SlideShare a Scribd company logo
1 of 28
1
GROUP MEMBERS
ADIL MUNIR
ZAIN-UL-ABIDEEN
—MAVLANA JALALUDDIN RUMI
2
Adhesive capsulitis, also
known as frozen
shoulder or periarthritis,
affects between 2% to 5
% of the adult population
and 10-20% of cases from
people suffering from
Insulin Dependent
Diabetes Mellitus
Blanchard, Barr & Cerisola
2010
Baums et al.
2007
Kisner 2002
Kivimaki & Pohjolainen 2001
3
SIGNS &
SYMPTOMS
4
SIGNS &
SYMPTOMS
5
SIGNS &
SYMPTOMS
6
RADIOGRAPHY
Example of Sub Coracoid Triangle sign in adhesive
capsulitis displayed on MR arthrography
!
PATHOLOGICAL
STAGES
9
PATHOLOGY
Stages of Adhesive Capsulitis
1 2 3 4
Reference : The basics you can find anywhere 5 Steps To Successful Storytelling Published on April 5, 2014 Featured in: Marketing & Advertising
10 10
STAGE 1
Loss of external rotation with intact rotator
cuff strength
Motion is limited in all directions and can’t
be restored with intra-articular injections.
STAGE 2
11
12
STAGE 3
LIMITATION
Significant adhesion and limited GH
motions, with substitute motions in
scapula.
Atrophy of muscles is noted
‘’FROZEN’’
(9-15 Months)
PAIN: only with motion / end
ROM
13
Progressive improvement in ROM, regaining
functional movements for daily activities
STAGE 4
GRAPHICAL RELATION OF
PAIN AND ROM
THOUGH ALL STAGES
1 - 4
PHYSICAL
THERAPY
MANAGMENT
GOAL OF THERAPY DURING THERAPY MODALITIES
- interrupt cycle of inflammation
and pain
- daily activity modification
- pain limited ROM
- patient education
• Postural training to discourage
thoracic kyphosis and a forward
humeral head position during
forward elevation.
• Gentle passive joint
mobilization and hydrotherapy
to stimulate joint
mechanoreceptors and decrease
nociceptive input (Owens-
Burkhart, 1991)
• TENS for pain management
• Cryotherapy to reduce
inflammation
PT
MANAGMENT
16
GOAL OF THERAPY DURING THERAPY MODALITIES
- decrease inflammation and
reduce pain
- minimize capsular restriction
- Activity modification to manage
painful activities
• Joint mobilizations and glides • Passive ROM
• Pendulum exercises
PT
MANAGMENT
17
PT
MANAGMENT
18
GOAL OF THERAPY DURING THERAPY ADDITIONAL HOME EXERCISES
- Minimize capsular adhesions and
restriction of movement
- Reducing pain and inflammation
• Passive joint glides for mobility
of capsule Shoulder through
abduction, adduction, flexion
and extension
• Proprioceptive neuromuscular
facilitation
• Soft tissue mobilization of the
subscapularis and pectoralis
minor
• Shoulder internal/external
rotation ROM scapula,
stretching and self mobilization
PT
MANAGMENT
19
PT
MANAGMENT
20
GOAL OF THERAPY DURING THERAPY MODALITIES
- Continue increasing ranges of
motion
- Retrain abnormal scapulohumeral
rhythm mechanics
- Restoration of full function
• Prolonged low-load stretching
with active warm up
• Mobilization with movement
(MWM) techniques to retrain
muscle function for proper
tracking of the humeral head
• Heat (promote relaxation of
musculature)
PT
MANAGMENT
21
PT
MANAGMENT
22
PHARMACUTICAL
&
SURGICAL
MANAGMENT
MANAGMENT
24
PHAMCUTICALS SURGICAL
• None-Steroidal Anti-Inflammatory Drugs
• Oral Steroids
• Subscapularis Nerve Blocks
• Intra-Articular Steroidal Injections
• Hydro dilatation
• Manipulation Under Anesthetics
• Arthroscopy
• Open Release Surgery
PATIENT
EDUCATION
PATIENT EDUCATION
?
ANY QUESTION?
28

More Related Content

What's hot

Plantar fasciitis
Plantar fasciitisPlantar fasciitis
Plantar fasciitismans4ani
 
Iliotibial Band Syndrome Inservice
Iliotibial Band Syndrome InserviceIliotibial Band Syndrome Inservice
Iliotibial Band Syndrome InserviceMegan Morris
 
