Objective: The purpose of this case study is to discuss a positive outcome following the use of radial shockwave therapy and cold laser in the treatment of a CrossFit athlete with chronic right shoulder impingement.
Clinical Features: A 31-year-old male presented to an outpatient chiropractic teaching clinic with chronic right shoulder pain. The pain was described as dull and radiating into the right arm. Radiographs revealed mild osteoarthritis of the right acromioclavicular joint. There was a decrease of active abduction and internal rotation range of motion due to pain, with point tenderness over the acromioclavicular joint. The Mumford procedure was the recommended medical treatment.
Intervention and Outcome: The patient received chiropractic adjustments and mechanical massage therapy to his right shoulder region with slight improvement. Shockwave therapy combined with cold laser was introduced at revaluation. The patient was advised to rest and/or limit his workout regime. The patient was compliant with the recommended treatment intervals, but did not limit his activity as directed. The patient was treated at a frequency of one or two days per week over the course of 16 weeks for a total of 28 visits, during which time there was a 50% reduction of pain, improved range of motion, and improved ability to perform his activities of daily living. Outcome assessment tool scores showed 63% improvement.
Conclusion: This case report suggests that in this patient, Shockwave therapy in combination with cold laser therapy and manipulative/manual therapies may result in improvement of pain and functional limitations due to chronic shoulder impingement and may offer a conservative option for similar patients.
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