Linear Avulsion Procedure

She said, she fell last night while playing volley ball. She landed on her right shoulder and heard a pop sound, too. She did not take any pain medicines. She applied icepack and felt burning pain. This was an interesting musculoskeletal assessment case. We assessed her right shoulder and compared with the left one. We found slight dislocation of the shoulder joint. She had good circulation in her right arm, no swelling noted in the right hand and the capillary refill was < 2 secs. Mary said, since she had burning pain, it could be a nerve injury, too. We also noted a slight swelling of her trapezius muscle on the right side. She complained of pain on palpation. Mary applied a sling to her right arm to keep it elevated. She may need an MRI to see the damage. Mary sent her to the urgent care. She told her that, since she heard the popped sound, the ER or Urgent care doctor can replace it. It will be a painful procedure, and she will need a strong pain medicine. She gave her the note for her teacher and asked her friend to drive her to the urgent

Per PT treatment log dated 11/18/15, the patient has attended 19 PT visits for the thoracic and lumbar spine from 08/27/15 through 11/13/15.

Per the work conditioning progress report dated 06/19/12, the patient has attended 19 work conditioning sessions and IW has made great progress.

Based on the progress report dated 10/07/16, the patient presents for evaluation of carpal tunnel syndrome on the right shoulder.

Based on the medical report dated 12/22/16, the patient was last seen on 10/13/16, and was recommended to have continued therapy. He has not had therapy secondary to insurance issues over the last month or so. He presents with ongoing right elbow pain status post cubital tunnel release and medial epicondylitis debridement, worsening with motion and activity, lifting, reaching, bending, upper extremity dressing, household

The patient notes that the injury happen when he was lifting some metal trash trays into a trash bin when he felt a sharp pain in his shoulders. Treatment history notes that the treatment to date has consisted of medications. Of note, the MRI done showed a large full thickness tear with retraction of the tendon. Physical examination of the left shoulder revealed that the range of motion has forward flexion of 0-175 degrees, external rotation of 0-40 degrees, and internal rotation to T12. There is positive Hawkins’ and Neer’s sign for impingement. There is weakness with abduction testing. Treatment plan notes recommendation, surgical intervention in the form of a left shoulder, subacromial decompression, rotator cuff repair surgery as necessary. A follow up of 2 to 3 weeks if surgery is authorized. As per medical summary and work status dated 6/14/16, it was noted that the patient has not improved significantly and would be needing surgery. The patient’s return to work date is 6/14/16 with no lifting over 10 pounds and no overhead reach. Follow up to clinic date is on

DOI: 3/19/2015. Patient is a 63-year-old right hand dominant male janitor who sustained injury while he was mopping when he began having right shoulder pain. Per OMNI, he was initially diagnosed with right shoulder impingement syndrome, neck strain and right shoulder strain.

The patient will continue physical therapy 1 day per week for 8 weeks where he will receive moist heat, cold packs, electrical stimulation, massage therapy, ultrasound to the right shoulder by followed by gentle range of motion and strengthening exercises with the goals of reducing pain, improving strength, improving range of motion, improving overall function, and teaching home exercise program.

Current request is for 12 Physical Therapy Visits for the Left Shoulder between 1/17/2017 and

MRI of the right shoulder report dated 03/04/14 revealed tear of the supraspinatus/infraspinatus tendon and subscapularis tendon. There is tendinosis of the teres minor. Abnormal signal is noted within the biceps tendon concerning for tear. Degenerative changes involving humeral head are seen. Bone marrow edema is noted involving the superior lateral aspect of the humeral head and the glenoid bone. Degenerative changes at the glenohumeral joint and the acromioclavicular joint are noted. There is edema and sclerosis of the posterior glenoid. Abnormal cortex of the posterior glenoid is demonstrated

Based on progress report dated 03/09/15, the patient reported of persistent left shoulder pain. She has attended at least 12 PT sessions with non resolution of her symptoms. Due to left shoulder pain with positive impingement test despite 7 weeks of conservative care with NSAIDS, muscle relaxant and PT, left shoulder MRI for further evaluation is recommended. PT for 3 times a week for 4 weeks is also requested. She was advised to continue Anaprox and Flexeril.

DOI: 2/19/2014. Patient is a 53-year old right-hand dominant female production worker who sustained injuries to her neck, low back, right shoulder, and bilateral knees as a result of cumulative trauma. Per OMNI entry, she was initially diagnosed with cervical radiculopathy, lumbosacral radiculopathy, bilateral shoulders tendinosis/bursitis and knee tendinosis/bursitis.

Per PT daily note dated 01/20/16, the IW has tended 5/6 sessions for his right shoulder.

Current request is for 6 Physical Therapy Visits for the Left Shoulder between 2/9/2016 and

Based on the progress report dated 06/02/16, the patient presents for evaluation of her left wrist. She is still having a lot of symptoms. She did have a repeat nerve study which showed normal.