Physiotherapy Management of the Rheumatoid Hand
Physiotherapy Management of the Rheumatoid HandPhysiotherapy Management of the Rheumatoid Hand
Physiotherapy Management of the Rheumatoid HandSayantika Dhar
 
Cervical spondylosis; Physiotherapy approach
Cervical spondylosis; Physiotherapy approachCervical spondylosis; Physiotherapy approach
Cervical spondylosis; Physiotherapy approachenweluntaobed
 
Limb length discrepency
Limb length discrepencyLimb length discrepency
Limb length discrepencyNaveed Jumani
 
Shoulder impingement syndrome
Shoulder impingement syndromeShoulder impingement syndrome
Shoulder impingement syndromeRatan Khuman
 
Iliotibial Band Syndrome (Itbs)
Iliotibial Band Syndrome (Itbs)Iliotibial Band Syndrome (Itbs)
Iliotibial Band Syndrome (Itbs)colinmasterson
 
Supraspinatus tendinitis 30may2013
Supraspinatus tendinitis 30may2013Supraspinatus tendinitis 30may2013
Supraspinatus tendinitis 30may2013Rahila Najihah
 
GOLFERS ELBOW AND PHYSIOTHERAPY MANAGEMENT
GOLFERS ELBOW AND PHYSIOTHERAPY MANAGEMENT GOLFERS ELBOW AND PHYSIOTHERAPY MANAGEMENT
GOLFERS ELBOW AND PHYSIOTHERAPY MANAGEMENT Shahid Uz Zafar
 
Periarthritis shoulder & painful arc
Periarthritis shoulder & painful arcPeriarthritis shoulder & painful arc
Periarthritis shoulder & painful arcDr venkatesh v
 
Anterior cruciate ligament-Injury & management
Anterior cruciate ligament-Injury & managementAnterior cruciate ligament-Injury & management
Anterior cruciate ligament-Injury & managementAnand Rao
 
Meniscal injury
Meniscal injuryMeniscal injury
Meniscal injurymanoj das
 

What's hot (20)

Plantar fasciitis
Plantar fasciitisPlantar fasciitis
Plantar fasciitis
 
Iliotibial Band Syndrome Inservice
Iliotibial Band Syndrome InserviceIliotibial Band Syndrome Inservice
Iliotibial Band Syndrome Inservice
 
Physiotherapy Management of the Rheumatoid Hand
Physiotherapy Management of the Rheumatoid HandPhysiotherapy Management of the Rheumatoid Hand
Physiotherapy Management of the Rheumatoid Hand
 
LUMBER CANAL STENOSIS ppt (5)
LUMBER CANAL STENOSIS ppt (5)LUMBER CANAL STENOSIS ppt (5)
LUMBER CANAL STENOSIS ppt (5)
 
Cervical spondylosis; Physiotherapy approach
Cervical spondylosis; Physiotherapy approachCervical spondylosis; Physiotherapy approach
Cervical spondylosis; Physiotherapy approach
 
Bicipital tendonitis
Bicipital tendonitisBicipital tendonitis
Bicipital tendonitis
 
Limb length discrepency
Limb length discrepencyLimb length discrepency
Limb length discrepency
 
Hip osteoarthritis
Hip osteoarthritisHip osteoarthritis
Hip osteoarthritis
 
Painful shoulder arc
Painful shoulder arcPainful shoulder arc
Painful shoulder arc
 
Shoulder impingement syndrome
Shoulder impingement syndromeShoulder impingement syndrome
Shoulder impingement syndrome
 
Tone
ToneTone
Tone
 
Iliotibial Band Syndrome (Itbs)
Iliotibial Band Syndrome (Itbs)Iliotibial Band Syndrome (Itbs)
Iliotibial Band Syndrome (Itbs)
 
Supraspinatus tendinitis 30may2013
Supraspinatus tendinitis 30may2013Supraspinatus tendinitis 30may2013
Supraspinatus tendinitis 30may2013
 
GOLFERS ELBOW AND PHYSIOTHERAPY MANAGEMENT
GOLFERS ELBOW AND PHYSIOTHERAPY MANAGEMENT GOLFERS ELBOW AND PHYSIOTHERAPY MANAGEMENT
GOLFERS ELBOW AND PHYSIOTHERAPY MANAGEMENT
 
Periarthritis shoulder & painful arc
Periarthritis shoulder & painful arcPeriarthritis shoulder & painful arc
Periarthritis shoulder & painful arc
 
Flat foot and Cavus foot
 Flat foot and Cavus foot Flat foot and Cavus foot
Flat foot and Cavus foot
 
