A new treatment for frozen shoulder
A recent study on treatment for frozen shoulder is showing promise for proprioceptive neuromuscular facilitation (PNF).
What is frozen shoulder and how is it treated?
Frozen shoulder, or adhesive capsulitis, causes structural changes in the glenohumeral joint. Specifically, the coracohumeral ligament and the capsular wall thickens, severely limiting active abduction. Passive movement is possible but painful, especially though the middle of abduction, between about 40 and 70 degrees of movement.
It's very difficult to treat this condition with conventional medicine. It typically gets better on its own in about a year, so a referral to physical therapy is often the extent of care by the physician.
But a new study reported in BMC Musculoskeletal Disorders has shown that PNF outperforms manual therapy in helping patients improve range of motion and decrease pain.
When treating patients who present with these symptoms, these techniques can be helpful:
What is PNF?
To put it simply, PNF is a progressive application of contract-relax movements with the affected joint.
In the study, 48 patients with frozen shoulder were divided into two groups. One group received manual therapy and the other PNF. The PNF techniques included active, passive, and rhythmic movements. Resistance was applied both using continuous resistance through active movements and contract-relax in static positions through active and passive movements. Actions included extension, flexion, abduction, retraction, and internal and external rotation. Traction of the shoulder was also passively applied.
Self-care included active range of motion in all the same actions: flexion, extension, abduction, retraction, and internal and external rotation.
MRI images were taken before and after the study as well as pain measurements using a visual analog scale and range of motion measurements.
In the group receiving PNF, MRI images showed changes in the thickness of both the coracohumeral ligament and the capsular wall. Pain and range of motion were also significantly better than for the manual therapy group.
The study gives us good indications on a treatment plan: Active, passive and rhythmic movement with resistance and self-care.
Getting trained in PNF and marketing your skills to medical professionals could be a great way to get referrals.