Author: Tyler Jackson, MD
Co Author #1: Alexander Tomesch, MD
Co Author #2: Will Denq, MD, CAQ-SM
Senior Editor: Carolyn Landsberg, MD
Editor: Michael Beasley, MD, FAMSSM
36-year-old left-handed male presented to Sports Clinic for evaluation of left shoulder pain.
He was lying in a hammock a few days prior when the tree broke, and a trunk fell directly onto his posterior left shoulder. He reported his pain was located deep within the shoulder and was non-radiating. He denied any previous injuries or surgeries to the shoulder. Pain was exacerbated by any upward movement of the shoulder and relieved with use of a shoulder sling and ibuprofen. Of note, he is a journalist by profession and writes for a living.
Inspection: No asymmetry, atrophy, open wounds, or edema.
Palpation: Tenderness at the inferior pole of the scapula and scapular spine; non-tender at the proximal biceps tendon, AC joint, and clavicle. Sulcus sign negative.
ROM:Abduction decreased with pain, adduction intact, external rotation
decreased with pain, internal rotation intact, flexion decreased with pain, and extension intact. Scapular reach testing to T4 or higher. No scapular winging.
Strength: abduction: 4/5, adduction: 5/5, internal rotation: 5/5,
external rotation: 5/5.
Special tests: Deferred due to findings on imaging.
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