Mallet finger
Mallet fingerMallet finger
Mallet finger
 
Anterior cruciate ligament-Injury & management
Anterior cruciate ligament-Injury & managementAnterior cruciate ligament-Injury & management
Anterior cruciate ligament-Injury & management
 
Tennis elbow(le)
Tennis elbow(le)Tennis elbow(le)
Tennis elbow(le)
 
Meniscal injury
Meniscal injuryMeniscal injury
Meniscal injury
 

Similar to Frozen Shoulder ( Adhesive Capsulitis )

Frozen shoulder ADHESIVE CAPSULITIS OF SHOULDER
Frozen shoulder ADHESIVE CAPSULITIS OF SHOULDERFrozen shoulder ADHESIVE CAPSULITIS OF SHOULDER
Frozen shoulder ADHESIVE CAPSULITIS OF SHOULDERDr Sushant S. Sonarkar
 
DEGENERATIVE DISC DISEASE 1.pptx
DEGENERATIVE DISC DISEASE 1.pptxDEGENERATIVE DISC DISEASE 1.pptx
DEGENERATIVE DISC DISEASE 1.pptxImran Hussain Kabir
 
DEGENERATIVE DISC DISEASE 1.pptx
DEGENERATIVE DISC DISEASE 1.pptxDEGENERATIVE DISC DISEASE 1.pptx
DEGENERATIVE DISC DISEASE 1.pptxImran Hussain Kabir
 
Osteoarthritis of Knee Joint by Dr. Aniruddha Barot (PT)
Osteoarthritis of Knee Joint by Dr. Aniruddha Barot (PT)Osteoarthritis of Knee Joint by Dr. Aniruddha Barot (PT)
Osteoarthritis of Knee Joint by Dr. Aniruddha Barot (PT)Dr.Aniruddha Barot (PT)
 
Frozen shoulder BY MIN^ED ACADEMY
Frozen shoulder BY MIN^ED ACADEMYFrozen shoulder BY MIN^ED ACADEMY
Frozen shoulder BY MIN^ED ACADEMYMINED ACADEMY
 
Subluxation and dislocation of temporo mandibular joint
Subluxation and dislocation of temporo mandibular jointSubluxation and dislocation of temporo mandibular joint
Subluxation and dislocation of temporo mandibular jointDr. Akshay Shah
 
Parkinson's Disease Rehabilitation.pptx
Parkinson's Disease Rehabilitation.pptxParkinson's Disease Rehabilitation.pptx
Parkinson's Disease Rehabilitation.pptxMamunul Abedin
 
Management of shoulder dysfunction in breast cancer
Management of shoulder dysfunction in breast cancerManagement of shoulder dysfunction in breast cancer
Management of shoulder dysfunction in breast cancerAakash jainth
 
癌症病人術後物理治療 賴忠駿
癌症病人術後物理治療 賴忠駿癌症病人術後物理治療 賴忠駿
癌症病人術後物理治療 賴忠駿Kit Leong
 
Management of thyroid eye disease
Management of thyroid eye diseaseManagement of thyroid eye disease
Management of thyroid eye diseaseSiva G
 
Lbp with radiculopathy
Lbp with radiculopathyLbp with radiculopathy
Lbp with radiculopathyNeurologyKota
 
Non Surgical Treatment of Strabismus
 Non Surgical Treatment of Strabismus Non Surgical Treatment of Strabismus
Non Surgical Treatment of StrabismusMeghna Verma
 
Painful arc syndrome
Painful arc syndromePainful arc syndrome
Painful arc syndromeorthoprince
 
Should I order an injection or let the specialist do it? – Part 1
Should I order an injection or let the specialist do it? – Part 1Should I order an injection or let the specialist do it? – Part 1
Should I order an injection or let the specialist do it? – Part 1SpinePlus
 
TEMPOROMANDIBULAR JOINT DISORDERS AND ITS PROSTHETIC MANAGEMENT (2) [Repaired...
TEMPOROMANDIBULAR JOINT DISORDERS AND ITS PROSTHETIC MANAGEMENT (2) [Repaired...TEMPOROMANDIBULAR JOINT DISORDERS AND ITS PROSTHETIC MANAGEMENT (2) [Repaired...
TEMPOROMANDIBULAR JOINT DISORDERS AND ITS PROSTHETIC MANAGEMENT (2) [Repaired...manjulikatyagi
 
Jose Austine- Shoulder instability
Jose Austine- Shoulder instability Jose Austine- Shoulder instability
Jose Austine- Shoulder instability Jose Austine
 

Similar to Frozen Shoulder ( Adhesive Capsulitis ) (20)

