ADDITIONAL EFFECT OF MYOFASCIAL RELEASE OF SHOULDER INTERNAL ROTATORS ON PAIN, RANGE, DISABILITY AND ELECTROMYOGRAPHY IN FROZEN SHOULDER

A. Aggarwal¹, M. Rathi¹

¹Dr. D. Y. Patil Vidyapeeth, Dr. D. Y. Patil College of Physiotherapy, Pune, India

Background: Frozen shoulder is characterized by pain, stiffness, and restricted functioning of the glenohumeral joint. Though capsular involvement is regarded as causative pathology, recent studies have shown muscle tightness, fascial restrictions, and trigger points can play an important role in its causation. Also, the glenohumeral capsule is strongly reinforced by the rotator cuff tendons, their role cannot be undervalued.

Purpose: This study was undertaken to find the role of contractile tissue in causation and maintaining the chronicity of the condition. This can happen out of guarding or body response to prevent pain in activities of daily living. As the capsular pattern has a major component that begins with external rotation followed by abduction and internal rotation, this study was undertaken to see if there is any additional effect of shoulder internal rotators myofascial release on improving pain, ranges, disability, and electromyography in these patients.

Methods: After the institutional ethical committee approval (DYPV/EC/391/2019), 56 frozen shoulder subjects with mean age 53.9 ± 7.09 were randomly allocated into Group A (Myofascial release and conventional treatment) and Group B (Conventional treatment). Treatment was given for 10 sessions, 5 sessions per week for 2 weeks. Subjects were evaluated at baseline and post 10th session. Outcome measures were the Numerical pain rating scale, Shoulder range of motion, Disabilities of arm, shoulder, and hand, and EMG Amplitude for pectoralis major and anterior deltoid.

Results: There was a statistically significant reduction in pain and disability along with improvement in shoulder range of motion in both groups with statistically more significant results in the experimental(Group A) group except for shoulder extension. Also, there was a significant decrease in pectoralis major muscle activity between-group comparisons.

Conclusions: The addition of shoulder internal rotators myofascial release decreases pain, disability, and muscle activity along with improving ranges. Future studies with longer follow up can be done to see the carry-over effect. Also comparing myofascial release with other related techniques such as self or instrument-assisted tools can be studied.

Implications: Myofascial release helps to decrease muscle stiffness which lessens pain and improves the quality of life. This breaks the vicious cycle of pain and joint stiffness. Its inclusion along with conventional protocol at an earlier stage can help to prevent the progression of the condition.

Funding acknowledgements: Nil

Keywords:
Adhesive capsulitis
Myofascial stretching
Muscle stiffness

Topics:
Musculoskeletal: upper limb
Orthopaedics
Disability & rehabilitation

Did this work require ethics approval? Yes

Institution: Dr. D.Y. Patil College of Physiotherapy,Dr. D.Y. Pati Vidyapeeth,Pune

Committee: Dr. D.Y. Patil Vidyapeeth

Ethics number: DYPV/EC/391/2019