Posterior Shoulder Pain Baseball Player: A Uncommon Diagnosis - Page #1

Author: Olabode Agaja, DO
Co Author #1: Caroline Pupke, OMS-IV
Co Author #2: Brad McCrady, D.O., FAOASM
Senior Editor: Mandeep Ghuman, MD, FAMSSM
Editor: Cleo Stafford, II, MD, MS

Patient Presentation:
17-year-old male baseball player with right shoulder pain for 16 months.

A 17-year-old male baseball player presented with shoulder pain for 16 months. He described the pain as being sharp, stabbing, and localized to the posterolateral aspect of the right shoulder. The patient felt a pull while pitching but no other inciting events at the onset. The symptoms were aggravated during the deceleration phase of his throwing motion and relieved with stretching exercises. He has attempted physical therapy and an interval throwing program, however, his symptoms returned when he increased his velocity during his return to play rehabilitation.

Physical Exam:
Musculoskeletal: Right shoulder showed no ecchymosis, edema. No Scapular dyskinesis or winging. No atrophy of upper trapezius, pectoralis, deltoids, supraspinatus, infraspinatus or biceps. Tenderness in the right posterior axilla without defects. Limited active abduction of the right shoulder to 160 degrees without a painful arc. All other range of motion testing of the bilateral shoulders within normal limits. Apley Scratch test revealed functional external rotation to T4 bilaterally and functional internal rotation to T7 bilaterally.

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