scapular stabilization exercises. She denied radicular pain into her arms, dysesthesias, weakness, or bowel or bladder changes.

History:
Past medical history includes left thumb fracture in 2013. Past surgical history includes right lower extremity fracture with ORIF.

Physical Exam:
Appeared well-developed, well-nourished, and in no acute distress.
Focused left shoulder exam revealed:
Full AROM and PROM.
Snapping of the left shoulder with abduction, which reproduced the pain in the scapulothoracic region.
5/5 strength in left shoulder abduction, flexion, internal and external rotation. 5/5 strength in left elbow flexion, elbow extension, wrist extension, and first dorsal interosseus muscle.
Negative left SLAP test.
Negative left Hawkin's test.
Negative left lift-off test.
Negative left belly press test.
Negative left empty can test.
Negative left Neer's test.
Negative left crossover test.
Negative left O'Brien's test.
Negative left Yergason's test.
Negative left Speed's test.
No tenderness to palpation over the left biceps tendon, acromioclavicular joint, or clavicle.
No edema in the left shoulder. Skin intact without abnormalities.

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