Shoulder Pain On The Pacific Crest Trail

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Shoulder Pain On The Pacific Crest Trail - Page #4

Working Diagnosis: Right long thoracic mononeuropathy Treatment: Rx: prednisone 50 mg daily x5 days (for possible neuritis) PT referral: Maintain shoulder range of motion Strengthen intact scapular stabilizers Avoid aggressive upper limb and overhead activities Outcome: Nearly 12 weeks after onset, medial scapular winging persisted without palpable contraction of the right serratus anterior, however, pain resolved. No sensory deficits or additional weakness developed. The patient returned to day hiking without a pack and started downhill skiing. He was counseled to avoid excessive poling during skiing. He will be monitored for recovery every 3 months with a plan to repeat electrodiagnostic testing if weakness persists. References: Martin RM and Fish DE. Scapular winging: anatomical review, diagnosis, and treatments. Curr Rev MSK Med. 2008; 1: 1-11. Rose K et al. Backpack palsy: a rare complication of backpack use in children and young adults. Euro J Paed Neuro. 2016; 20: 750-753. Seror P. Neuralgic amyotrophy: an update. Joint Bone Spine. 2016; 84(2): 153-158. Sahin F et al. Compression neuropathy of the long thoracic nerve and accessory nerve secondary to heavy load bearing: a case report. Eura Medicophys. 2007; 43: 71-41. Return To The Case Studies List.		Back
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