Upper Extremity S: Pt. is a 16 y.o. male high school football player.

He was performing hitting drills during practice and began having p! 6/10 in his R shoulder, particularly w/ the ripping motion. Pt. has no hx of shoulder inj. O: Pt. has no bruising, bleeding, or visible deformity. He has p! w/ palpation of the greater and lesser tubercles. With AROM and PROM, pt. had increased p! w/ ABD and FLEX >90 degrees, and IR and ER. RROM pt. scored 4+/5 for ABD, FLEX, IR, and ER, and 5/5 for all other ROM tests. Sulcus Sign, Neers, Hawkins-Kennedy, Adsons, Allens, Yergasons, Spring, OBriens, and Anterior/Posterior Apprehension Tests all Negative. Empty Drawer Test positive for p!. A: Diff. Diagnosis: AC joint sprain, Rotator Cuff strain. STG: Begin tx for p! and initiate rehabilitation protocols to improve shoulder strength and stability. LTG: RTP p! free. P: Pt. is self- limited during activity. Pt. began immediate tx w/ warm-up and stretching before and ice after activity. Pt. to begin rehabilitation exercises immediately. Monitor signs and symptoms, refer if needed. Loriann D. Mathews, ATS

Rehabilitation Plan Diagnosis: Rotator Cuff strain Problems/Impairments 1. Pain w/ movement 6/10 2. Loss of strength Overall Primary Functional Limitations 1. Difficulty hitting during tackling. 2. Inability to play football with full function. Overall Functional Goals (The patient) Playing with full strength and pain free, as measured by subjective reports and MMT compared bilaterally, within 3 weeks.

Rehabilitation Plan: Functional Goal #1: (The patient) Diminish pain as measured by subjective reports by 100% within 7 days to improve function for football related activities such as hitting. Modalities/ Treatment Ice Bag General Indications/ Settings Comments Pain Pt. should ice after all activity for minimum of 20 minutes, daily.

Exercise Passive ROM, stretching

Sets N/A

Reps N/A

Comments Pt. to be stretched before activity to maintain ROM. Stretches include ER, IR, ABD, and ADD stretches.

Functional Goal #2: (The patient) Improve strength of rotator cuff muscles, measured bilaterally, to assist in shoulder stabilization and improved function during participation in football. Exercise Sets Reps/Time Comments (Progression/Purpose/ Other) Pt. will use band to perform ER w/ resistance. Pt. will use band to perform IR w/ resistance. Performed w/ band to increase strength in surrounding structures

ER w/ band

12

IR w/ band

12

Extension

12

Flexion

12

to improve stability of GH joint. Performed w/ band to increase strength in surrounding structures to improve stability of GH joint.