Arif Karmali1, Jennifer McLeod2. 1. Elite Sport Performance, Calgary, Alberta; Resident of the Royal College of Chiropractic Sports Sciences (Canada). 2. Elite Sport Performance, Calgary, Alberta.
Abstract
OBJECTIVE: To present the assessment and conservative management of chronic shoulder pain in the presence of a humeral avulsion of the inferior glenohumeral ligament (HAGL) lesion in an active individual. CLINICAL FEATURES: A 47 year-old female office-worker with constant, deep, right shoulder pain with occasional clicking and catching claimed to have "tore something" in her right shoulder five years ago while performing reverse bicep curls. A physical exam led to differential diagnoses of a Superior Labrum Anterior to Posterior (SLAP) lesion, Bankart lesion, and bicipital tendinopathy. A Magnetic Resonance Arthrogram revealed a HAGL lesion. INTERVENTION AND OUTCOME: A conservative chiropractic treatment plan in addition to physical therapy was initiated. The patient reported 75% improvement in symptoms after 4 treatments over a four-week duration. SUMMARY: This case demonstrates the successful implementation of a conservative plan of management suggesting that the treatment provided to this patient should be considered and attempted prior to arthroscopic surgery.
OBJECTIVE: To present the assessment and conservative management of chronic shoulder pain in the presence of a humeral avulsion of the inferior glenohumeral ligament (HAGL) lesion in an active individual. CLINICAL FEATURES: A 47 year-old female office-worker with constant, deep, right shoulder pain with occasional clicking and catching claimed to have "tore something" in her right shoulder five years ago while performing reverse bicep curls. A physical exam led to differential diagnoses of a Superior Labrum Anterior to Posterior (SLAP) lesion, Bankart lesion, and bicipital tendinopathy. A Magnetic Resonance Arthrogram revealed a HAGL lesion. INTERVENTION AND OUTCOME: A conservative chiropractic treatment plan in addition to physical therapy was initiated. The patient reported 75% improvement in symptoms after 4 treatments over a four-week duration. SUMMARY: This case demonstrates the successful implementation of a conservative plan of management suggesting that the treatment provided to this patient should be considered and attempted prior to arthroscopic surgery.