Case History
A 19-year-old right-handed female presented to our clinic with a chief complaint of left shoulder activity-related pain of approximately six months’ duration. She subsequently underwent six months of physical therapy and received two subacromial cortisone injections with minimal relief. On physical examination, she reported pain over the anterior and lateral shoulder. She had pain with resisted supraspinatus testing but full strength. She also had moderate discomfort with abduction and external rotation (posterior impingement sign). There was mild tenderness to palpation over the biceps tendon in the groove as well. She had full range of motion and no anterior or posterior shoulder instability. Subscapularis and infraspinatus tests were normal and she had a negative O’Brien’s test, negative jerk test, and negative subacromial impingement test. There was no scapular dyskinesis or glenohumeral internal rotation deficit (GIRD). The remainder of her exam was unremarkable.
An MRI showed a partial supraspinatus tendon tear and moderate tendinosis of the intra-articular portion of the long head of the biceps (LHB). There was no evidence of anterior or superior labral tear. The upper border of the subscapularis tendon was intact. She opted for surgical management after a thorough discussion of operative and non-operative treatment options.