Frozen Shoulder

Introduction: Currently no any standard medical, surgical, or therapy regimen is universally accepted as the most efficacious treatment for restoring motion in patients with shoulder adhesive capsulitis. Present study was planned to check the short term effectiveness of anterior and posterior Kaltenborne joint mobilization techniques for improving shoulder external rotation range of motion in patients with shoulder adhesive capsulitis. Methodology: Total of 40 patients diagnosed with shoulder adhesive capsulitis were recruited and randomly allocated into two groups. In Group A (n= 20) subjects were treated with Therapeutic ultrasound (8mins,2w/cm2 ,3Mhz),Kalternborn anterior mobilization techniques ,Stretching exercises and strengthening exercises for roatator cuff using theratubes, whereas subjects in Group B (n= 20) received Therapeutic ultrasound (8mins,2w/cm2 ,3Mhz),Kalternborn posterior mobilization techniques ,Stretching exercises and strengthening exercises for roatator cuff ...

Background: Effectiveness of any individualized therapeutic modality in reducing pain in frozen shoulder is questionable and the combination of therapies has contradictory results. Objectives: The purpose of this study was to check the effectiveness between the treatment modalities of Ultrasound therapy and End range mobilization over Cryotherapy and Stretching as a treatment program in alleviating pain of patients with frozen shoulder. Methods: Forty subjects diagnosed to have frozen shoulder were randomly assigned to two groups. Subjects in Group I received Ultrasound therapy and End range mobilization of shoulder while subjects in Group II got Cryotherapy and Stretching of shoulder. Both the groups were treated for 6 days a week for 4 weeks. Response to pain was considered as the outcome measure. Results: Statistical analysis was done considering p<0.05 as statistically significant and the"t" value were estimated. It was found that ultrasound therapy when combined with end range mobilization had"t" value of 1.8342 in comparison to that of cryotherapy combined with stretching group. Conclusion: Ultrasound therapy with end range mobilization produced a better result than cryotherapy with stretching in reducing pain and therefore can be recommended in the treatment of frozen shoulder.

Background: Effectiveness of any individualized therapeutic modality in reducing pain in frozen shoulder is questionable and the combination of therapies has contradictory results. Objectives: The purpose of this study was to check the effectiveness between the treatment modalities of Ultrasound therapy and End range mobilization over Cryotherapy and Stretching as a treatment program in alleviating pain of patients with frozen shoulder. Methods: Forty subjects diagnosed to have frozen shoulder were randomly assigned to two groups. Subjects in Group I received Ultrasound therapy and End range mobilization of shoulder while subjects in Group II got Cryotherapy and Stretching of shoulder. Both the groups were treated for 6 days a week for 4 weeks. Response to pain was considered as the outcome measure. Results: Statistical analysis was done considering p&lt;0.05 as statistically significant and the„t‟ value were estimated. It was found that ultrasound therapy when combined with end ran...

Introduction: Currently no any standard medical, surgical, or therapy regimen is universally accepted as the most efficacious
treatment for restoring motion in patients with shoulder adhesive capsulitis. Present study was planned to check the short term
effectiveness of anterior and posterior Kaltenborne joint mobilization techniques for improving shoulder external rotation range
of motion in patients with shoulder adhesive capsulitis.
Methodology:  Total of 40 patients diagnosed with shoulder adhesive capsulitis were recruited and randomly allocated into two
groups. In Group A (n= 20) subjects were treated with Therapeutic ultrasound (8mins,2w/cm
2
,3Mhz),Kalternborn anterior
mobilization techniques ,Stretching exercises and strengthening exercises for roatator cuff using theratubes, whereas subjects in
Group B (n= 20) received Therapeutic ultrasound (8mins,2w/cm
2
,3Mhz),Kalternborn posterior mobilization techniques
,Stretching exercises and strengthening exercises for roatator cuff using theratubes. These were recorded before and after the
session of the training. Total duration of the study was 2weeks.
Results :  Statistical analysis of the data revealed that Group A and Group B, there was a highly significant difference between
VAS1 and VAS6 (P<0.01), highly significant difference in ROM1 and ROM6(P<0.01) , highly significant difference in
Functional Assessment Questionnaire Score FAS1 and FAS6(P<0.01).
Conclusion: The study confirmed that Posterior Kaltenborne joint mobilization is effective as compared to anterior Kaltenborne
joint mobilization and to bring about overall improvement in the condition.

