Symptoms:

  • Pain and clicking on the right shoulder- external rotation and abduction cause pain.
  • Pain in the left glute
  • Crepitus in the right shoulder during movement,

Visual assessment:

  • The right hip internally rotates with compensatory external rotation of the right tibia
  • The definition apparent in the lateral wall of the left rectus abdominus indicates atrophy of the left transversus abdominus.
  • The lack of distance between the legs may indicate tightness of the adductors bilaterally
  • Right knee appears lower then the left due to eversion of the right foot, however the right hip is higher- this may be due to a structurally longer right leg?
  • Right shoulder is depressed and a little internally rotated.
  • Curvature of the spine to the right which drops the right shoulder

Palpable assessment:

  • Right hip is higher then the lef
  • Right foot everts more then the left
  • Right hallux limitus

Muscle tests:

  • Hamstrings are weak bilaterally

Functional movements:

  • the right hip looks to be more unstable (valgus collapse) indicating lengthening of the right gluteus medius

  • the adductors look dominant in the squat as the knees appear close together.  The right tibia is excessively externally rotated indicating tightness of the it band and lateral hamstrings.

Conclusion:

  • External rotation and hypertrophy of the left leg shoudler be achieved by left glute max activations
  • Proper squatting technique with alignment of the lower limbs
  • Activation of the right hip abductors

Future tests:

  • Test structural length of legs to determine why right hip is higher with a more everted foot.
  • Check right big toe mobility
  • Video gait
  • Check position of scapulae in standing