Clinical Pearl: Positional Inhibition for Frozen Shoulder | Modern Manual Therapy Blog

Clinical Pearl: Positional Inhibition for Frozen Shoulder

We've all treated our fair share of frozen shoulders. While I do not have any sort of magical technique that will auto-magically improve their ROM, I do have a technique that will make ranging and mobilizing them much more comfortable on their end.

Stretching is all about perception and frozen shoulders, whether they are painful or not have a high amount of tone. Trying to mobilize or simply passively range the arm through high tone is like trying to quickly range a CVA or TBI with high tone quickly - it's not going to happen.

Positional Inhibition for Frozen Shoulder
  • The patient should be lying supine
  • you will be standing on their involved shoulder side, inferior to the shoulder
  • instead of "distracting" the glenohumeral joint in the typical, anterior, inferior and lateral direction, do the opposite
  • provide "compression" very lightly and slowly in a superior, medial, and posterior direction (medial being the biggest component of relief)
  • hold for 1-3 minutes, then try ranging or mobilizing them
  • the end feels that were previously hard should be quite a bit softer due to the inhibition of tone from the passive tissue slacking
  • bonus, try wrapping the proximal humerus with an EDGE Mobility Band to further modulate stretch and pain perception while mobilizing or the patient is self ranging, do it lightly to avoid paraesthesia!

Since a true frozen shoulder is what I would classify as a slow responder (at least in range, not necessarily in pain - that can be modulated rapidly), we can only make movement more comfortable, but cannot rush the new range. I have not tried TDN for these cases, but I hear it works well. Do you have any other ways to make frozen shoulders more comfortable for clinic and home self treatment? Chime in below or on the facebook page!

Keeping it Eclectic....


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