Abstract
A 40-year-old female patient with a medical diagnosis of left subacromial impingement syndrome was seen for physical therapy treatment for 6 sessions in an 8-week period at an outpatient orthopedic clinic. Sessions were provided by a physical therapy student under the supervision of a licensed physical therapist.
The patient was evaluated at the initial encounter with the use of observation, goniometry, manual muscle test, joint passive accessory movement, palpation, visual analog scale, and shoulder pain and disability index with a cluster of special tests to confirm the presence of SAIS and biceps tendinopathy. A plan of care was established to address impaired shoulder range of motion, postural dysfunction, pain with overhead movements and activities of daily living, and restricted ability to play softball and work at a desk. The main goals for the patient were to return to playing softball and reduce shoulder pain. The main interventions used were manual therapy utilizing instrument-assisted soft-tissue mobilization, ischemic compression, and joint mobilizations to the glenohumeral joint and thoracic spine with the addition of stretching and patient education.
The patient responded well to the physical therapy interventions. She achieved the goals of improving range of motion, returning to softball, decreasing pain, and improving her posture. The patient was discharged home with an independent home exercise program, and a warmup routine for her upper extremities before softball games.