Date of Award

2019

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Renee Mabey

Keywords

Shoulder Injuries -- rehabilitation; Shoulder Injuries -- therapy; Case Reports

Abstract

Background and Purpose: Shoulder dysfunction is a broad expression that encompasses the shoulder girdle not being able to perform fluently, without pain, or within normal ranges of motion. Current literature elaborates on potential causes of dysfunction such as: osteoarthritis, impingement syndrome, and cervical myelopathy. From a clinical standpoint, it is crucial to differentiate between possible diagnoses to ensure the proper treatment is utilized.

Case Description: The patient was a 66‐year‐old female who was referred with the initial diagnosis of shoulder osteoarthritis. She presented with headache pain that was debilitating and followed a pattern consistent with muscle guarding, limited L shoulder ROM, guarded forward shoulder posture, and scapular upward rotation force couples that were not functioning properly. A score of 45/70 on the Pain Disability Index (PDI) was recorded at evaluation.

Discussion and Conclusion: It was evident that osteoarthritis was not the underlying source of her dysfunction. The patient was treated twice a week for 4 weeks with exercises that promoted corrected scapular upward rotation force couples, exercise to reduce forward rounded shoulder posture, and manual therapy to relive muscle guarding. The patient reduced PDI score to 3/70, restored shoulder ROM to equal bilaterally, and improved posture and scapular alignment.

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