Frozen shoulder ADHESIVE CAPSULITIS OF SHOULDER
Frozen shoulder ADHESIVE CAPSULITIS OF SHOULDERFrozen shoulder ADHESIVE CAPSULITIS OF SHOULDER
Frozen shoulder ADHESIVE CAPSULITIS OF SHOULDER
 
DEGENERATIVE DISC DISEASE 1.pptx
DEGENERATIVE DISC DISEASE 1.pptxDEGENERATIVE DISC DISEASE 1.pptx
DEGENERATIVE DISC DISEASE 1.pptx
 
DEGENERATIVE DISC DISEASE 1.pptx
DEGENERATIVE DISC DISEASE 1.pptxDEGENERATIVE DISC DISEASE 1.pptx
DEGENERATIVE DISC DISEASE 1.pptx
 
Osteoarthritis of Knee Joint by Dr. Aniruddha Barot (PT)
Osteoarthritis of Knee Joint by Dr. Aniruddha Barot (PT)Osteoarthritis of Knee Joint by Dr. Aniruddha Barot (PT)
Osteoarthritis of Knee Joint by Dr. Aniruddha Barot (PT)
 
Frozen shoulder BY MIN^ED ACADEMY
Frozen shoulder BY MIN^ED ACADEMYFrozen shoulder BY MIN^ED ACADEMY
Frozen shoulder BY MIN^ED ACADEMY
 
Frozen Shoulder
Frozen Shoulder Frozen Shoulder
Frozen Shoulder
 
Subluxation and dislocation of temporo mandibular joint
Subluxation and dislocation of temporo mandibular jointSubluxation and dislocation of temporo mandibular joint
Subluxation and dislocation of temporo mandibular joint
 
Shoulder instability
Shoulder instabilityShoulder instability
Shoulder instability
 
Parkinson's Disease Rehabilitation.pptx
Parkinson's Disease Rehabilitation.pptxParkinson's Disease Rehabilitation.pptx
Parkinson's Disease Rehabilitation.pptx
 
Management of shoulder dysfunction in breast cancer
Management of shoulder dysfunction in breast cancerManagement of shoulder dysfunction in breast cancer
Management of shoulder dysfunction in breast cancer
 
Achilles tendinopathy
Achilles tendinopathyAchilles tendinopathy
Achilles tendinopathy
 
癌症病人術後物理治療 賴忠駿
癌症病人術後物理治療 賴忠駿癌症病人術後物理治療 賴忠駿
癌症病人術後物理治療 賴忠駿
 
Katigraha
KatigrahaKatigraha
Katigraha
 
Management of thyroid eye disease
Management of thyroid eye diseaseManagement of thyroid eye disease
Management of thyroid eye disease
 
Lbp with radiculopathy
Lbp with radiculopathyLbp with radiculopathy
Lbp with radiculopathy
 
Non Surgical Treatment of Strabismus
 Non Surgical Treatment of Strabismus Non Surgical Treatment of Strabismus
Non Surgical Treatment of Strabismus
 
Painful arc syndrome
Painful arc syndromePainful arc syndrome
Painful arc syndrome
 
Should I order an injection or let the specialist do it? – Part 1
Should I order an injection or let the specialist do it? – Part 1Should I order an injection or let the specialist do it? – Part 1
Should I order an injection or let the specialist do it? – Part 1
 
TEMPOROMANDIBULAR JOINT DISORDERS AND ITS PROSTHETIC MANAGEMENT (2) [Repaired...
TEMPOROMANDIBULAR JOINT DISORDERS AND ITS PROSTHETIC MANAGEMENT (2) [Repaired...TEMPOROMANDIBULAR JOINT DISORDERS AND ITS PROSTHETIC MANAGEMENT (2) [Repaired...
TEMPOROMANDIBULAR JOINT DISORDERS AND ITS PROSTHETIC MANAGEMENT (2) [Repaired...
 
Jose Austine- Shoulder instability
Jose Austine- Shoulder instability Jose Austine- Shoulder instability
Jose Austine- Shoulder instability
 

Recently uploaded

Physiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationPhysiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationMedicoseAcademics
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptxWINCY THIRUMURUGAN
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.whalesdesign
 
High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)kishan singh tomar
 
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfSGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfHongBiThi1
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxNaveenkumar267201
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionkrishnareddy157915
 
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfPAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfDolisha Warbi
 
Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Vaikunthan Rajaratnam
 
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfHongBiThi1
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectiondrhanifmohdali
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsMedicoseAcademics
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...Shubhanshu Gaurav
 
ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptPradnya Wadekar
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE Mamatha Lakka
 

Recently uploaded (20)

Physiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationPhysiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.
 
