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  1. #1
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    Brief Medical History Overview

    Age: 28 years, Male, Presenting Problem Since: From 1 april 2019, Symptom Behaviour: constant, Symptoms Worse (24hr Behaviour): Symptoms are worse when I wake up in the morning, Easing Factors:: warming the tendoms and muscles with mobility, Investigations: ecografía, No Diabetes, No history of High Blood Pressure, No Medications, No Osteoporosis, No Hx of Cancer, No Unexplained Weight Loss, No Bowel/Bladder issues

    Major problem / Symptomatic Areas

    Shoulder - Posterior - Left

    Shoulder - Anterior - Left

    Post Limited ROM with pain: External rotation with abducted shoulder

    Physical Agents In Rehabilitation


    SORRY FOR MY BAD ENGLISH. I'M A SPANIARD.

    On April 1, 2019 (date of the pathology).

    I was training one arm pull-ups, and during the end of the concentric phase of the movement I noticed a "crack" in the shoulder area (I was doing negative repetitions helped with an elastic band);

    I noticed a diffuse pain in the back area of ​​the shoulder and stopped training (since then I have not worked out again).

    I stopped training and continued with my normal life; a week, the pain went down a little (at rest I did not notice it anymore), but it hurts in the external rotation, specially with abducted shoulder.

    I decided to give him a full breath, and taking advantage of a vacation I decided to took 15 days lying on the bed, and apparently the pain decreased.
    - Nowadays, fully external rotation in abduction is impossible (especially resting on a wall or lying on a hard surface, such as the floor or even a mattress).

    - Abduction of the arm is possible and there is no loss of range of movement, although it hurts at the end of it.

    - If I hang from a pull-up bar the shoulder hurts very much (intense diffuse pain).

    - In the external rotation I have not lost strength in the first degrees of rotation, but when it reaches where it stops my strength dissipates. Likewise, in the area of ​​maximum external rotation I do not have any force to push down, if it falls it is mainly due to the effect of gravity.

    - In the physiotherapy clinic they told me that it was infraspinatus tendinitis. I had an ultrasound scan of the supraspinatus and it was a little damaged, there was no bursitis, and apparently I was told that at the tendinous level there was no tear ...

    WHAT KIND OF PATHOLOGY COULD BE?

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  2. #2
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    Re: Limited ROM with pain: External rotation with abducted shoulder

    Looks to me like your humeral head moves up and anterior during the external rotation in an abnormal way. This suggests a structure that is involved in maintaining the position of the head is damaged in some way. This could even be an internal rotator that was working with the lats in an inner range of a single arm pull-up. Having said that there are a lot of possible structures. Really you need an MRI of the shoulder and upper humerus to look at all tendons, including the biceps. The video from the back showing what your scapulae are doing is also showing very abnormal movement of both the left side and also the humeral head in relation to it.

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  3. The Following User Says Thank You to physiobob For This Useful Post:

    Limited ROM with pain: External rotation with abducted shoulder

    john_titor (19-06-2019)

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    Re: Limited ROM with pain: External rotation with abducted shoulder

    Quote Originally Posted by physiobob View Post
    Looks to me like your humeral head moves up and anterior during the external rotation in an abnormal way. This suggests a structure that is involved in maintaining the position of the head is damaged in some way. This could even be an internal rotator that was working with the lats in an inner range of a single arm pull-up. Having said that there are a lot of possible structures. Really you need an MRI of the shoulder and upper humerus to look at all tendons, including the biceps. The video from the back showing what your scapulae are doing is also showing very abnormal movement of both the left side and also the humeral head in relation to it.
    I'm afraid of adhesive capsulitis and arthritis... are both possible?

    Other question: could it be SLAP tear or some kind of luxation?

    Sorry for my bad english. I wish you were in Spain, cuz I would have go to your clinic...
    I'm afraid of adhesive capsulitis. Do you think I have a cure?


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    Re: Limited ROM with pain: External rotation with abducted shoulder

    I don’t think either are suspects unless of course your shoulder moved like this before the recent issue. Hearing a crack indicates an acute injury, even if on top of a longer standing deterioration of a tendon like the supraspinatus. You should not be training at all on the shoulder until it’s accurately diagnosed as right now the movement is dysfunctional and will lead to other issues (like a ‘frozen shoulder’ type scenario).

    An MRI would be the best option. A dynamic MRI even better.


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    Re: Limited ROM with pain: External rotation with abducted shoulder

    Aircast Airselect Short Boot
    Do you have any pain with resisted internal rotation or adduction? Test it at different angles of abduction. It could be a torn teres major or lat.



 

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