Is it Frozen Shoulder?

One of our patient comes with left shoulder pain and stiffness. He is having this problem 6 months back and he consulted many orthopaedicians and took lot of analgesics. Professionally he is a martial art tutor. The pain started gradually and decreased range of motion slowly. Now he has 110 degree of shoulder flexion and 100 degree abduction and 50% movement loss of rotations. All orthopaedicians diagnosed as frozen shoulder , but during the movement of his shoulder the restriction or end point feels rubbery or elastic end feel.

He came 4 days back in our clinic for physiotherapy services. On first day, our treatment protocol is same as that of frozen shoulder but we feel the end feel... so we changed the treatment protocol... we reassessed patient that find out trigger points over subscapularis, and tightness of latissmus dorsi muscles.

So we applied myofascial therapy, neuro muscular therapy and trigger point therapy for the particular muscle groups along with usual mobilization (mulligan techniques) and exercises... on third day there is 80% decrease in pain and 85% increase in range of motion...

Subscapularis is a rotator cuff muscle whose job is to stabilize the humeral head and seat it deeply into the glenoid fosa. It is the powerful medial rotator of the humerus. Problems over subscapularis produces loss of lateral rotation and abduction movement..that mimics the frozen shoulder syndrome.

A through knowledge about the muscles and their function is most useful when treating this type of disorders..where traditional physiotherapy fails..............

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