""Background: Effectiveness of any individualized therapeutic modality in reducing pain in frozen
shoulder is questionable and the combination of therapies has contradictory results. Objectives: The
purpose of this study was to check the effectiveness between the treatment modalities of Ultrasound
therapy and End range mobilization over Cryotherapy and Stretching as a treatment program in
alleviating pain of patients with frozen shoulder. Methods: Forty subjects diagnosed to have frozen
shoulder were randomly assigned to two groups. Subjects in Group I received Ultrasound therapy and
End range mobilization of shoulder while subjects in Group II got Cryotherapy and Stretching of
shoulder. Both the groups were treated for 6 days a week for 4 weeks. Response to pain was considered
as the outcome measure. Results: Statistical analysis was done considering p<0.05 as statistically
significant and the„t‟ value were estimated. It was found that ultrasound therapy when combined with
end range mobilization had„t‟ value of 1.8342 in comparison to that of cryotherapy combined with
stretching group. Conclusion: Ultrasound therapy with end range mobilization produced a better result
than cryotherapy with stretching in reducing pain and therefore can be recommended in the treatment
of frozen shoulder.
Keywords: Frozen shoulder, ultrasound therapy, end range mobilization, cryotherapy, stretching""

Background: Effectiveness of any individualized therapeutic modality in improving the range of motion of shoulder in adhesive capsulitis is questionable and the combination of therapies has contradictory results. Objectives: The purpose of this study was to check the effectiveness between the treatment modalities of Ultrasound and End range mobilization over Cryotherapy and Stretching as a treatment program in improvement of active range of motion in patients with adhesive capsulitis of shoulder. Methods: Forty subjects diagnosed to have adhesive capsulitis were randomly assigned to two groups. Subjects in Group I received Ultrasound and End range mobilization of shoulder while subjects in Group II got Cryotherapy and Stretching of shoulder. Both the groups were treated for 6 days a week for 4 weeks. ROM‘s of shoulder in abduction and external rotation were the outcome measures considered. Results: Statistical analysis was done considering p<0.05 as statistically significant and the‗t‘ values were estimated. It was found that ultrasound when combined with end range mobilization had a value of 3.4498 in comparison to 1.7773 of cryotherapy combined with stretching group. Conclusion: Ultrasound with end range mobilization produced a better result than cryotherapy with stretching and therefore can be recommended in the treatment of second stage adhesive capsulitis of shoulder.

Frozen shoulder merupakan rasa nyeri yang mengakibatkan keterbatasan lingkup gerak sendi (LGS) pada bahu. Mungkin timbul karena adanya trauma, mungkin juga timbul secara perlahan-lahan tanpa tanda-tanda atau riwayat trauma. Keluhan utama yang dialami adalah nyeri dan penurunan kekuatan otot penggerak sendi bahu dan keterbatasan LGS terjadi baik secara aktif atau pasif. Frozen shoulder secara pasti belum diketahui penyebabnya. Penyebab dari frozen shoulder antara lain tendinitis, rupture rotator cuff, capsulitis, post immobilisasi lama, trauma serta diabetes mellitus. Respon autoimmunal terhadap rusaknya jaringan lokal yang diduga menyebabkan penyakit tersebut.

Introduction: Frozen shoulder (aka Adhesive Capsulitis) is traditionally extremely difficult to treat. Patients suffer from pain and limited joint mobility lasting an average of 3 to 4 years. This condition creates a total health care cost between $7-$8,000 per episode. Evidence supports manual therapy (including mobilizations) and exercise before manipulation under anesthesia or arthroscopic surgery. About 7%-15% of patients suffer permanent motion loss. Clinical results suggest frozen shoulder may be more effectively treated and less costly using AquaStretch TM (A/S), a new form of aquatic myofascial release.

