| Of all the treatment options available for a stiff | | | | other factors which prevent a manipulation from |
| arm, a frozen shoulder manipulation is the one | | | | the the best course of action. For instance, if the |
| that is feared the most by patients with this | | | | patient has a history of osteoporosis, there is an |
| condition. As a clinician I'm often asked if this will | | | | increased risk of sustaining a fracture as the arm |
| cure the symptoms, to which I quickly reply "It | | | | is carried through various ranges of motion. Also, |
| depends". The consensus among most medical | | | | because of the sudden high velocity stretching, |
| professionals is that aside from surgery, a | | | | there is a small risk of developing a brachial plexus |
| manipulation should be one of the last courses of | | | | injury, which is basically an injury to the nerves |
| action. | | | | that pass through the shoulder. Even rotator cuff |
| To begin with, even though it is a closed | | | | tears have been documented after a procedure |
| procedure (non-surgical), a manipulation under | | | | such as this. A skilled orthopedic physician |
| anesthesia is traumatic to the shoulder's joint | | | | specializing in disorders of the upper extremity |
| capsule and soft tissue structures in and around | | | | can determine a patient's risk for the above. |
| the shoulder complex. In theory the clinician is | | | | After the procedure is performed physical |
| trying to break loose adhesions that have formed | | | | therapy must be initiated immediately, as soon as |
| around the capsule, thereby freeing up motion in | | | | day one after the manipulation in order to |
| the shoulder. What happens in some cases though | | | | maintain any motion that was restored. Ideally the |
| is actual tearing of the capsule itself. Motion is | | | | patient should attend PT daily for the first week |
| restored, but as the body begins to repair the | | | | to control swelling and prevent further loss of |
| area it lays down more scar tissue which can | | | | motion. |
| potentially cause more loss of motion and pain. | | | | As one can see, a frozen shoulder manipulation is |
| This means the patient must undergo additional | | | | a serious consideration and should be done only |
| physical therapy to prevent further loss of | | | | after conservative measures fail. Adhesive |
| motion. | | | | capsulitis treatment requires persistence, patience, |
| When considering to undergo this type of | | | | and dedication to achieve full and productive range |
| treatment the patient must also account for | | | | of motion and function. |