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    Adhesive Capsulitis

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    sirish413
    The patient, a 50-year-old female housewife, presented with a 3-4 month history of shoulder pain and limited range of motion, especially overhead. Examination revealed positive impingement tests and decreased shoulder mobility. She was diagnosed with rotator cuff tendinitis and prescribed a physical therapy regimen including ultrasound, stretching, strengthening exercises, and manual therapy techniques to reduce pain, improve range of motion, and return her to normal activities.

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    Adhesive Capsulitis

    Uploaded by

    sirish413
    18 views10 pages
    The patient, a 50-year-old female housewife, presented with a 3-4 month history of shoulder pain and limited range of motion, especially overhead. Examination revealed positive impingement tests and decreased shoulder mobility. She was diagnosed with rotator cuff tendinitis and prescribed a physical therapy regimen including ultrasound, stretching, strengthening exercises, and manual therapy techniques to reduce pain, improve range of motion, and return her to normal activities.

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    adhesive capsulitis (3)

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    The patient, a 50-year-old female housewife, presented with a 3-4 month history of shoulder pain and limited range of motion, especially overhead. Examination revealed positive impingement tests and decreased shoulder mobility. She was diagnosed with rotator cuff tendinitis and prescribed a physical therapy regimen including ultrasound, stretching, strengthening exercises, and manual therapy techniques to reduce pain, improve range of motion, and return her to normal activities.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    18 views10 pages

    Adhesive Capsulitis

    Uploaded by

    sirish413
    The patient, a 50-year-old female housewife, presented with a 3-4 month history of shoulder pain and limited range of motion, especially overhead. Examination revealed positive impingement tests and decreased shoulder mobility. She was diagnosed with rotator cuff tendinitis and prescribed a physical therapy regimen including ultrasound, stretching, strengthening exercises, and manual therapy techniques to reduce pain, improve range of motion, and return her to normal activities.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 10

    Name: rani

    Age 50 years

    Sex female

    -Occupation: housewife

    Date of examination: 30.1.2022

    Patient s complaint: inability to lift arm above head level and

    difficulty in activities like ,combing ,dressing,

    bathing etc due to shoulder paiń

    HISTORY

    Duration of symptoms: 3-4 months

    Onset of symptoms: insidious onset of pain and restriction of movements.

    PAIN

    Location: anterolateral arm and shoulder

    Quality: intermittent

    Intensity:6-7 on VAS

    Aggravating factors: Overhead actvities, touching back,

    Relieving factor: HWF

    MEDICAL HISTORY

    .Diabetes

    Hypertension

    HISTORY OF TRAUMA

    H/o fall or sudden jerk to the shoulder absent

    OBSERVATION

    POSTURE

    Cervical spine: no forward head posture

    Shoulder: Normal

    Scapula : Normal (not protracted or abducted)

    Thoracic spine: normal

    Lumbar : normal lordosis present

    Pelvis: no abnormal tit

    Scapulohumeral rhythm: excessive scapular movements during elevation


    in initial phase

    INSPECTION

    Skin

    Color normal, no signs of inflammation

    Scar not present

    Soft tissue inspection

    Swelling- not present

    Muscle contours- normal when compared with normal side.

    Gait inadequate arm swing

    Attitude of affected upper extremity- arm by the side

    End feel : firm


    SPECIAL TEST

    Apleys scratch test positive

    ROTATOR CUFF lesion/impingement/tendinitis

    Hawkins Kennedy test-

    speed test -

    Empty can test-

    False positive on day 1 because of pain and muscle spasm


    MANAGEMENT

    AIM

    1. Pain relief

    2. To gain range of motion

    3. muscle strengthening

    4. Maintain range of motion and muscle strength

    5. return to Functional activitise

    1. PAIN RELIEF

    Hot pack on left shoulder 10 min

    To relax muscles,pain relief and increase pliability of soft tissues.

    Pulsed ultrasound 0.8 W/cm2 to increase extensibility of joint

    capsulee

    .Night pain - cold pack for 15 min

    Exercise protocol

    Scapular PNF

    pattern

    for scapula stabilization

    And pain relief

    hold relax shoulder adductors


    shoulder extenders

    To relax and stretch adductors and extensors

    oscillations for pain relief

    DAY 3 &4

    Gental mobilization of shoulder

    Inferior glide

    Posterior glide

    Anterior glide

    4-5 glides

    hold relax stretching

    Strengthening in newly gained range.

    Manual resistance

    Rhythmic stabilization

    Dynamic reversals

    HOME EXERCISE PROTOCOL

    1. Codman's exercises

    2. Active assisted flexion

    3. Isometric shoulder external /internal rotation

    4. Active abduction/against wall


    5.

    Anterior Capsular stretching

    DAY 5 ONWARDS

    Mobilization of shoulder

    10 glides (inferior anterior posterior)

    Mobilization with movement for scapula in scaption plane and frontal plane

    strengthening (alternating isometrics)

    Hold relax .contract relax stretching

    Capsular stretching (anterior capsule,posterior capsule ,inferior capsule)

    Finger ladder for active assisted flexion and abduction


    Can Hold end position in newly gained range of motion

    . Night pain : before treatment 6-7

    After PT treatment 2

    Special test

    Empty can test- negative

    Speed test negative

    SPADI decreased from 58 % to 41%

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