A patient presents with adhesive capsulitis of the shoulder joint. The ROM examination reveals restricted external rotation and abduction of the shoulder. The FIRST mobilization procedure that should be done for this patient is:

A patient presents with adhesive capsulitis of the shoulder joint. The ROM examination reveals restricted external rotation and abduction of the shoulder. The FIRST mobilization procedure that should be done for this patient is:

• A. Posterior glide
• B. Distraction
• C. Anterior glide
• D. External rotation

Answer: (B)

Adhesive capsulitis creates a tight, inflamed glenohumeral joint where the capsule limits movement, with external rotation and abduction most restricted. The safest first mobilization is gentle joint distraction, which separates the joint surfaces, reduces compressive forces, and helps decrease pain and muscle guarding. This creates a more favorable environment for subsequent ROM gains. After the joint is unloaded and pain is better controlled, you can progress to targeted glides (for example, a posterior glide to improve external rotation and an inferior glide to assist abduction). Starting with distraction avoids stressing a guarded joint and sets the stage for effective later ROM work.

Adhesive capsulitis creates a tight, inflamed glenohumeral joint where the capsule limits movement, with external rotation and abduction most restricted. The safest first mobilization is gentle joint distraction, which separates the joint surfaces, reduces compressive forces, and helps decrease pain and muscle guarding. This creates a more favorable environment for subsequent ROM gains. After the joint is unloaded and pain is better controlled, you can progress to targeted glides (for example, a posterior glide to improve external rotation and an inferior glide to assist abduction). Starting with distraction avoids stressing a guarded joint and sets the stage for effective later ROM work.