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Double Block On The Spike In A Division I Volleyball Player - Page #1
 

Author: Anastasia Weinberg, MD
Co Author #1: Shannon Philipps, DO
Co Author #2: Iridi Pavliqoti, MD
Senior Editor: Kristine Karlson, MD, FAMSSM
Editor: Rahul Kapur, MD, FAMSSM

Patient Presentation:
A 21-year-old Division I beach volleyball player presented with six months of shoulder pain worsened with overhead activity resulting in inability to continue sport participation.

History:
A 21-year-old right-hand-dominant Division I beach volleyball player presented with six months of insidious-onset right posterior shoulder pain. Associated symptoms included clicking, weakness, and intermittent tingling radiating from the shoulder into the hand. She denied any inciting trauma but reported a recent history of pneumonia one to two months prior. Pain worsened with overhead activity and improved with rest but never fully resolved, reaching 8/10 at its worst. She completed a trial of physical therapy with limited benefit and had not pursued injections. Due to persistent weakness, she was unable to continue volleyball participation since the end of the prior season, and her symptoms began interfering with daily activities. She denied prior surgery involving the affected extremity. She reported two siblings who also play volleyball and have experienced similar symptoms.

Physical Exam:
Inspection: Normal alignment, notable infraspinatus muscle atrophy. Tenderness to palpation along infraspinatus and posterior greater tuberosity. ROM: Active forward elevation: 170. Passive forward elevation: 170. External rotation: 70. External rotation in abduction: 90. Internal rotation in abduction: 80. Special tests: Hawkins Impingement negative. Speed's Test negative. O'Brien's Active Compression Test negative. Jobe's Test: Positive. Horn Blowers Test: Negative. No anterior shoulder pain with maximal abduction and ER. Strength: Scapular Plane: 5/5, External Rotation: 4/5, Internal Rotation: 5/5, Deltoid: 5/5, Biceps: 5/5. Stability: Negative Apprehension test.

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