"His progress to date has been pretty good.
The main agg. factor for his clunking shoulder was
- doing high reps of lat pull downs in the gym ie 10 in a row.
- Shoulder clunked when he started to fatigue, so was clunk free at rep 6-7.

Currently his mgmt to date has included
- Scapular setting exercises (He had a Winging Scap)
- Internal rototor strengthening exercises
- Reduction of reps of pull downs"

Hi, sorry to come in late on this thread. My suggestion is external rotators. Generally, these tend to be weaker than internal rotators so if he needs to be strengthening anything it should be this. I read an article in a gym magazine (sorry don't know the ref) about training for doing chin ups. The trainer said that building up external rotator strength is critical to the successful performance (and good form) of this skill. Trying looking up articles about this on the net.

Also has he tried setting his scapula prior to pulling down on the lat pull downs? It's easy to get lazy and not move properly, especially when fatigued. Teaching general body awareness may help. Also look at hand position on the lat pull down bar and in pull ups- a wide grip generally stresses the shoulder more