Wednesday, 31 December 2008

Left Teres Minor strain (Grade II)

A wushu ex-elite athlete came with complaints of pain and weakness in his left shoulder after landing awkwardly with his arm hyperextended during training yesterday. He could only lift (abduction) his left arm with much difficulty above the level of his shoulder. He would feel more pain as he lifts his arm further.

Upon examination, I found that he had difficulty rotating his arm outwards (External Rotation) and lifting sideways (abduction).There was tenderness of the insertion of the teres minor muscle. He also has a lesser shoulder muscle bulk on his left and some multidirectional instability.

He was advised to continue RICE treatment for another 2 days and prescribed isometric exercises. He was also given simple exercises for the painfree range of motion while starting early proprioceptive exercises using the wall and ball. However, he was advised not to abduct his arm above the level of his shoulder initially.

He would be reviewed in 1 week to reassess his progress. An elite athlete would undergo an ultrasound scan to determine the extent of muscle strain. Clinically, he was having a Grade II strain.

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