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45 year old female came to Back In Action Physical Therapy with complaints of right arm pain and limited right shoulder elevation after wrestling a male partner the night before. She complains of pain mid upper arm on lifting arm forward and out to the side.

Objective assessment reveals limited and painful shoulder flexion and abduction. Repeated movement testing reveals that passive right shoulder extension decreases pain and increases strength for lifting arm forward after. Screening for neck motion reveals limited neck extension, right side-bending and rotation. Repeated neck extension with self overpressure using hands at base of neck increases neck ROM and decreases right arm pain after.

Treatment assigned to patient included neck retraction/extension with hand on lower neck for overpressure and R shoulder passive extension placing hand on counter behind her back then squatting to achieve full extension to end range 10 repetitions every hour until symptoms subside.

Patient reports that she had no pain by the end of the first day when lifting right shoulder or in right arm from neck movement. Patient did not need further treatment as she continued home program for two days with complete resolution of arm and shoulder symptoms.

Discussion: This condition responded as a classic derangement of the right shoulder after straining to maintain shoulder stability during wrestling activity. Neck derangement complicated the picture with referred symptoms into the right arm and hand. Therefore the self treatment required two home exercises to treat both conditions, thereby gaining resolution of symptoms more quickly. Although not all conditions will respond this rapidly, the sooner after trauma treatment is received the more likely the condition will heal without developing further damage or becoming a chronic condition.