Patients with adhesive capsulitis have a painful restriction of both active and passive GH joint motion in all planes, or a global loss of GH joint motion. In 1946, Neviasernamed the condition "adhesive capsulitis" based on the radiographic appearance with arthrography, which suggested "adhesion" of the capsule of th GH joint limiting overall joint space volume. The contralateral or normal shoulder should always be examined and given regular stretching exercise programme as a precautionary measure to maintain its functional capacity.Ĭodman introduced the term "frozen shoulder" in 1934 to describe patients who had a painful loss of shoulder motion with normal radiographic studies.Patient who are complaining of pain in the night (nocturnal pain) should be treated by heat therapy or thermo therapy.Patient having diabetes responds very slow to the treatment and also feel much more pain as compared to those who are non-diabetic.The importance or necessity of regular stretching must be explained to the patient even after he had recovered from stiffness and pain to avoid the recurrence of periarthritis or stiffness.Frozen Shoulder Exercises for Home and Cautions:
#Frozen shoulder full
By this patient respond very well for acquiring full range by properly guided simple and specific Frozen shoulder exercises which ensures relaxed graduated stretching of the contracted capsule. By self assisted stretching- Method of performing is, the patient uses his normal or contralateral arm for gradually stretching the affected shoulder.įor this, manipulation and mobilising techniques are given by "MAITLAND".This may be done in supine or sitting position. By weight and pully- Tolerable weight must be used.The above mentioned Frozen shoulder exercises can be done in two ways:
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Shoulder internal rotation with extension, adduction and elbow flexion i.e attaining "hand to lumbar position". Shoulder elevation with flexion, abduction and external rotation. Graduated relaxed sustained stretching based on the PNF pattern are following types: The specific Frozen shoulder exercises should include the maximum number of combination of various movement by minimising the number of exercises. However improvement in the range of other movements is not always at the same rate. While planning the frozen shoulder exercises one must give due importance to the fact that contracted soft tissue when objected to repeated prolong mild tension show extensibility and plastic elongation.Īn increase in the movement following the session of prolonged stretching was usually associated with a corresponding increase in the other movements too. Exercise Programmeįrozen shoulder exercises plays an important role in management of the condition. Mobilization by accessory movements of acromio-clavicular, sterno-clavicular and/or scapulo-thoracic joint articulation is also extremely helpful. The reduction in pain occurs because of the neuro-modulation effect on the mechanoreceptors with in the joint. Gentle relaxed passive movements reduces pain and pathologic limits of motion. Slow and rhythmic circumduction at the glenohumeral joint, in forward stoop position effectively induces relaxation and promotes mobility. To induce relaxation, always begin with slow rhythmic movement. Axial traction and approximation is carried out along with antero-posterior glide and abduction- adduction glide. The physiotherapist grasping the arm above the shoulder joint carries out relaxed passive gliding movement of head of humerus on glenoid. The patient is placed in supine position with the affected shoulder in maximum possible abduction and neutral rotation and elbow in 90 degree of flexion. However ultrasound, beside deep heating, has the added advantages of increasing excitability of the contracted soft tissue and is therefore performed. Though prior heating of the joint has been found to facilitate relaxation and mobilization, one may use the heat modality suitable to the patient's response. iii) Specific shoulder exercises to offer graduated stretching. Mobilization is attained by 3 basic approaches: 
However it may be remembered that strengthening of muscle is secondary to mobilization.
To increase extensibility of the thickened and contracted capsule of the joint at the anteroinferior border and at the attachment of the capsule to the anatomical neck of humerus. Frozen Shoulder Exercises aim to reduce pain, increase extensibility of the capsule, and improve strength of the rotator cuff muscles.
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