| Of all the remedies and solutions available for | | | | Physical therapy for a frozen shoulder is likewise |
| treating adhesive capsulitis, the two treatments | | | | best performed under the guidance of a therapist |
| that receive the most attention are the frozen | | | | with experience in this area. Just because a |
| shoulder manipulation and physical therapy. A | | | | therapist has a license doesn't mean they can |
| manipulation under anesthesia (MUA) conjures | | | | provide the best treatment plan. One is best |
| ideas of an instant cure while PT is viewed as the | | | | served to do a little investigation about a |
| longer route to a normal functioning shoulder. In | | | | therapist's credentials and experience before |
| either case, therapy is still part of the treatment - | | | | blindly following his or her lead. This is why you |
| or at least it better be. So the question often | | | | can see so many forum or blog posts on the |
| asked is that between the two procedures, | | | | internet by unhappy patients who have tried |
| "which is best?" The answer depends on an | | | | therapy with minimal to no results. The clinical |
| individual's circumstances and expectations. | | | | process is simple for a good outcome with |
| A frozen shoulder manipulation is typically | | | | physical therapy: 1) Pain/muscle spasm control, 2) |
| performed by an orthopedic physician. The patient | | | | Proper manual joint mobilization, 3) Home exercise |
| is prepped and given a general anesthesia. The | | | | prescription with correct frequency and intensity, |
| affected shoulder is then carried to its end point | | | | 4) measures for gain, and 5) appropriate follow-up. |
| of motion followed by a quick thrust into a normal | | | | If this process is followed by a clinician |
| range. This is hopefully done in each plane of | | | | experienced in the treatment of adhesive |
| motion: Forward elevation, abduction (out to the | | | | capsulitis the outcome will be good and only |
| side and overhead), external rotation (rotating the | | | | conservative measures need to be used. With this |
| arm/shoulder towards the patient's back), internal | | | | I must confess that in my opinion therapy is the |
| rotation (rotating the shoulder towards the front | | | | best solution overall. As i said before, in either |
| of the body), and across the body. Extension is | | | | case therapy will be needed as even in the case |
| rarely performed as this motion is not usually | | | | of an MUA the shoulder will quickly stiffen and |
| deficient with this condition. What is important to | | | | scar tissue will form, potentially causing a greater |
| achieve normal motion is to stabilize the scapulae | | | | dysfunction than before. |
| (shoulder blade) during each of these thrusts. If | | | | These days it is crucial that the patient take |
| not done in this manner, the shoulder may appear | | | | some of the responsibility for their care by doing |
| to be carried to full range of motion, but is | | | | their due diligence in regards to the treatments |
| actually not because the shoulder blade is simply | | | | that are recommended to them. Even though a |
| going along for the ride. This can lead to a poor | | | | frozen shoulder manipulation seems to be the |
| outcome with this treatment. With that said, a | | | | quicker cure, physical therapy in the long run can |
| frozen shoulder manipulation should be performed | | | | provide better and more lasting results if the |
| by a competent clinician with experience in this | | | | patient chooses their therapist wisely. |
| procedure. | | | | |