STAR-Shoulder Classification

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The patient presented with a shoulder disorder, a common orthopedic condition. To diagnose and treat the patient, the pathoanatomic diagnosis and the treatment based classification scheme called as staged approach for rehabilitation classification (STAR- Shoulder) was used as given by McClure and Michener 1. This classification is a staged classification and has three different levels: Screening, Pathoanatomic diagnosis, and A rehabilitation classification.
Level 1: Screening
On History- The patient was a 49-year-old Caucasian male with a chief complaint of pain and weakness in R shoulder abduction and external rotation (dominant shoulder). He was a retired baseball player. He has been a baseball pitcher for 12 years before he retired 5 years back. However, the patient still plays baseball as a recreation sport. Currently, he works as a cashier at Walmart. His job duties include the constant use of arms and sometimes heavy labor like lifting boxes and stocking them in shelves above the shoulder height. The pain was first experienced one month back while throwing the ball during the early cocking phase of a baseball game. The pain reported is 6/10 on the visual analog scale which is a deep dull aching pain on the lateral side of R shoulder which aggravates with movements involving overhead …show more content…

The patient was also negative for any yellow flags.
On Physical Examination- On active movements, R shoulder abduction and external rotation were weak 3+/5 as measured by the manual muscle testing. On passive movements, the pain was reported with R shoulder abduction over 90 degrees and external rotation. Eccentric movements were more painful than PROM. On palpation, tenderness was present over the anterolateral aspect of the R shoulder. Sensations and reflexes were intact both Upper Extremity. At times the patient has night pain and rest

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