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..............