Background: Effectiveness of any individualized therapeutic modality in improving the range of motion of shoulder in adhesive capsulitis is questionable and the combination of therapies has contradictory results. Objectives: The purpose of this study was to check the effectiveness between the treatment modalities of Ultrasound and End range mobilization over Cryotherapy and Stretching as a treatment program in improvement of active range of motion in patients with adhesive capsulitis of shoulder. Methods: Forty subjects diagnosed to have adhesive capsulitis were randomly assigned to two groups. Subjects in Group I received Ultrasound and End range mobilization of shoulder while subjects in Group II got Cryotherapy and Stretching of shoulder. Both the groups were treated for 6 days a week for 4 weeks. ROM‘s of shoulder in abduction and external rotation were the outcome measures considered. Results: Statistical analysis was done considering p&lt;0.05 as statistically significant and ...

Frozen Shoulder (FS) by many specialists is still considered a benign, self-limiting condition, which usually resolves without intervention. This concept originated in the 70', stating that FS will proceed from "the freezing" phase, with the predominance of inflammation and pain to "the frozen" phase with marked stiffness in the joint and "the thawing" phase, with a progressive return to the normal Range Of Motion (ROM) and function. Nevertheless, numerous authors have recently challenged this concept, arguing that most patients with FS will never fully recover, and suffer from residual pain and loss of function. Lack of early intervention, when a patient does not improve with conservative treatment, might lead to disability. We have discussed the recent concepts in the natural course of the disease and discussed both noninvasive and surgical methods in the treatment of FS.

Background: Effectiveness of any individualized therapeutic modality in reducing pain in frozen shoulder is questionable and the combination of therapies has contradictory results. Objectives: The purpose of this study was to check the effectiveness between the treatment modalities of Ultrasound therapy and End range mobilization over Cryotherapy and Stretching as a treatment program in alleviating pain of patients with frozen shoulder. Methods: Forty subjects diagnosed to have frozen shoulder were randomly assigned to two groups. Subjects in Group I received Ultrasound therapy and End range mobilization of shoulder while subjects in Group II got Cryotherapy and Stretching of shoulder. Both the groups were treated for 6 days a week for 4 weeks. Response to pain was considered as the outcome measure. Results: Statistical analysis was done considering p<0.05 as statistically significant and the"t" value were estimated. It was found that ultrasound therapy when combined with end range mobilization had"t" value of 1.8342 in comparison to that of cryotherapy combined with stretching group. Conclusion: Ultrasound therapy with end range mobilization produced a better result than cryotherapy with stretching in reducing pain and therefore can be recommended in the treatment of frozen shoulder.

Frozen Shoulder (FS) by many specialists is still considered a benign, self-limiting condition, which usually resolves without intervention. This concept originated in the 70’, stating that FS will proceed from “the freezing” phase, with the predominance of inflammation and pain to “the frozen” phase with marked stiffness in the joint and “the thawing” phase, with a progressive return to the normal Range Of Motion (ROM) and function. Nevertheless, numerous authors have recently challenged this concept, arguing that most patients with FS will never fully recover, and suffer from residual pain and loss of function. Lack of early intervention, when a patient does not improve with conservative treatment, might lead to disability. We have discussed the recent concepts in the natural course of the disease and discussed both noninvasive and surgical methods in the treatment of FS.

This case documents the treatment of a middle-aged woman with chronic, unresponsive adhesive capsulitis (frozen shoulder) using manipulation, active release therapy, and electronic acupuncture. She had not responded to typical physical therapy but did respond to active release therapy along with adjunctive manipulation and acupuncture. In our course of treatment we wanted to see if we could significantly improve pain-free range of motion and normal; function without using invasive treatments like surgery and manipulation under anesthesia. Over a course of five weeks, using a soft tissue manipulation technique known as active release technique along with electrified acupuncture and home exercises, we were able to increase her range of motion to near normal and her function to normal. She was not forced to miss any work because of the treatment and can now do all the things she needs to do for work.

