Hii this patient had left side brachial plexopathy cabg done in 2014. now get relief with medication.. but now he came with Right shoulder pain flexion is 90 abduction is 70 all painful movements..I checked resisted movt. Empty can and rotation all painful.. he had mild pain frm march and range was full that time.. frm 2- 3 days range reduced.. And while he is sleeping supine unable to put shoulder down.. and patient is having pain at the marked region only.. not at shoulder tip or else.. What can b d cause??



pain site sometimes misguids us.. shoulder impingement follows this course.. In supine Deltoid overactivity against gravity can not be checked by rotator cuff so the pain occurs.. Do IFT on given spot for patients satisfaction.. ssf to supra & infraspinatus.. trigger pt release. .. work on scapula for a week eg. Scapula sets, swiss ball push, wall washes.. later work on rotater cuff with thera bands.. ROM wil b last option.

sir there is no exactly MTrp on affected area.. dull aching pain countinues and while lying supine more sharp shooting pain..

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spurling test is negative.. resisted isometric movt. of shoulder all r painful and no tingling sensation but while lying sharp shooting pain.. is it possible to occur brachial plexopathy on right side now?? coz during cabg his arm was hanged and after that he got left plexopathy so what can b d reason.. should he needs to go for MRI??

restriction occur posterior capsular structure along with triceps muscle weakness and tightness long head give rise to pain directed points.follow the pattern of movt. start with hot fermentation and mobilisation after that use of thera band activity.streching of capsule also imp.

it may be radiating pain during supine position need to cervical traction and for shoulder joint apply hot formentation,IFT,shoulder mobilisation,stick exercises for shoulder and marking points they are trriger points of post fiber of deltoid,Teres minor and infraspinatus

apply ice packfor few days than apply tens if any swelling is there ultra sound also be use ful slowly u have to do mobilization exersises while sleeping in supine position put small pillow under where u marked

even putting pillow under shoulder is painful in supine.. patient is sleeping on unaffected side lying

Check for end feel of Shoulder movts. If capsular end feel then go for moist pack and Maitland glides of restricted movements and posterior capsular stretch. If end feel is muscular or stretch then Do MET and Trigger release of infraspinatus, Subscapularis and Latissimus Dorsi.

periarthritis shoulder..

Agree with Dr Gajendra. Please check for any cervical pathology. Could be because of Cx referred pain. Try manual traction and sliders (ULTT) stretch and shoulder active exercises in pain free ranges. Might help him to some extent

Do check external rotation range in shoulder neutral as well as ninety degrees abduction . Does he follow any capsular pattern ?? Also check trigger points at lat dorsii ....??

Check scapulo-thoracic stiffness.... It also represents same course... Mobilise scapulo-thoracic joint.... Will reduce pain and improve ROM...

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Brachial Plexopathy

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