Year: 2016
Type: conference-paper
Study design: Case Report
Abstract: HISTORY: A 27-year-old male reports to physical therapy evaluation with R shoulder pain following an injury during Jiu-jitsu 4 weeks prior. He experienced immediate onset of pain following a submission attempt where his arm was forcefully externally rotated. At time of evaluation, he experienced pain with pressing and pulling exercises in R shoulder that would sometimes radiate down to posteriolateral arm. PHYSICAL EXAMINATION: Initial examination of the R arm revealed hypomobility throughout thoracic and lower cervical spine, tight posterior shoulder capsule with anterior humeral head migration, and limited shoulder ROM secondary to pain. Neural testing resulted in + radial nerve tension, which was reduced with head-tilt, indicating proximal facilitation. His rotator cuff strength was strong and pain-free. He had extreme tenderness to palpation and reproduction of arm symptoms over axillary nerve in quadrangular space. DIFFERENTIAL DIAGNOSIS: Labral tear Rotator cuff tear/impingement Radiculopathy Neural tension Axillary nerve entrapment TESTS AND RESULTS: R shoulder AP and lateral radiographic views Bony structure and alignment intact FINAL WORKING DIAGNOSIS: R axillary nerve entrapment with C5-6 facilitation resulting in “double crush” TREATMENT AND OUTCOMES: Thoracic and cervical manipulation Posterior shoulder capsule mobilizations Cross-friction to teres minor and major Radial nerve sliders Progressive scapular strengthening Open-chain to closed-chain Mid-range to end-range Able to return to Jiu-jitsu and regular workout routine at 6 weeks. ROLE OF PRIMARY AUTHOR: Diagnosis and treatment of patient of interest.
Authors: Sean M. Harris, A. Romero Ortiz, Nikki A. Hawkins
Language: English
Topic: Peripheral Nerve Disorders
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2330865674