Abstract
[Purpose] The object of this study was to examine the application and outcomes of exercise therapy based on clinical anatomy of the shoulder joint. [Subjects] The subjects were 20 men diagnosed as having frozen shoulder: mean age, 54.0 ± 3.3; 14 right and 6 left shoulders. [Method] After performing conventional exercise therapy, physical therapy based on clinical anatomy was performed. The treatment consisted of: 1) upper arm axis rotation utilizing the shoulder joint range of motion (ROM); 2) direct extension of the fifth and sixth heads of the muscle belly of the subscapular muscles; 3) application of light massage to the intersection of the teres minor muscle and the triceps brachii; and 4) application of light massage to the suprascapular vein. Treatments 1) to 4) were all applied in a random manner. According to the presence or absence of scapula immobility, shoulder joint flexion, abduction and internal and external rotation as well as The Japanese Orthopaedic Association (JOA) score, which assesses general shoulder function and pain, were assessed, and their values at the end of 4 weeks intervention were investigated with the t test. [Results] Significant increases in shoulder joint ROM, flexion, abduction, and internal and external rotation were found with both scapula mobility and immobility. The JOA score showed a significant increase from 15.0 ± 6.0 to 25.7 ± 3.0. [Conclusion] We consider that for conditions in which extension of the shoulder in the upward direction causes pain in the peripheral secondary shoulder joints or for decreases of ROM in the scapulohumeral joint, exercise therapy based on clinical anatomy should be tried before surgery as an effective measure of conservative treatment.