Background: Frozen shoulder is an insidious condition that begins with pain and gradual restriction of movement in the shoulder region. There are various methods of treating frozen shoulder (both surgical and non-surgical).Among the non-surgical methods there is no specific method accepted universally. Purpose of this study is to determine the combined effectiveness of Glenohumeral End-Range Mobilization and Contract-Relax technique for glenohumeral internal rotators in patients with adhesive capsulitis.
Methods: 60 frozen shoulder patients randomized 30 subjects into each experimental and control group. Group A (experimental group) received Glenohumeral End-Range Mobilization, Contract-Relax Technique for glenohumeral internal rotators and Shoulder Pendular Exercises 2 times a week for a period of 4 weeks (8 sessions).Group B (control group) received Shoulder Pendular exercises 2 times a week for a period of 4 weeks (8 sessions). Outcome measures included are VAS, SPADI and goniometry for assessing pain, functional ability and ROM for the shoulder joint.
Results: The average improvement of VAS for Group A and Group B were 4.5 and 3 respectively using median. The U-value was 176, which is statistically highly significant (p value = 0.000).The average improvement of Shoulder Pain and Disability Index for Group A and group B were 56.9333 and 10.3667 respectively using mean and Standard Deviation. The t-value was 35.91181, which is statistically highly significant (p value = 0.000).
Conclusion: The results indicated that both Group A and Group B had significant improvement in the scores of VAS, SPADI and GONIOMETRY scores at the 4th week when compared to base line values, but when comparing the end results of group A and group B it has been found out that group A intervention is more effective then Group B in treating the internal rotators of patients with adhesive capsulitis

BACKGROUND: Frozen shoulder is a musculoskeletal disorder resulting from chronic inflammation of the capsule subsynovial layer and characterized with capsular thickening, progressive fibrosis, and contracture of the glenohumeral joint capsule. This condition is a relatively common condition that mimics other condition and its management requires deliberate consideration of patient’s condition. REVIEW ARTICLE: This article reviews and summarize latest findings of frozen shoulder. The diagnosis of frozen shoulder is described from the patient history, physical examination in look, feel, and move sequence to the supporting examinations. The current evidence of managements of frozen shoulder is described, from the nonoperative to the surgical approach. CONCLUSION: Most of frozen shoulder cases resolve spontaneously thus conservative treatment should be the first choice of frozen shoulder. However, for cases that failed with conservative treatment and had a debilitating effect to patient...

Frozen shoulder is a common condition in which the articular shoulder capsule swells and stiffens, restricting its mobility. Key characteristics are gradual onset of shoulder stiffness, pain especially at night, and restriction in movement of the shoulder. It is generally diagnosed clinically or with the help of imaging technique. Conservative treatments include analgesics, oral steroids, and intra-articular corticosteroid injections. If symptoms persist despite conservative measures, the surgical treatments were adopted. In modern medicine managing, such conditions are really a hard task. In Unani System of Medicine, there is specific treatment which can provide complete relief; for this, an Unani physician acquires different manipulative therapies such as regimental therapy (massage and cupping). In this paper, one such case is discussed in which patient was distressed by the pain and restricting movements of joints so that performing even small daily tasks are impossible for him/...

Introduction: Currently no any standard medical, surgical, or therapy regimen is universally accepted as the most efficacious treatment for restoring motion in patients with shoulder adhesive capsulitis. Present study was planned to check the short term effectiveness of anterior and posterior Kaltenborne joint mobilization techniques for improving shoulder external rotation range of motion in patients with shoulder adhesive capsulitis. Methodology: Total of 40 patients diagnosed with shoulder adhesive capsulitis were recruited and randomly allocated into two groups. In Group A (n= 20) subjects were treated with Therapeutic ultrasound (8mins,2w/cm 2 ,3Mhz),Kalternborn anterior mobilization techniques ,Stretching exercises and strengthening exercises for roatator cuff using theratubes, whereas subjects in Group B (n= 20) received Therapeutic ultrasound (8mins,2w/cm 2 ,3Mhz),Kalternborn posterior mobilization techniques ,Stretching exercises and strengthening exercises for roatator cuff using theratubes. These were recorded before and after the session of the training. Total duration of the study was 2weeks. Results : Statistical analysis of the data revealed that Group A and Group B, there was a highly significant difference between VAS1 and VAS6 (P<0.01), highly significant difference in ROM1 and ROM6(P<0.01) , highly significant difference in Functional Assessment Questionnaire Score FAS1 and FAS6(P<0.01). Conclusion: The study confirmed that Posterior Kaltenborne joint mobilization is effective as compared to anterior Kaltenborne joint mobilization and to bring about overall improvement in the condition.

