The Shoulder

Help - Treatment

ARTHRITIS: CAPSULAR STRETCHINGS

The capsular stretchings show no result

Expected result

A subjective improvement occurs after about five sessions. An objective improvement (increase of the ROM) should occur after five to ten sessions. If this is not the case by then, further capsular stretchings should be abandoned

Correct diagnosis?

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

The indication for capsular stretchings of the shoulder is a traumatic arthritis or an immobilization arthritis in stage I or II (with absence of a spastic end-feel). In the case of nocturnal pain there is little chance for success.
Capsular stretchings carried out too softly

If there is too little pressure, no result will be attained. However, too much stretching will result in an increase of the inflammation and the pain. The intensity of the stretching should be such that after each session some after-pain is felt, which nevertheless should not last more than 2 hours. Thus the message is to start carefully and increase progressively.
Right sequence

Stretchings are done three times a week, for about 15-20 minutes each. An improvement may be expected after some six sessions (two weeks). The treatment is continued until the pain has disappeared and the mobility has become completely normal again(usually after about twenty sessions)
No change with capsular stretching

If there is no objective improvement after five to ten sessions, then, any further capsular stretching must be given up.