Symptoms: tension headaches, right shoulder pain.

Palpable assessment:

  • The right infraspinatus and right teres major are hypertrophied.
  • A slight left rib hump was apparent in prone.
  • The left foot is everted
  • The right hip is higher when checked in standing

Visual assessment:

  • The torso looks to be rotated to the right with the pelvis rotated to the left

Right shoulder is abducted, depressed and protracted

 

Protracted right shoulder

The right shoulder is protracted, indicating tightness of the pec minor, 1st and 2nd rib attachments

 Functional movement assessment

  •  the right foot pronates normally during walking but the left foot adducts at toe off.

 

  • There is reduced ankle rocker in the left foot

Treatment

will consist of creating tension in the right retractors, upward rotators and elevators of the right scapula, specifically the trapezius upper, lower and middle fibres and the right rhomboids.  The right serratus anterior may be locked short.  Stretching will focus on the right pec minor/major.

Exercises will include for the right arm only: single hand rows , single handed upper shrugs , pec minor stretch ,

Conclusion:

The client has generally good posture with a depressed, internally rotated and downwardly rotated scapula. Appropriate exercises should remedy this in a short time.

The dropped right shoulder is creating tension on the scalenes, with their attachments on the transverse processes C2-C7 may potentially be causing the tension headaches.

The right hip is higher causing a mild C-curve scoliosis toward the left.

Additional notes:

As the right scapula is internally rotated and the right elbow points more inwards then the left, this would mean a laterally rotated right glenohumeral joint and therefore short lateral rotators (infraspinatus and teres minor.

A slight left rib hump was apparent in prone which would insinuate a slight C-curve scoliosis toward the left. Could the abducted right arm cause a c-curve scoliosis due to its greater lever then the left arm?