Hi,

well i feel that current research does not support the use of physiotherapy for the Wikipedia reference-linkfrozen shoulder, that is Maitlands mobilisation or manual therapy. But please ensure it is a frozen shoulder and all other possible reasons for reduced ROM have been exhaused, however the "gold standard" for diagnosing a frozen shoulder is via arthroscopic evaluation of the capsule.

exercise prescription is important as an atempt to reduce further adhesions and complications whilst giving the patient some self control of the symptoms. Again research is foggy due to various types of exercise and lack of monitoring complience. There is little evidence to support mobilisation, of the few studies, one was impingement and the other was end-stage at about 12 months. In theory it should work based on Maitlands claims but as yet no research to my knowledge that has proved this theory in the shoulder capsule.

The real treatment for frozen shoulder is an MUA, when time and physio have been exhausted, and it is here that physiotherapy plays its biggest role, that is post surgery.

Hydrodilation or capsular distention is as discribed above, and i know it has been used as a diagnostic tool where fluid capacity has found to be reduced from a "normal", however ethics wont allow injections into the good shoulder for comparison!

The best treatment for frozen shoulder is patient education, pain management and a home exercise programme for at least 6/12. If symptoms are same or worse then refer for an MUA, by the time they see the consultant, and theatre waiting times, they will have probably got better :\