UNDERSTANDING FROZEN SHOULDER
FROZEN
SHOULDER , PERIARTHIRITIS OF SHOULDER AND ADHESIVE CAPSULITIS ARE SYNONIUM IN MEDICAL VOCABALARY . SHOULDER JOINT MOVEMENT ARE RESTRICTED ACTIVELY AS WELL AS PASSIVELLY AND PAINFUL.
MORE PRECISELY ABDUCTION, EXTERNAL ROTATION AND INTERNAL ROTATION OF SHOULDER JOINT
ARE MOST AFFECTED MOVEMENTS.
PATIENT FEEL PAIN IN SUDDEN JERKY MOVEMENT –
CAN’T SLEEP ON THAT SIDE . SLEEP DISTRUBE DUE TO PAIN.
-DIFFICULTY IN WEARING OF CLOTHES ESPECIALLY
UNDERGARMENTS.
-SOMETIMES CONSTANT PAIN.
ANALYSIS
GLENO HUMERAL JOINT IS STIFF OR HYPO MOBILE
(GH) .
THORACO-SCAPULAR
JOINT IS HYPERMOBILE
G.H
JOINT-ROTATOR CUFF
MUSCLES ARE TIGHT OR SHORT
CAPSULE IS TIGHT
TEST
PATIENT
POSITION –PRONE LYING SHOULDER 90◦ABDUCTION. ELBOW 90◦ FLEXED .
MOVE THE
ARM UPWARD ( EXTERNAL ROTATION) –SCAPULA GOES IN ABDUCTION.IT MEANS POSTERIOR
CAPSULE IS TIGHT.
MOVE THE
ARM DOWNWARD ( INTERNAL ROTATED)-
SCAPULA GOES IN ADDUCTED POSITION.
BOTH TEST
ARE SUGGESTIVE OF GH JOINT LIGHTNESS IN
COMPANSION TO THORACO- SCAPULAR JOINT.
IN SUCH
SITUATION IF WE TRY TO INCREASE ROM OF ABDUCTION OR INTERNAL ROTATION OR
EXTERNAL ROTATION ALL FORCE IS TRANSMITTED TO HYPER MOBILE-SCAPULA-THORACO
JOINT RATHER THAN GH JOINT.
FORCE PASSIVE
MOVEMENTS OR STRETCHING OF SHOULDER JOINT
COMPLEX,INEFFECTIVE TO GH JOINT .WE HAVE TO DISGUSE A STRETCHING PROGRAMME IN
SUCH A WAY THAT WORK ON GH JOINT-
EXERCISE FOR
FORZEN SHOULDER
ACCERARY
JOINT MOVEMENTS ARE VERY IMPORTANT FOR COMPLITION OF PHYSIOLOGICAL MOVEMENTS.
SUPERIOR
TRANSLATION OF HUMERAL HEAD
ANTERIOR
TRANSLATION OF HUMERAL HEAD
INFERIOR
AND POSTERIOR TRANSLATION OF HEAD
THESE ARE
ACCECERRY MOVEMENTS OF SHOLDER JOINT.
WHILE YOU
TRYING TO INCREASE INTERNAL ROTATION EXCESSIVE ANTERIOR TRANSLATION TAKE PLACE.
WITH EXCESSIVE TRANSLATION JOINT CAPSULE TRAUMATISE AND FURTHER DETERIATE THE
SYMPTOMS
1.AVOID
SUPERIOR TRANSLATION
2.AVOID
ANTERIOR TRANLATION
THESE
ACCESSORY MOVEMENT TAKE PLACE WHEN YOUR DO PHYSIOLOGICAL MOVEMENT-
WHICH YOU
TRY TO INCREASE INTERNAL ROTATION ANTERIOR GLIDE START AT GH JOINT
ON
ELEVATION SUPERIOR GLIDE IS CLEARLY VISIBLE.
DO POSTERIOR
GLIDES AND INFERIOR GLIDES
NO EXERCISE
IF PAIN IN REST (IT IS SUGGESTIVE OF ACTIVE INFLAMMATION)
DO POSSIVE
EXERCISE WITH POSTERIOR AND INFERIOR GLIDE
RESTORE
MEDIAL ROTATION FIRST
NO
ABDUCTION UNTIL 75%MEDICAL ROTATION RESTORE
DESIGN
EXERCISE IN SUCH A WAY SO THAT SCAPULAR MOVEMENT ARE STIFER.
UNDERSTANDING
FROZEN SHOULDER
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.
PATIENT FEEL PAIN IN SUDDEN JERKY MOVEMENT –
CAN’T SLEEP ON THAT SIDE . SLEEP DISTRUBE DUE TO PAIN.
-DIFFICULTY IN WEARING OF CLOTHES ESP.
UNDERGARMENTS.
-SOMETIMES CONSTANT PAIN.
ANALYSIS- GLENO HUMERAL JOINT IS STIFF OR
HYPO MOBILE (GH)JOINT .THORACO-SCAPULAR JOINT IS HYPERMOBILE
G.H
JOINT-ROTATOR CUFF
MUSCLES ARE LIGHT OR SHORT CAPSULE IS LIGHT
TEST – PATIENT POSITION –PRONE LYING
SHOULDER 90◦ DEGREE
ABDUCTION. ELBOW 90◦ FLUXED .
GH JOINT-
EXTERNAL ROTATION –SCAPULA GOES IN ADDUCTED.(POST CAPSULE TIGHT)
GH JOINT
INTERNAL ROTATED- SCAPULA GOES IN ADDUCTED POSITION.
BOTH TEST
ARE SUGGESTIVE OF GH JOINT LIGHTNESS IN COMPANSION TO THORACO- SCAPULAR JOINT.
IN SUCH
SITUATION IF WE TRY TO INCREASE ROM OF ABDUCTION OR INTERNAL ROTATION OR
EXTERNAL ROTATION ALL FORCE IS TRANSMITTED TO HYPER MOBILE-SCAPULO-THORACIC
JOINT RATHER THAN GH JOINT.
FORCE PASSIVE
MOVEMENTS OR STRETCHING OF SHOULDER JOINT
COMPLEX,INEFFECTIVE TO GH JOINT .WE HAVE TO DISGUSE A STRETCHING PROGRAMME IN
SUCH A WAY THAT WORK ON GH JOINT-
EXERCISE
FOR FORZEN SHOULDER
1.AVOID
SUPENSIVE GLIDE
2.AVOID
ANTENSIVE GLIDE
THESE ACCESSORY MOVEMENT TAKE PLACE WHEN YOU DO
PHYSIOLOGICAL MOVEMENT-WHICH YOU TRY TO INCREASE INTERNAL ROTATION ANTERIOR
GLIDE START AT GH JOINT
ON ELEVATION
SUPERIOR GLIDE IS CLEARLY VISIBLE . THEREFORE AVOID THESE MOVEMENT BUT WITHOUT
GLIDES.
UNDERSTANDING
FROZEN SHOULDER
DO POSITION
GLIDES
INFERIOR
GLIDE
NO EXERCISE
IF PAIN IN REST (IT IS SUGGESTIVE OF ACTIVE INFLAMMATION)
DO POSSIVE
EXERCISE WITH POSITION AND INFERIOR
GLIDE
RESTORE
MEDICAL 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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