High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)
 
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfSGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung function
 
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfPAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
 
Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.
 
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissection
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functions
 
American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...
 
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
 
Biologic therapy ice breaking in rheumatology, Case based approach with appli...
Biologic therapy ice breaking in rheumatology, Case based approach with appli...Biologic therapy ice breaking in rheumatology, Case based approach with appli...
Biologic therapy ice breaking in rheumatology, Case based approach with appli...
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
 
ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologyppt
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE
 

Frozen Shoulder ( Adhesive Capsulitis )

  • 3. Adhesive capsulitis, also known as frozen shoulder or periarthritis, affects between 2% to 5 % of the adult population and 10-20% of cases from people suffering from Insulin Dependent Diabetes Mellitus Blanchard, Barr & Cerisola 2010 Baums et al. 2007 Kisner 2002 Kivimaki & Pohjolainen 2001 3
  • 7. RADIOGRAPHY Example of Sub Coracoid Triangle sign in adhesive capsulitis displayed on MR arthrography !
  • 9. 9 PATHOLOGY Stages of Adhesive Capsulitis 1 2 3 4 Reference : The basics you can find anywhere 5 Steps To Successful Storytelling Published on April 5, 2014 Featured in: Marketing & Advertising
  • 10. 10 10 STAGE 1 Loss of external rotation with intact rotator cuff strength
  • 11. Motion is limited in all directions and can’t be restored with intra-articular injections. STAGE 2 11
  • 12. 12 STAGE 3 LIMITATION Significant adhesion and limited GH motions, with substitute motions in scapula. Atrophy of muscles is noted ‘’FROZEN’’ (9-15 Months) PAIN: only with motion / end ROM
  • 13. 13 Progressive improvement in ROM, regaining functional movements for daily activities STAGE 4
  • 14. GRAPHICAL RELATION OF PAIN AND ROM THOUGH ALL STAGES 1 - 4
  • 16. GOAL OF THERAPY DURING THERAPY MODALITIES - interrupt cycle of inflammation and pain - daily activity modification - pain limited ROM - patient education • Postural training to discourage thoracic kyphosis and a forward humeral head position during forward elevation. • Gentle passive joint mobilization and hydrotherapy to stimulate joint mechanoreceptors and decrease nociceptive input (Owens- Burkhart, 1991) • TENS for pain management • Cryotherapy to reduce inflammation PT MANAGMENT 16
  • 17. GOAL OF THERAPY DURING THERAPY MODALITIES - decrease inflammation and reduce pain - minimize capsular restriction - Activity modification to manage painful activities • Joint mobilizations and glides • Passive ROM • Pendulum exercises PT MANAGMENT 17
  • 19. GOAL OF THERAPY DURING THERAPY ADDITIONAL HOME EXERCISES - Minimize capsular adhesions and restriction of movement - Reducing pain and inflammation • Passive joint glides for mobility of capsule Shoulder through abduction, adduction, flexion and extension • Proprioceptive neuromuscular facilitation • Soft tissue mobilization of the subscapularis and pectoralis minor • Shoulder internal/external rotation ROM scapula, stretching and self mobilization PT MANAGMENT 19
  • 21. GOAL OF THERAPY DURING THERAPY MODALITIES - Continue increasing ranges of motion - Retrain abnormal scapulohumeral rhythm mechanics - Restoration of full function • Prolonged low-load stretching with active warm up • Mobilization with movement (MWM) techniques to retrain muscle function for proper tracking of the humeral head • Heat (promote relaxation of musculature) PT MANAGMENT 21
  • 24. MANAGMENT 24 PHAMCUTICALS SURGICAL • None-Steroidal Anti-Inflammatory Drugs • Oral Steroids • Subscapularis Nerve Blocks • Intra-Articular Steroidal Injections • Hydro dilatation • Manipulation Under Anesthetics • Arthroscopy • Open Release Surgery
  • 28. 28

Editor's Notes

  1. To use this title animation slide with a new image simply 1) move the top semi-transparent shape to the side, 2) delete placeholder image, 3) click on the picture icon to add a new picture, 4) Move semi-transparent shape back to original position, 5) Update text on slide.
  2. Tip: When using complex image as full-bleed background add a transparency (70%-90%) fill layer to give contrast to text.
  3. To use this title animation slide with a new image simply 1) move the top semi-transparent shape to the side, 2) delete placeholder image, 3) click on the picture icon to add a new picture, 4) Move semi-transparent shape back to original position, 5) Update text on slide.