how to minimize pain during Gliding/Mobilizations?

Can some1 tell me how to minimize pain during Gliding/Mobilizations? for example, a received a patient with frozen shoulder. When i tried to mobilize it through glides, the patient was un willing for mobilization due to severe pain. similar case in stiff knee, more precisely, post op stiff knee. the problem is same, when i tried glides, patient asked me to stop due to severe pain. it is important to mention that intensity or power applied for moblizing was low. Kindly guide me how can i minimize pain during procedure. thank u,

Hi Kaleem

In regards to the frozen shoulder, the shoulder may be in the freezing or frozen stage. In these stages i do not recommend mobilisations as they do not seem to help and only cause more pain and may even flare up the problem.

In general you may try soft tissue release and some heat therapy prior to mobilsations. This allows the joint to free up meaning the glides may become easier and easier for the patient to tolerate. I have some friends who us IF/TENS for 10 minutes prior to mobilisations.
Also when the patient complains of pain when mobilising, try altering the direction of your force and ask the patient how that feels.

good luck

Quote:

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Originally Posted by johnwarda

Hi Kaleem

In regards to the frozen shoulder, the shoulder may be in the freezing or frozen stage. In these stages i do not recommend mobilisations as they do not seem to help and only cause more pain and may even flare up the problem.

In general you may try soft tissue release and some heat therapy prior to mobilsations. This allows the joint to free up meaning the glides may become easier and easier for the patient to tolerate. I have some friends who us IF/TENS for 10 minutes prior to mobilisations.
Also when the patient complains of pain when mobilising, try altering the direction of your force and ask the patient how that feels.

good luck

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Can mobilization be done while TENS applied? suppose before knee posterior glide, i apply TENS and then try to mobilize. i'm a newly graduate and need to learn a lot..

Hi

I am a final year student of B.P.T(bachelor in Physiotherapy). As I treated many frozen shoulder patients, so I will suggest to apply host pack first, then give traction.First start with the oscillatory movements in the available range with traction. Then go for glides. Correct traction force will give relief from pain to great extent.

Another thing which I really want to mention is that If a patient is having pain at night, then give cold pack instead of hot pack. It will really reduce the pain.

---------- Post added at 08:54 PM ---------- Previous post was at 08:52 PM ----------

Quote:

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Originally Posted by KiranC

Hi

I am a final year student of B.P.T(bachelor in Physiotherapy). As I treated many frozen shoulder patients, so I will suggest to apply host pack first, then give traction.First start with the oscillatory movements in the available range with traction. Then go for glides. Correct traction force will give relief from pain to great extent.

Another thing which I really want to mention is that If a patient is having pain at night, then give cold pack instead of hot pack. It will really reduce the pain.

---------- Post added at 08:54 PM ---------- Previous post was at 08:52 PM ----------

I don't think its a good idea Kaleem.

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thank u very much. i also need info about facial paralysis. i.e. when to advice patient exercises?

Can you please tell me the reason of facial paralysis?Are half side face muscles paralysed???Is it Bell's palsy? Whats the diagnosis?

it's bell's palsy. also tell about traumatic facial palsy e.g after ear surgery or after road side accident..