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Hey All! Posted below is a description of this weeks patient case:
Patient: 49 y/o Female, Stay at home Mom, Primary Adhesive Capsulitis
MOI: Patient presents to physical therapy with right shoulder pain that began around December 2021. She was doing dumbbell presses while working out at home; felt symptoms onset the next day and has rested since then. Was working out/lifting 4-5 days per week. Notes progressive worsening of stiffness and “toothache pain” over the past few months.Chief Complaint: Right shoulder pain described as anterior shoulder pain that would radiate down the bicep region; denies symptoms past elbow. Feels stiffness and limited mobility. Did not have resting pain. Starting to feel the same twinge in left shoulder. Feels like she over-rested it. Denies N/T. Does feel tightness in UT region but not neck pain. Lost ability to reach behind back 1 month ago.
NPRS: Best 0/10, Worst 10/10
Treatment to Date: Cortisone injection
Agg. Factors: reaching OH (stiffness), reaching behind back (stiffness and pain), rotation (stiffness)
Easing Factors: wall slides flexion
Imaging: X-ray – per patient report, was told she has “frozen shoulder”Shoulder AROM – Right/Left Respectively:
Flexion: 113/153
Abduction: 110/170
IR: glute/T7 (HBB)
ER: 44/75
Pain and tightness/stiffness noted on Right side; anterior shoulder “twinge” on left side with flexion and abductionShoulder PROM – Right only
Flexion: 109
Abduction: 83
ER: 20
All stiffness prior to pain; potential guarding -
Sarah
Thank you for your research on this case.
I may not be able to make the call so I wanted to bring up these points for you to discuss on the call.Looking further at this study, it shows the mobs were performed after ultrasound.
Did you perform the ultrasound on this patient (I haven’t seen a machine in 5 plus years so I am unsure how to turn one on)?Also, mobs were written at a certain MHz. Are you familiar with how to create the temp?
Lastly, how long do you usually performs mobs on patients? I rarely see people spend 15 min straight doing mobs so would love to see how well this played out clinically.
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Sarah
Thank you for your research on this case.
I may not be able to make the call so I wanted to bring up these points for you to discuss on the call.Looking further at this study, it shows the mobs were performed after ultrasound.
Did you perform the ultrasound on this patient (I haven’t seen a machine in 5 plus years so I am unsure how to turn one on)?Also, mobs were written at a certain MHz. Are you familiar with how to create the temp?
Lastly, how long do you usually performs mobs on patients? I rarely see people spend 15 min straight doing mobs so would love to see how well this played out clinically.
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Sarah, thanks for sharing your case. It should be an interesting JC!
Would you mind sharing more details about your objective evaluation? ie joint mobility, special testing, palpation, cervical screen, etc.
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