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Case Study: Resolving Left Shoulder Blade Pain

52 year old female nurse presented to physical therapy with left shoulder blade pain after walking a 100 lb German Shepard (11 days prior) that pulled her left arm out to the side when lunging to chase a cat. At initial visit patient reported having left shoulder blade and left arm constant pain. On examination patient was found to have no loss left shoulder ROM, Positive neural tension Median N left arm, minimal loss of neck retraction, extension and left side-bending. Repeated movement testing reveals a direction of preference (movement that decreases symptoms) for neck left side-bending or unloaded neck extension. Findings indicated a posterior-lateral cervical joint derangement with referred symptoms to left shoulder blade and arm. Home program assigned included neck left side-bending 10 repetitions every hour until symptoms remain abolished.

On return one week later patient reports no shoulder blade pain for one day and home exercise of neck left side-bending has been decreasing pain consistently when performing. Findings at second visit included negative neural tension left arm, no shoulder blade pain on palpation, neck ROM returned to normal and there was no pain on repeated left neck side-bending. Patient was instructed to continue neck side-bending as needed to keep symptoms abolished and return for two more visits to start strengthening and posture exercises.

This case study represents the response of most spinal derangements when accurately diagnosed for appropriate treatment and when the client is motivated to perform one simple exercise throughout the day in order to get their symptoms better rapidly.

If you would like to know if you or someone you know could benefit from a McKenzie evaluation call Ted at (503) 445-4936.