Symptoms

  • Diffuse pain in the right mid thoracic region
  • Right knee gets sore when running

Palpable assessment

  • Left foot everts
  • Left erector Spinae are hypertrophied relative the right
  • Right hip is slightly higher (tested when standing)

ROM

  • Left hip has less extension (tested in prone)
  • Lack of shoulder flexion especially the right

Muscle Testing

  • Left QL is hypertrophied but weak
  • Left external obliques tested weak
  • Right hip abduction with external and internal rotation weak
  • Left hip abduction with internal rotation weak
  • Right rhomboids, trapezius weak

Visual assessment

  • Left shoulder is internally rotated
  • Right hip is slightly externally rotated (possible external rotation of right tibia)
  • Prominence of right rhomboid indicates atrophy of right trapezius
  • Right shoulder is slightly depressed
  • Left erector Spinae are hypertrophied relative the right

Fig.1 the right scapula has less upward rotation then the left which may relate to weakness of the serrator anterior or shortness of one or more of the rotator cuff muscles.

 

Fig.2 the right hip is slightly higher due to eversion of the left foot or relative inversion of the right foot

Fig.3 both knees lack full extension

Fig.4 with limited shoulder flexion and limited upward rotation of the scapula especially on the right, the Erector Spinae must compensate by excessively extending in the labelled area which is the site of pain in the client.