Abstract
A 14-year-old female high school softball pitcher was seen for student physical therapy treatment for 11 sessions over a 9-week period at an outpatient orthopedic physical therapy setting under the supervision of a licensed physical therapist. The patient was evaluated at the initial encounter with the Numeric Pain Rating Scale (NPRS), Range of Motion (ROM) measured using a goniometer, Manual Muscle Testing (MMT), and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) disabilities/symptoms and sports/performing arts subscales. A plan of care was established to address shoulder ROM and strength limitations, overhead reaching to catch a softball, full upper extremity weightbearing, overhand throwing, and return to softball. The main goals for the patient were to have no pain with any functional use of her arm, be able to reach overhead to catch a softball, bear full weight on her arm for straight leg sliding, overhand throw, and return to softball. The main interventions used were range of motion (ROM) exercises, joint mobilizations, therapeutic exercise focusing on rotator cuff strengthening, shoulder stabilization, overhead strength, weight bearing, and vasopneumatic therapy. The patient responded well to physical therapy interventions and showed significant improvement in shoulder ROM and strength. By the end of the course of treatment, the patient was able to do a right sided high plank at ground level, overhand throw a softball at 50% maximum speed without pain or compensations, reach overhead to catch a softball without pain, and had an improvement in her QuickDASH disability/symptoms score from 29.55% to 0% and QuickDASH sports module score from 100% to 25%. The patient was discharged to home with a home exercise program and a recommendation on when to fully return to softball.