Assessment of shoulder range of motion in patients with frozen shoulder is important aspect for physiotherapist for documentation and to check progression in disease. From long time, goniometer is used as gold standard measurement tool for measuring range of motion. Due to some practical difficulties like finding out precise bony landmark for fulcrum, aligning two arms as per long axis of bones and subjective errors among less experienced physiotherapist and students, goniometer may be less appropriate for using. There are many smart phone applications including Clinometer are available to measure joint range of motion and is easy to use in some aspect compared to goniometer. Our aim was to compare the result of smart phone clinometer with gold standard goniometer for measuring shoulder rotational ranges in patients with frozen shoulder. The mean and standard deviation of the range of internal rotation measured by goniometer and clinometer was 42.4°±10.90° and 42.36°±11.38°, respect...

Introduction: Currently no any standard medical, surgical, or therapy regimen is universally accepted as the most efficacious treatment for restoring motion in patients with shoulder adhesive capsulitis. Present study was planned to check the short term effectiveness of anterior and posterior Kaltenborne joint mobilization techniques for improving shoulder external rotation range of motion in patients with shoulder adhesive capsulitis. Methodology: Total of 40 patients diagnosed with shoulder adhesive capsulitis were recruited and randomly allocated into two groups. In Group A (n= 20) subjects were treated with Therapeutic ultrasound (8mins,2w/cm2 ,3Mhz),Kalternborn anterior mobilization techniques ,Stretching exercises and strengthening exercises for roatator cuff using theratubes, whereas subjects in Group B (n= 20) received Therapeutic ultrasound (8mins,2w/cm2 ,3Mhz),Kalternborn posterior mobilization techniques ,Stretching exercises and strengthening exercises for roatator cuff ...

Background: Effectiveness of any individualized therapeutic modality in reducing pain in frozen shoulder is questionable and the combination of therapies has contradictory results. Objectives: The purpose of this study was to check the effectiveness between the treatment modalities of Ultrasound therapy and End range mobilization over Cryotherapy and Stretching as a treatment program in alleviating pain of patients with frozen shoulder. Methods: Forty subjects diagnosed to have frozen shoulder were randomly assigned to two groups. Subjects in Group I received Ultrasound therapy and End range mobilization of shoulder while subjects in Group II got Cryotherapy and Stretching of shoulder. Both the groups were treated for 6 days a week for 4 weeks. Response to pain was considered as the outcome measure. Results: Statistical analysis was done considering p&lt;0.05 as statistically significant and the„t‟ value were estimated. It was found that ultrasound therapy when combined with end ran...

Background and Objective. Frozen shoulder syndrome (FSS) causes pain and restriction of movement in the shoulder. The aim was to assess changes in shoulder muscle isometric maximal voluntary contraction (MVC) force and active range of motion (AROM) in patients with frozen shoulder syndrome (FSS) after manipulation under general anesthesia (MUA). Material and Methods. In total, 18 patients with FSS (9 women and 9 men) with a mean age of 53.6 years (SD, 9.7) participated in this study. MVC force of shoulder flexors, adductors, and internal and external rotators was measured by a handheld dynamometer. AROM in the same directions was measured goniometrically. The patients were screened according to the intensity of pain by day and at night. The data were collected before MUA and 1 and 6 months after MUA. A significant reduction in MVC force and AROM was noted before MUA in the involved extremity as compared with the uninvolved extremity (P&lt;0.05). These parameters for the involved ext...