Increasing abduction range - supraspinatus tendinosis

[The Full Nelson]

My patient has been diagnosed with supraspinatus tendinosis via an ultrasound. He is about 40 years old, not overly active.

His active range of flexion, external rotation and hand-behind-back are all steadily improving with anti-inflammatories, passive mobilisation, soft tissue work, and assisted-active exercises. However, his abduction range is still poor (~45degrees, with marked shoulder hitching).

Does anyone have any tips for me to increase this range? Currently he is using a stick to assist his own abduction range, as well as sliding his hand up the wall to increase range.

Should he be pushing through pain? What mobs, specifically should I be using?

Thanks!

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[roycar]

how do.

how long has the pt had this problem?

hows the pts scapular mobility and strength of scapular stabilisers?
whats scapulohumeral rhythm like with active flexion?

is passive range of abduction limited as well as active?

if its stiffness thats limiting abduction i find maitland longitudinal mobs just before the point of max abduction tend to help if done properly. important to actually remember the orientation of the joint though when the arm is abducted and make sure its an inferior glide thats happening.