Systemic Compensations for Sacroiliac Joint Dysfunction - Shoulder Specific

(From the 2013 National Athletic Trainers’ Association’s Annual Symposia.)

American football is a very aggressive sport whose physical contact style of play can lead to numerous and severe injuries.

However, today’s case is a non-contact, off the field injury:

20 year old male Division I college football player. His primary position is that of a punter/kicker. During weight training, he was placed with the offensive linemen for pulling day (cleans, snatches, deadlifts). At the top part of the snatch (, he felt his right shoulder “give way” and drop down although he was able to keep the weight over his head.

Limited right shoulder ROM in all planes (esp abduction/IR)
Special Tests: +crank/clunk, +O’Brien, Sulcus sign

Right labral tear (confirmed via MRI-arthrogram)

Right sided sacroiliac (SI) joint dysfunction created a functionally short right leg. Standing posture demonstrates his right hip and shoulder sit lower than his left. When he is in an overhead press situation, the right arm is taking >50% of the weight. This lead to an inferior glide of the humeral head and subsequent tear of the glenoid labrum.