Frozen shoulder is an all-too-common musculoskeletal ailment that can cause a significant amount of pain. Besides its painful presence, it can cause very limiting range of motion restrictions in the shoulder.

This painful condition, furthermore, can and will lead to abnormal mechanics within the shoulder complex. This can include the shoulder joint itself (i.e. glenohumeral joint), the shoulder blade (i.e. scapula), the joint connecting the collar bone and shoulder blade (i.e. acromioclavicular joint), and more.

It will also lead to problems in the soft tissues themselves, such as the muscles. This can involve muscle spasms, trigger points, etc.

There are a lot of opinions and research out there regarding the best treatment methods for a frozen shoulder. This post is going to focus on a particle research article entitled: The effect of muscle-biased manual therapy on shoulder kinematics, muscle performance, functional impairment, and pain in patients with frozen shoulder.

Sometimes research articles can be a little difficult to understand and interpret. We want to help with that!

So, we’re going to key in on this article describing the comparison between including or excluding muscle-biased manual therapy techniques in the treatment of frozen shoulder.

Let’s break things down!

Purpose of the Research Article

This article is specifically comparing the effects of muscle-biased manual therapy techniques versus other treatment methods and manual therapy commonly used to treat frozen shoulder.

Manual therapy is a broad way of saying hands-on techniques performed by a trained healthcare provider, such as a physical or occupational therapist. Manual therapy can include superficial or deep techniques and can focus on improving movement of the joints or soft tissues, such as the muscles.

Manual therapy to the joints, called joint mobilizations, are a common go-to in the rehab world to assist in treating frozen shoulder. These techniques are helpful and effective (otherwise, they wouldn’t be utilized); however, this article was aiming to determine if muscle-biased manual therapy was more effective vs regular, more traditional therapy, which included a greater focus on joint mobilizations and other common forms of rehab for frozen shoulder.

What Happened During the Study

This article describes a 6-8-week program, involving 12 therapy visits. During this time, two groups of 17 individuals were enlisted from two separate hospital groups. These patients had been official diagnosed with frozen shoulder in one shoulder and met the criteria to participate in the study.

One group was assigned to receive muscle-biased manual therapy, while the other was assigned to receive regular, more traditional physical therapy.

The muscle-biased manual therapy interventions involved using hot packs and manual therapy to specific muscle groups, such as the pecs, rotator cuff, upper trapezius, etc.

In this study, the regular physical therapy group specifically utilized hot packs, a modality called interferential current therapy (similar to a TENS unit), and deep joint mobilizations.

Various objective tests were utilized to assess the following:

• Shoulder blade mechanics and muscle initiation during functional activities

• Pain levels

• Shoulder range of motion

• Specific shoulder blade, or scapular, special testing

• Effects on functional tasks

Let’s see what happened!

End Results

In a nutshell, improvements were observed in both groups of participants, particularly with pain and functional tasks.

Here’s where the muscle-biased manual therapy group excelled though:

• Greater improvement in measurements for shoulder blade motions and range of motion

• Increased activation of the lower trapezius muscle

• Increased shoulder abduction (i.e. moving the arm away from the midline of the body)

• Increased functional shoulder internal rotation (i.e. reaching the thumb to the waist behind the back).

Another difference to note is that while both groups helped to improve range of motion, this progress seemed to be noticed in the earlier weeks of treatment in the muscle-biased manual therapy group. Now, this doesn’t mean that the joint mobilizations in the other group weren’t effective, just not as efficient as the muscle-biased group.

Key Takeaways

When it comes to management of frozen shoulder, there are many possible treatment approaches to consider.

A combination of manual therapy techniques, modalities, and exercise are common treatment approaches used in a rehab setting.

This article was able to show some increased benefits and superiority of muscle-biased manual therapy techniques for optimal recovery. We don’t want you to think this means to neglect other forms of manual therapy, but simply that muscle-biased techniques should be highly considered and included in treatment of frozen shoulder.

Be sure to take a closer look at the research article below!

Reference:

1.   Tang CK, Shih YF, Lee CS. The effect of muscle-biased manual therapy on shoulder kinematics, muscle performance, functional impairment, and pain in patients with frozen shoulder. Journal of Hand Therapy. Published online June 2024. doi:https://doi.org/10.1016/j.jht.2024.02.010.