Centre For Frozen Shoulder Treatment

Frozen Shoulder Treatment

FROZEN SHOULDER , PERIARTHEOLIS OF SHOULDER AND ADHESIVE CAPSULITIS ARE SYNONIUM JANGON IN MEDICAL VOCABALARY . SHOULDER  JOINT MOVEMENT ARE RESTRICTED  ACTIVELY AS WELL AS PASSIVELLY AND PAINFUL ALSO MORE PRECISELY ABDUCTION, EXTERNAL ROTATION AND INTERNAL ROTATION OF SHOULDER JOINT ARE MOST AFFECTED MOVEMENTS.

UNDERSTAND BIOMECHANICS OF SHOULDER JOINT

FLEXION OR ABDUCTION OF SHOULDER JOINT ACCOMLISHED WITH THESE ACTION

ON ELEVATION HUMERAL HEAD START TRANSLATE DOWNWARD AND START MOVING IN EXTERNAL ROTATION .SIMULTANEOUSLY SCAPULA ALSO MOVE WITH HUMERAL HEAD IN 1:2 RATIO. IT MEANS IF  GH JOINT MOVE 90 DEGREE UP SCAPULA MOVE 30 DEGREE. UNDERSTANDING THIS MECHANISM IS IMPORTANT TO CHECK THE DYNAMIC CENTER OF ROTATION (D.C.R.)

SYMPTONS OF FROZEN SHOULDER

  ðŸ‘‰  PATIENT FEEL PAIN IN SUDDEN JERKY MOVEMENT –

 ðŸ‘‰  CAN’T SLEEP ON THAT SIDE .

 ðŸ‘‰  SLEEP DISTRUBE DUE TO PAIN.

 ðŸ‘‰  DIFFICULTY IN WEARING OF CLOTHES ESP. UNDERGARMENTS.

 ðŸ‘‰  SOMETIMES CONSTANT PAIN.

 ðŸ‘‰  ANALYSIS- GLENO HUMERAL JOINT IS STIFF OR HYPO MOBILE (GH)JOINT .

 ðŸ‘‰  G.H JOINT-ROTATOR CUFF MUSCLES ARE TIGHT OR SHORT

 ðŸ‘‰  CAPSULE IS TIGHT OR FIBROSED.CAPSULE ELSTICITY REDUCED

 ðŸ‘‰  CAPSULE MAY ADHAIR TO ADJACENT TISSUE

 ðŸ‘‰  GLOBAL RESTRICTION OF MOVEMENTS ARE DUE TO FIBROSIS OR ADHESIONS

 

FIBROSIS


 Test

 ðŸ‘‰  PATIENT POSITION –PRONE LYING SHOULDER  90◦ DEGREE ABDUCTION. ELBOW 90◦ FLEXED .

 ðŸ‘‰  GH JOINT- EXTERNALLY  ROTATED BY RAISING ARM UP

 ðŸ‘‰  SCAPULA GOES IN ABDUCTION. IT MEANS POST CAPSULE IS  TIGHT IN COMPARISION TO THORACO-SCAPULAR JOINT

 

👉  GH JOINT- INTERNALLY ROTATED- SCAPULA GOES IN ADDUCTED POSITION.

 ðŸ‘‰  BOTH TEST ARE SUGGESTIVE OF GH JOINT TIGHTNESS IN COMPANSION TO THORACO- SCAPULAR JOINT.

 ðŸ‘‰  IN SUCH SITUATION IF WE TRY TO INCREASE RANGE OF MOTION OF ABDUCTION OR INTERNAL ROTATION OR EXTERNAL ROTATION ALL FORCE IS TRANSMITTED TO HYPER MOBILE-SCAPULO-THORACIC JOINT RATHER THAN GH JOINT.

 ðŸ‘‰  FORCE PASSIVE MOVEMENTS OR STRETCHING OF  SHOULDER JOINT COMPLEX,INEFFECTIVE TO GH JOINT .WE HAVE TO DESIGN A STRETCHING PROGRAMME IN SUCH A WAY THAT WORK ON GH JOINT-

 


 

EXERCISE FOR FORZEN SHOULDER

1.AVOID SUPERIOR GLIDE

2.AVOID ANTERIOR GLIDE 

THESE  ACCESSORY MOVEMENT TAKE PLACE WHEN YOU DO PHYSIOLOGICAL MOVEMENT

 INTERNAL ROTATION IS ASSOCIATED WITH ANTERIOR TRANSLATION OF HUMERAL HEAD AT GH JOINT

ON ELEVATION SUPERIOR GLIDE IS CLEARLY VISIBLE . THEREFORE DO THESE MOVEMENT BUT WITHOUT TRANSLATION OF HEAD OF HUMERUS .

DO POSTERIOR GLIDES

DO INFERIOR GLIDE

NO EXERCISE IF PAIN IN REST (IT IS SUGGESTIVE OF ACTIVE INFLAMMATION)

DO PASSIVE EXERCISE WITH POSTERIOR AND INFERIOR TRANSLATED POSITION

RESTORE MEDIAL ROTATION FIRST

NO ABDUCTION UNTIL 75%MEDICAL ROTATION RESTORE

DESIGN EXERCISE IN SUCH A WAY SO THAT SCAPULAR MOVEMENT  ARE STIFFER.

 

 

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