Tim Lappin/Baseball 4/13/2014 Time: 9:50 a.m.

S-Freshman 3rd baseman c/o R post. Shoulder p! that has been irritating him for the past two wks. Pain occurs during the follow through phase but there is no pain while batting. Patient has prior hx of R shoulder p! but has played through it. Patient describes pain 7/10. States there is no numbness or tingling associated with injury. Patient has not seen any health care provider since his last injury. States he takes Tylenol on practice days. O-Patient approached me in the Athletic Training room. Normal shoulder position. Normal arm hang, clavicle shape and height. Normal scapular position. No deformity, E, or sw. No p! with palpation of the greater tuberosity, lesser tuberosity, bicipital groove, ant. /middle deltoid, trapezius, and rhomboids. Pain with palpation of the post. deltoid. Normal PROM. Pain w/ horizontal adduction AROM and Pain w/ functional ex. rot. Neg. Apley scratch test, ant. Apprehension test, yergasons, ant/middle/post. Deltoid muscle test, OBriens, and post. Instability in the plane of the scapula tests. Positive empty can test. A-df dx includes supraspinatus strain for the pos. empty can test. Infraspinatus, and teres minor strains for the pain palpated on the posterior shoulder and pain w/ ex. rot. Posterior Deltoid strain for pain palpated on the posterior shoulder. Inj. to the posterior capsule or labrum for the pain w/ horizontal adduction. Patient is thought to have injured their posterior cuff muscles including the supraspinatus, infraspinatus, and teres minor for the positive empty can test and pain w/ external rotation. The follow through phase is causing the external rotators (infraspinatus and teres minor) to eccentrically contract so this p! is also indicative of a posterior rotator cuff strain. STG is to treat symptomatically and rehabilitate utilizing therapeutic bands, rhythmic stabilization, Is, Ys, and Ts, and Hughston series to strengthen rotator cuff and surrounding GH muscles. LTG is to have the patient throwing p! free at pre-injury status. P-Patient is advised to take NSAIDs b.i.d. until inflammation subsides. Symptoms will be treated with cryotherapy and premodulated electrical stimulation. Rehab to strengthen rotator cuff muscles. Patient is cleared to hit in practice and games. No throwing until symptom dissipate. Corey Richards ATS

Rehabilitation plan Week 1 97005/97006 Evaluation/re-evaluation

97750 Physical performance or measurement test with written report Arm Bike warm-up 5 min 3x15 3x10

97110 Therapeutic bands (ER, IR, D1, D2, retraction) 97110 Dumbbell abduction series (Ys, Ts, and Is) 97110 Hughston Series 3x10

97110 Rhythmic stabilization 3x45 sec 97110 Body blade 97110 Push-up plus 97016 Gameready 3x45 sec 3x10 20 min 20 mins

97014 Electrical stimulation