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Translating a Stuck Shoulder into One That Moves

When the shoulder gets stuck and just won't move properly, it's called a "frozen shoulder." The medical term for this condition is adhesive capsulitis. Treatment with drugs and exercise doesn't always work. In such cases the doctor may advise a joint manipulation under anesthesia.

This type of manipulation has some problems, though. There is a chance of damaging the soft tissues in and around the shoulder joint. A new way to do manipulation for adhesive capsulitis is proposed by the author of this study. The new method is called translational manipulation (TM).

This report carefully reviews both the old and the new methods. How, when, and why to do TM is covered in detail. Hand placement and forces involved in the treatment are also discussed.

The authors describe when and why to repeat the technique in some cases. Doctors performing this treatment are given key points to remember for a successful manipulation. A single case study involving a woman in a car accident is presented. Her case showed how TM can be used when other areas of the joint are also hurt. Unless it's done right, TM could cause more harm than good in such cases.

According to this report, TM is safe and effective. Its results are reproducible. This means another skilled manipulator can use this method with the same good results. The key to a successful manipulation without causing further damage to the soft tissues of the joint is to control the forces through the joint. When TM fails, the authors advise combining arthroscopic release with manipulation.

References: Jeffrey D. Placzek, MD, PT, et al. Theory and Technique of Translational Manipulation for Adhesive Capsulitis. In The American Journal of Orthopedics. April 2004. Vol. 33. No. 4. Pp. 173-179.

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