Abstract
We present a case of a 22-year-old university sportsman who presented at a private hospital in Lahore in December 2018 with complaint of severe pain in the anterolateral aspect of the right shoulder after playing cricket. On palpation, greater tubercle of the right shoulder was found to be tender along with the muscle belly of supraspinatus. A muscle trigger point was identified during palpation, while painful arc was also present on abduction. Physical tests, including Hawkins- Kennedy, Neers sign and empty can test, were found to be positive. The musculoskeletal ultrasound revealed that supraspinatus and bicep tendons were intact. The patient was managed by dry needling technique. The novelty of this clinical trial was the application of trigger point dry needling for the management of subacromial pain syndrome. Muscle trigger point symptoms can present as rotator cuff tears, supraspinatus tendonitis and bicipital tendonitis leading to misdiagnosis. Clinicians should look for muscle trigger points before making a differential diagnosis.
Highlights
Subacromial pain syndrome is a major cause of discomfort and affects the performance of athletes, cricketers
Muscle trigger point symptoms can present as rotator cuff tears, supraspinatus tendonitis and bicipital tendonitis leading to misdiagnosis
Clinicians should look for muscle trigger points before making a differential diagnosis
Summary
Subacromial pain syndrome is a major cause of discomfort and affects the performance of athletes, cricketers. It is a significant health problem with a prevalence rate of 25% in the general population.[1] The most common presentations are frozen shoulder (adhesive capsulitis), Rotator Cuff Tendinopathy and Muscle Trigger Points (MTrps). Supraspinatus tendonitis, bicipital tendonitis, partial rotator cuff tear and muscle trigger point were the differential diagnosis until further investigations was carried out. Progressive resistance training exercise regimen was initiated with follow up after two days Another session of dry needling was carried out followed by the application of heating pads. Written consent was taken from the patient prior to writing the case report for publication
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