Case Study – Shoulder Pain

April 24, 2013 | By

– Dr. Dhairav Shah

Mr. X complained of right shoulder pain since many years. He had difficulty in lifting his hand above his head and doing any activity in that position. He always felt a click in the shoulder and by evening the shoulder feels tired, heavy and painful. Also felt that the shoulder strength was very poor on his right hand. Mr. X had been suffering from this problem for many years and had given up on all treatment options and had decided to try physiotherapy as the last option or else would just give up on his shoulder pain.


When Mr. X was examined for the first time at physiorehab it was noted that his shoulder blade muscles had been significantly wasted (decrease in size of muscle) because of which he had minimal stabilization of his right shoulder (which was the cause of clicks).

Shoulder Blade Muscle

Also, because of the above, his rotator cuff (important movers and stabilizers at the shoulder) were not working adequately and thus he used to complain of pain, tiredness and heaviness in the shoulder.

Rotator Cuff Muscles

Also, on further examination of his sling system it was noted that his Light buttock muscles were also very weak and his Light oblique muscle (abdominal muscle) was weak.

Sling System

Mr. X was diagnosed as scapular dyskinesia with posterior oblique sling dysfunction.


Mr. X was put on a supervised exercise programme as follows:

  • 4 weeks of scapula (shoulder) stabilization programme
  • Rotator cuff strengthening programme (strengthening of supraspinatus, infrapsinatus, teres minor and subscapularis muscles)
  • Kinetic control of his shoulder
  • Lt Gluteal (butt) strengthening and core strengthening programme
  • He was also given a lot of postural advice

During 4 weeks of his training programme Mr X reported that his pain had significantly gone down and his clicks had diminished to a large extent and were less painful now. He also started feeling stronger and confident to use the shoulder now.

Post 4 weeks he was given an intensive home exercise programme to follow which was inclusive of his butt strengthening exercises also.

Mr. X is following the same programme at home and living with a better and confident shoulder.

At PhysioRehab we believe in supervised targeted muscle specific exercise after our detailed assessment of the problem.

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Category: Case Studies

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