Right Shoulder Pain Case Study

Russell Carrington is a 25 year old right handed relief pitcher for the MLB team the Baltimore Orioles. Carrington has been playing baseball since he was seven years old and this was his third season in the Major Leagues. Carrington was at the mound and in the motion of throwing a fastball, when he felt a “pop” in his overhand motion. He dropped to his knees and clinched his right shoulder in pain. Athletic trainers came onto the field an upon examination Carrington stated his arm felt like it was “dead” and felt like it was “catching”. Carrington was seen by the team physician. She performed ROM exercises, strength, and stability tests on his shoulder and examined his neck and head to ensure pain wasn’t coming from a pinched nerve. She concluded that further testing and imaging was necessary. Carrington had an X-ray and MRI done on his shoulder and he was diagnosed with a type II SLAP (Superior Labrum Anterior and Posterior) lesion. He didn’t want surgery done because he would miss the remainder of the season and possibly the next, so doctors prescribed non-steroid anti-inflammatory medication and five months physical therapy to strengthen the shoulder capsule. After completion of physical therapy, the pain didn’t improve and arthroscopy surgery was recommended.

Patient is a 57-year-old male fuel tank driver who sustained cumulative trauma on 2/7/2004 due to repetitive movement caused by delivering fuel. As per QME dated 1/25/14, the patient has numbness in the fingers and the patient is diagnoses that he has carpal tunnel syndrome. The left wrist had undergone carpal tunnel surgery; however, he gets numbness from the wrist up into his forearm and numbness in the fingertips. It was also noted that on 12/5/13, the patient complains of shoulder pain bilaterally at 7/10. It is constant and goes into noth arms, along with weakness with numbness in the hands, decreased ability to perform activities of daily living, and impared grip. The pain in the bilateral shoulders is constant and aching with intermittent

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

The patient wants to also update me as far as the arm pain he mentioned last time. He says his left arm is feeling better now. He is noticing that his right shoulder is hurting at times, especially in certain positons such as while he is sleeping and if he has his arm raised over his head while he is lying down. He had no specific injury or trauma. He is not aware of anything that makes it better or worse. He is not using any medication for it thus far. He would be interested in having

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.

S: TM just finished working on a car in the back step off platform into pit, wielding AN Car, and fell back on pipes on his left lateral side. The initial pain was 10 out of 10 and it was difficult to breath related to pain. Now, he rates his pain at 5 to 6 out of 10, aching paint to his left shoulder and his left lateral rib cage. Denies any headache, blurred vision, N/V. Ice X 20 minutes now did helped him with symptoms management.

Client reported this week she is having shoulder pain. She also submitted MRI Rx. With the following findings:

Patient is diagnosed with pain disorder with related psychological factors and complex regional pain syndrome I of the right upper limb, chronic pain syndrome. He will follow-up in 4 weeks.

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.

The patient is a 64-year-old gentleman who tells me nine or 10 days ago he started having pain in his right shoulder which started in the morning. He states that prior to this he has been doing increased amount of work at his horse farm. He has had to not only bale hay, he has needed to lift 15 car batteries up onto a platform. He also tells me he caught a heavy "I beam" and felt a jerk of his shoulder several days prior to onset of pain. He states the day after the onset of the pain, he had such back pain, he had a difficult time sleeping. He was taking Advil every six hours, but this was not helping the pain. At that point, the pain was gone up not only in his right shoulder but going up his neck and down his arm. He tells me that he then switched to Aleve, two tablets twice a day and started using ice alternating with heat. He states the ice seems to work magic for him and one week after the pain started he woke in the morning and had no pain. He states that he still gets an occasional twinge, but it is almost completely resolved. He does worry because he works on a horse farm and does not want to have any sort of intervention if not needed. He does occasionally get aches and pains in his shoulders and at this point, this is the state he is in.

On 11/21/2017, the claimant presented for a follow-up for his right shoulder. He reported right shoulder pain rated at 3/10. He stated that the range of motion had returned to normal. On examination of the right shoulder, a full range of motion was noted with resolved tenderness. The impingement sign was positive. X-ray of the right shoulder on 10/20/2017 was negative for fracture or dislocation. He was diagnosed with a traumatic arthropathy of the right shoulder. Continued physical therapy was recommended.

Diagnoses are cervical radiculopathy, right shoulder pain, nondisplaced fracture of the greater tuberosity of the right humerus and right shoulder bursitis. He has reached maximal recovery for his right shoulder. MD is concerned that the elbow and hand pain are related more to his neck as he has a history of cervical radiculopathy and his symptoms are more of tightness than pain that can be localized. He has had epidural injections in the past for left sided radiculopathy. An updated MRI is requested. If there are right-sided findings, he will be sent for possible injection for the upper extremity pain. Otherwise, he will be sent for a second opinion for his continued

Since this was my first shoulder evaluation, I did every possible shoulder and elbow special test just to rule out anything I could. I explained that Valgus and Varus stress tests of the elbow were negative, Hawkins-Kennedy and Neer were both negative, Drop Arm and Empty Can were also negative. I even tested for lateral and medial epicondylitis all showing negative results. But surely when I performed Yergason’s and Speeds Test on my athlete, they both came back positive with pain. While stating all of this to Tim I told him the athlete had tenderness over both the proximal and distal biceps tendon and the athlete is probably having muscle tightness in his arm due to a change in mechanics because his arm is sore when he throws. The point tenderness and positive special tests lead to be believe this athlete is suffering from biceps tendonitis. After going through my evaluation with Tim, I told him about the treatments we would be doing on this athlete today. First, I wanted to do ultrasound on the anterior part of the shoulder with a 3 MHz, continuous cycle, to get thermal effects so we can decrease the inflammation of the biceps

Are you suffering from persistent shoulder pain, limited shoulder movement or weakness? These could be signs of a separated shoulder or other shoulder injury. Other common symptoms include shoulder bruising or swelling, a bump and swelling at the top of your shoulder, weakness in your shoulder or arm or other general shoulder pain. Common causes of a separated shoulder include: