Bilateral Shoulder Pain In A High School Football Player - Page #1

Author: Brian Kurose, MD
Co Author #1: Michael K. Fong, MD
Co Author #2: Marissa S. Vasquez, MD

Patient Presentation:
A 17 year old right-handed male football defensive tackle presented with a 2 year history of bilateral (Left > Right) shoulder pain. The pain is located in the posterior shoulder. It is an achy/sharp, non-radiating pain. It only occurs during games (while blocking). He does note some associated clicking and catching of left shoulder. the pain had been progressively worsening to extent of not being able to complete games.

He reports at least 6-7 episodes of each shoulder subluxing without dislocation. The symptoms began after separate non-traumatic injuries incurred during games. He deines recent right shoulder discomfort (last occurrence 6 months prior to visit). Pertinent negatives included no constitutional symptoms, rest pain, pain with activities of daily living, neck pain or family history of rheumatologic or connective tissue diseases.

Physical Exam:
General: No dysmorphic features
Neck: Full range of motion. No pain tenderness. Negative Spurlings bilaterally. Musculoskeletal noted general hyperlaxity including thumb hyperextension to degree toughing distal forearm, bilaterally. Left shoulder full range of painless motion. No point tenderness. Rotator cuff testing within normal limits. Positive labral and instability testing (posterior direction). Right shoulder exam similar findings of instability only.

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