This document outlines a 3-phase treatment approach for adhesive capsulitis. Phase 1 focuses on pain control, maintaining mobility, and education. Treatments include heat, range of motion, and soft tissue work. Phase 2 adds controlled stretching and strengthening. Phase 3 emphasizes increased flexibility, strength, and a return to normal function through self-care exercises. The goal is to progressively reduce pain and regain full, pain-free movement of the shoulder joint.

1. Different PT approach
in adhessive capsulitis
Mohammad akeel
(B.P.Th 4th year)

2. Phase-1=protection phase
Goal;
control pain & muscle guarding,maintain joint integrity & mobility,maintain
function of associated region
Mx;
• Hot pack=20 mint/2 session
• Codman’s ex=10R/2 session;flex/ext/add/abd (pain free range)
• STM=cervical & periscapular muscle
• ROM ex=elbow/forearm/wrist/fingers;several times a day

3. Pt education/home advise-
• Hot water fermentation
• Pendular ex
• Rom ex=above & below the joint
• Avoid sleeping on affected side

4. Phase-2=controlled motion phase
Goal;
• Control pain & spasm,progressively inc joint & soft tissue mobility
Mx;
• Hot pack
• Assisted ROM ex=wand ex; using cane or t-bar=5R/2 set/2 session
• Gear shift ex=5R/2 set/2 session
• Sholder wheel=10R; clockwise& anticlockwise
• Finger ladder=5R/2 session;flex/abd

5. • Wand ex-

6. • Gear shift ex-

8. • Pulley ex
• Passive joint mobilization=G3 sustained(7 sec) or G 3&4 oscillation(60
sec)
• manual stretching=PNF stretching;30 sec hold/3R/2 session
• MWM=improve joint tracking
• strenthening
• Protected wt bearing= hold 10sec/5R/2set/2 session

9. • Pulley ex-

10. • Passive shoulder joint mobilization-

11. • MWM-

12. • Pectorals stretch

13. • Wt. bearing-

14. Pt education/hme advise-
• Hot pack
• Pendular ex; more vigrous
• Gear shift ex
• Wand ex
• Self stretching
• Self mobilization
• strengthening

15.  Self pectoral stretch-

16. • Self mobilization-

17. Phase-3=return to function phase
• Goal;
• Progressively increase flexibility & strength,pliometrics (if need)
• Mx;
• Self stretching
• Self strengthening
• Capsular stretching

18. • Inferior Capsular stretching-

19. Pt education/home advise-
• Hot pack=before ex
• Icing=after ex
• Streching=hyperactive muscles=pectorals
• Strengthening=hypoactive muscles=scapular stablizar muscles
• Self capsular stretch

20. • Self cap stretching-

21. Reference-
• Therapeutic exercise_colby kisner 6th edition
• Essentials of orthopedics for PT_john ebnezar rakesh john 3rd edition

22. thank you