5 Joint Mobilisation Techniques To Relieve Frozen Shoulder

Frozen shoulder, clinically known as adhesive capsulitis, affects up to 5% of the general population and can drastically impact daily activities. This debilitating condition typically progresses through three distinct phases: freezing, frozen and thawing. While traditional treatment approaches often rely heavily on pain management and waiting out the natural course of the condition, specific joint mobilisation techniques have shown promising results in accelerating recovery and improving range of motion. Understanding these five evidence-based mobilisation techniques can provide practitioners and patients with effective strategies for addressing this challenging condition.

Glenohumeral Distraction Technique

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Glenohumeral distraction represents a fundamental joint mobilisation technique frequently employed in the treatment of frozen shoulder conditions. This therapeutic approach involves applying controlled distraction forces to the glenohumeral joint to enhance mobility and decrease pain associated with capsular restrictions.

The technique requires precise patient positioning, with the shoulder maintained at approximately 20 degrees of abduction, 20 degrees of horizontal adduction, and slight external rotation or neutral position. Accurate palpation of the greater and lesser tubercles of the proximal humerus guarantees ideal joint alignment during the procedure. The joint capsule can be effectively targeted through various directional forces, including posterior gliding, inferior glides, and multidirectional mobilisations.

For patients presenting with frozen shoulders, glenohumeral distraction techniques can be particularly beneficial in improving range of motion and reducing mechanical restrictions. The procedure is typically performed with the joint in its loose-packed position, allowing for maximum capsular stretch and enhanced therapeutic outcomes. The versatility of directional applications enables clinicians to target specific capsular restrictions based on individual patient presentations, making it an essential component in the thorough management of adhesive capsulitis and related shoulder pathologies. Similar to sacroiliac joint dysfunction, patients may experience clicking or popping sensations during the mobilisation procedure.

Caudal Glide Mobilisation

The caudal glide mobilisation technique serves as a critical intervention for addressing inferior capsular restrictions in patients with frozen shoulder conditions. This manual therapy approach specifically targets the inferior aspect of the shoulder joint capsule, facilitating improved shoulder abduction range of motion through sustained inferior glide of the humerus relative to the glenoid fossa.

The procedure is performed with precise positioning of the patient's shoulder joint in the loose pack position, approximately 20 degrees of abduction and external rotation. This positioning optimises the effectiveness of the inferior glide mobilisation while ensuring patient comfort and joint accessibility. During the technique, the therapist applies a controlled caudal force to create a sustained inferior translation of the humeral head, directly addressing capsular restrictions that limit normal glenohumeral arthrokinematics.

For patients presenting with frozen shoulder, this mobilisation technique is particularly beneficial when integrated into an extensive treatment approach. The caudal glide mobilisation, combined with both active and passive range of motion exercises, helps restore normal shoulder mobility by systematically addressing the inferior capsular restrictions that characteristically limit shoulder abduction in adhesive capsulitis cases. As part of a non-invasive approach, this technique aligns with chiropractic principles that focus on avoiding surgery and medications while promoting natural healing methods.

Posterior Joint Glides

While caudal mobilisations address inferior capsular restrictions, posterior joint glides offer a complementary approach for treating frozen shoulder by specifically targeting posterior capsular tightness. This technique involves the controlled mobilisation of the humeral head in a posterior direction, effectively lengthening the posterior capsule and facilitating improved shoulder mobility.

To perform posterior glides effectively, the patient is positioned with the glenohumeral joint in its loose-packed position, allowing for optimal joint mobilisation. The therapist applies sustained pressure to the humeral head in the posterior direction while maintaining proper joint alignment. This targeted approach helps restore normal arthrokinematics and improve shoulder flexion and abduction movements that are typically limited in frozen shoulder conditions.

The effectiveness of posterior glide mobilisations can be enhanced when integrated with other mobilisation techniques, particularly inferior glides. This exhaustive approach addresses multiple capsular restrictions simultaneously. Careful attention to proper positioning and technique guarantees isolated glenohumeral joint mobilisation, maximising the therapeutic benefit and helping patients progress toward full range of motion in their affected shoulder. Spinal adjustments techniques can complement shoulder mobilisation treatments by optimising overall nerve function and supporting natural healing processes.

Scapulothoracic Release

During frozen shoulder treatment, scapulothoracic release serves as a crucial complementary intervention that addresses restricted movement patterns between the scapula and thoracic wall. This technique specifically targets the restoration of normal biomechanical relationships between these structures, which often become compromised in patients with adhesive capsulitis.

The mobilisation procedure is typically performed with the patient positioned in side-lying, enabling optimal access for the practitioner to apply directed forces. Various techniques are implemented, including medial and lateral scapular glides, superior and inferior translations, and rotational movements to improve scapulothoracic mobility. These systematic mobilisations help normalise the gliding mechanics between the scapula and thoracic spine, which is essential for proper shoulder function.

When integrated with glenohumeral joint mobilisations, scapulothoracic release techniques can considerably enhance treatment outcomes for frozen shoulder patients. By addressing compensatory movement patterns and restricted scapular mobility, practitioners can facilitate improved range of motion at the glenohumeral joint. This complete approach recognises the interconnected nature of shoulder mechanics and guarantees that both primary and secondary movement dysfunctions are appropriately addressed during rehabilitation. Similar to ankle rehabilitation, practitioners typically recommend 3-12 treatment sessions based on the severity of the condition and individual patient needs.

External Rotation Progression

Progressing external rotation mobilisation requires a systematic approach that respects tissue tolerance and patient comfort levels. When initiating external rotation techniques, the physiotherapy practitioner should begin with gentle grade I and II mobilisations around the shoulder joint to promote pain relief and reduce protective muscle guarding.

As tissue compliance improves, practitioners can advance to grade III and IV mobilisations, focusing on end-range resistance points while monitoring the rotator cuff's response. The progression typically involves going from supported positions, such as supine with the arm at 30-45 degrees of abduction, to more challenging positions including seated and standing external rotation movements.

Each progression stage should incorporate oscillatory movements that gradually increase in amplitude and duration. Careful attention must be paid to scapular positioning and stabilisation throughout the movement sequence. When the patient demonstrates improved tolerance to manual therapy, self-mobilisation techniques can be introduced to complement in-clinic treatments. The end goal is to achieve functional external rotation range without compensatory movement patterns or excessive rotator cuff activation. Regular reassessment of capsular end-feel and pain responses guides the advancement through mobilisation grades. Integration with soft tissue therapy techniques can enhance treatment outcomes by addressing both joint mobility and muscle function simultaneously.

Conclusion

These five joint mobilisation techniques represent evidence-based interventions for addressing adhesive capsulitis. When applied systematically, these methods target specific anatomical restrictions within the glenohumeral complex and surrounding structures. The progressive nature of these mobilisations, from gentle distraction to more advanced external rotation techniques, provides clinicians with an extensive approach to restoring shoulder mobility and functional range of motion in patients with frozen shoulder.