Working with a patient with ~5 years of chronic anterior shoulder pain. History of labral repair with no meaningful improvement.
Pain is a deep anterior ache, fluctuates. Aggravated by pressing but also by pulling (pull-ups/pulldowns), which consistently trigger significant upper trap/neck tightness followed by increased shoulder discomfort.
Gets reliable short-term relief (1–2 weeks) from aggressive pec/anterior shoulder myofascial work. Prior PT focused on external rotator /rear delt work without resolution.
No obvious scapular winging at rest. Suspecting scapular dyskinesis (anterior tilt/poor upward rotation), pec minor/subscap dominance, and trap compensation pattern. Curious if others would lean toward motor control issue vs residual structural limitation, and what you’d prioritize intervention-wise in a case like this.