Marge, an athletic trainer with three years of experience, was checking in on the tennis team. Rosa, a 19 year old female player approached Marge. After some small talk, Marge asks Rosa if anything is going on. Rosa states, "I will tell you, but promise not to tell coach?" Marge thinks for a second and agrees. Rosa begins explaining that she has been experiencing shoulder pain for the past several weeks. She describes her pain as intense while serving and achy during most overhead shots and any other movement and notes pain at night. She reports that the pain developed several weeks ago and that is had been getting progressively worse and now is affecting her serve velocity. Marge's initial observation was unremarkable. She did note palpable point tenderness near the greater tuberosity. During MMT of Rosa's biceps, deltoids, triceps, internal rotators, and elbow flexors and extensors, Marge observes weakness and also notices that Rosa resists abducting the shoulder (3/5) and external rotation at 0 degrees (3/5) as compared with the unaffected arm. The scapular stabilizers on the affected side also appear weak, and these movements cause discomfort for Rosa. Ligamentous testing about the shoulder is unremarkable. Marge performs the following special tests: Neer, Hawkins-Kennedy, empty can, and Yergason's. The only positive test was Hawkins-Kennedy. Dermatomes and tendon reflexes are WNL.
