Optimizing Functional Performance in Sprengel's Shoulder: A Case Report

Sprengel's deformity is a rare congenital musculoskeletal condition characterized by elevation and malposition of the scapula, leading to cosmetic deformity and functional limitations of the shoulder complex. The condition is commonly associated with restricted scapulothoracic mobility, reduced glenohumeral range of motion, muscle weakness, and impaired upper-limb function, which may affect activities of daily living and quality of life. This case report describes the clinical presentation, radiological findings, and physiotherapy management of a patient with Sprengel's shoulder. A structured six-week physiotherapy rehabilitation program was implemented to improve shoulder mobility, muscle strength, scapular control, and functional performance. The intervention was delivered progressively in three phases: pain management and mobility restoration; stretching, postural correction, and isometric strengthening; and advanced resistance training, scapular stabilization, proprioceptive facilitation, and task-oriented functional activities. Following the intervention, significant improvements were observed in shoulder function. Manual Muscle Testing (MMT) grades improved from 3/5 to 4/5 in the upper trapezius, middle trapezius, lower trapezius, rhomboids, serratus anterior, and levator scapulae muscles. Active shoulder flexion increased from 120° to 160°, while shoulder abduction improved from 110° to 155°. Functional disability, assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, improved from 32.5/100 to 12.5/100. Enhanced scapular control, postural alignment, overhead reaching ability, and overall upper-extremity function were also noted. This case highlights the potential benefits of early, individualized, and progressive physiotherapy rehabilitation in improving functional outcomes in individuals with Sprengel's deformity.