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Similaire à Frozen Shoulder ( Adhesive Capsulitis )
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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
- 18. PT MANAGMENT 18
- 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
- 20. PT MANAGMENT 20
- 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
- 22. PT MANAGMENT 22
- 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
- 27. ANY QUESTION?
- 28. 28
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