There is this patient that I just saw for the first time, complaining of left shoulder pain for the past 9 months. They had previously sought treatment from another physiotherapist, but found it ineffective. Currently, they are relying on exercises from YouTube, which provide only temporary relief, if any.
Upon assessment, the patient's shoulder range was limited to 120° flexion and 90° abduction, severely impacting daily activities. They experienced pain in the left front and rear deltoid muscles during shoulder external rotation, indicating significant dysfunction. Additionally, limited neck range and tension in the stomach region were observed during the assessment, suggesting a complex interplay of factors contributing to the shoulder pain.
Considering the clinical presentation, a diagnosis of "Frozen Shoulder" was made based on the symptoms. Treatment began with addressing the neck through muscle release, cervical joint mobilization, and Manual Lymphatic Drainage. These techniques aimed to alter the energy dynamics surrounding the neck and shoulder, promoting a shift from a rigid to a more fluid state, akin to melting ice.
Specific focus was placed on the ligaments surrounding the shoulder joint, including the Glenohumeral ligament, Coracohumeral ligament, and Coracoacromial ligament.
Refer the image (link below) for better understanding of the shoulder ligaments
https://images.app.goo.gl/8WoNnh2fkeWcewJi6
The goal was to release tension, reduce inflammation, and improve joint mobility. Joint mobilization techniques were cautiously employed to activate mechanoreceptors and alleviate pain, primarily using Grade 1 and 2 techniques to avoid exacerbating discomfort.
Remarkably, the patient demonstrated significant improvement post-treatment, with shoulder flexion range increasing to almost 160° to 170° from the initial 120°. They reported noticeable relief and a marked difference in shoulder function immediately after the session. °
Despite these promising results, ongoing assessment and monitoring are essential to gauge the long-term effectiveness of treatment and determine the prognosis. The next session will provide valuable insights into the patient's progress and guide future interventions.
Stay tuned for the next blog update to follow this case and learn more about the patient's journey towards recovery!