The Shoulder

ARTHRITIS : CAPSULAR STRETCHING

The capsular stretching shows a deterioration

Correct diagnosis?

Check whether a capsular pattern is indeed present.
Correct indication ?

The indication for capsular stretching of the shoulder is a traumatic artritis or an immobilisational arthritis in stage I and II (in the absence of a spastic endfeel). With all other forms of artritis, capsular stretching may worsen the situation. Also when nocturnal pain is present, there will usually be little chance for result.
No contra-indications ?

Every primary- inflammatory arthritis is a contra-indication for capsular stretching. In practise, this means each capsular pattern where no previous trauma or immibilization can be proven. Even so each mechanical arthritis with a degree of inflammation that is too pronounced (stage III or even stage II when a spastic endfeel is present).
Correct Technique
Correct Intensity

There is only moderate discomfort, no real increase of pain during the stretching. Too much stretching will result in an increase of the inflammation and the pain.

The intensity of the stretching needs to be such that some after-pain is present after each session.However, this after-pain should not exceed 2 hours.

The message, therefore, is to start building carefully and progressively.