Uncommon Yet Helpful Treatment Techniques For Frozen Shoulder
If you're struggling with the stiffness, pain, and impracticality of a frozen shoulder (adhesive capsulitis), you'll know that finding relief is the priority. A 2023 clinical study put two uncommon physio techniques - Muscle Energy Technique (MET) and Kaltenborn mobilisation - head-to-head. Let's break down the specific results and what they may mean for your recovery.
The Study at a Glance
Objective: To directly compare the effectiveness of the Muscle Energy Technique (MET) and the Kaltenborn Mobilisation Technique (KMT) on range of motion, pain, and function in chronic frozen shoulder.
Participants: 32 adults with chronic "frozen stage" adhesive capsulitis (stiffness >3 months, significant loss of motion). Both groups received the same baseline care: moist heat, stretching, and pendulum exercises.
Intervention: One group received passive joint glides (KMT), the other received active, resisted contractions (MET), for 10 treatment sessions over two weeks.
How The Techniques Were Specifically Performed
Understanding the difference in application is key to understanding the results.
Kaltenborn Mobilisation (KMT)
The Approach: Passive, therapist-driven. The therapist applies graded glides and traction to the shoulder joint to stretch the capsule.
- Glenohumeral Traction: Gentle pulling to separate joint surfaces.
- Ventral & Caudal Glides: Specific gliding motions to restore accessory joint movement, held for 30 seconds each.
The patient remains relaxed while the therapist moves the joint.
Muscle Energy Technique (MET)
The Approach: Active, patient-involved. The therapist positions the shoulder at its restriction barrier. The patient then performs a gentle, submaximal contraction away from the barrier.
- For a stiff shoulder: A 10-second isometric contraction of the internal rotators to improve external rotation.
- After relaxing, the therapist gently moves the joint to a new, improved barrier. Repeated for 5 repetitions.
The patient is an active participant in unlocking their own stiffness.
The Head-to-Head Results: What Improved More?
Both groups improved, but the between-group comparison tells the crucial story.
| Outcome Measure | Kaltenborn (KMT) Result | Muscle Energy (MET) Result | Clinical Takeaway |
|---|---|---|---|
| Range of Motion (External Rotation & Abduction) | Significantly Improved | Significantly Improved | Statistically Equal. Both techniques were equally effective at restoring lost shoulder mobility. |
| Pain (Numeric Pain Rating Scale) | Significantly Reduced | Significantly Reduced More | MET was superior. The active MET approach led to greater pain reduction than passive mobilisation. |
| Function (SPADI Questionnaire) | Significantly Improved | Significantly Improved More | MET was superior. Greater pain relief and active involvement likely translated to better functional gains in daily tasks. |
A Physio's Analysis: Why Might MET Have an Edge?
This study aligns with a key principle in modern rehab: active strategies often outperform purely passive ones for lasting change. MET's superiority in pain and function could be due to:
- Neurological Inhibition: The gentle isometric contraction may help calm overactive pain signals and relax guarding muscles more effectively.
- Being actively involved helps retrain the brain's sense of the joint, improving movement confidence.
- Safety & Comfort: MET allows the patient to control the contraction force, which may feel safer and less provocative than a therapist-applied stretch on a very stiff, painful joint.
Study Limitations & Who This Applies To
It's important to interpret these findings within the study's context:
- Specific Population: Results apply to chronic "frozen stage" adhesive capsulitis. Different stages (like the very painful "freezing" stage) may benefit more/less than alternative approaches.
- Short-Term Focus: The study only measured outcomes immediately after 2 weeks of treatment. Long-term durability of results needs more research.
- Part of a Package: Both techniques were applied alongside heat and exercises. The findings support MET as a valuable component of a comprehensive treatment plan, not a standalone miracle.
Integrating This Into Your Rehab
As a physio, this research reinforces a patient-centred approach. For a chronic stiff shoulder:
- Don't Just Stretch It, Engage It: Incorporate active techniques like MET to reduce pain and build confidence alongside mobility work.
- Match the Tool to the Phase: In the very painful phase, gentle MET and pain-modifying strategies may take priority. In the stiff phase, a combination of MET and careful mobilization can be powerful.
- Function is the Ultimate Goal: The superior functional improvement with MET is a critical finding. Rehab must always connect to making daily life and meaningful activities easier.
Need Personalised Guidance?
If you'd like help trying to uncover the underlying cause of your pain or dysfunction, consider booking an online Telehealth consultation with Grant here!
