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Hydrodissect The Pain Away: Anterior Shoulder Pain In A Volleyball Player - Page #1
 

Author: Alexander Anshus, MD
Co Author #1: Gerardo Hizon MD
Co Author #2: John How MD
Senior Editor: Christian Fulmer, DO
Editor: Juana Vargas, MD

Patient Presentation:
32 year old male with no past medical history who presents with right anterior shoulder pain.

History:
He has been experiencing anterior shoulder pain intermittently for approximately 5 years. The patient was a former Division 1 men's volleyball player, and symptoms began a few years after graduating. The onset was insidious. He describes sharp, nonradiating, anterior shoulder pain which is occasionally worsened by activity, and he occasionally wakes up with the pain. He performs overhead weight lifting without pain. He notes painless clicking in the shoulder and acromioclavicular joint which is positional, worse when the shoulder is flexed and internally rotated. He has done home physical therapy exercises with some improvement in symptoms. His symptoms have limited participation in volleyball over the last several years, at times for 6 months to over 1 year.

Physical Exam:
Vitals are unremarkable.

Right Shoulder: Mild tenderness over the proximal long head of the biceps tendon, with tenderness to the anterior deltoid just medial to the biceps tendon. Speeds, Yergasen's, and O’Brien's tests are negative. No evidence of muscular atrophy. Strength and sensation is intact throughout the right upper extremity. No tenderness or deformity to the clavicle, coracoid, or acromioclavicular joint. Range of motion of the shoulder is intact and symmetric.

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