Male Weight Lifter With Painful Shoulder

A 36-year-old male weight-lifter complained of a dull-achy sensation in his right shoulder. He reported that there was no trauma or previous injury to the affected region.

The only significant finding during physical examination was Apley’s Scratch Test, Action 3. During the third maneuver, the patient is instructed to place the hand on the low back and then attempts to reach as far superior as possible; towards the scapula. This action tested for glenohumeral adduction, internal rotation, and scapular retraction with downward rotation. There was an approximate 6 cm inferior difference between the affected right shoulder and the unaffected left shoulder.

What do you think is causing this pain?

For the correct diagnosis, see the complete description of the case.