Problem: Shoulder Pain
A 40-year-old female competitive tennis player has right shoulder pain that has worsened over the past several weeks. She usually has pain in the beginning of her warm-ups, but once she is warmed up, she is able to play without pain. However, her pain is significant within about 2 hours of finishing a match. Her pain is primarily in the deltoid insertion. She has been examined by a sports medicine physician who has recommended a course of strengthening prior to resuming playing tennis again. Her imaging studies indicate she has inflammation, but no structural damage to the shoulder complex. On examination of the patient has full range of motion except that she lacks approximately 20° of external rotation. She has a rounded shoulder posture. Her glenohumeral rotators and abductors are weak. She has mild winging of her right scapula. Her posture is a contributing factor to her problem.
a) What instructions can be provided to help her address the cause?
b) What exercises would reinforce the efforts to address/change her posture?
c) What soft tissue changes would this patient have, and what will need to be treated?