Restoration of Normal Length of Upper Trapezius and Levator Scapulae in Subjects with Adhesive Capsulitis

Study Design: Prospective clinical trial of subjects with Adhesive Capsulitis

Objective: To find the effect of restoration of length of the shortened upper trapezius and levator scapula muscle with muscle energy technique and sustained passive stretching techniques along with Maitland joint mobilization for glenohumeral joint as compared to Maitland joint mobilization alone on range of motion and scapular position at rest in subjects with unilateral adhesive capsulitis.

Background: The glenohumeral hypomobility in adhesive capsulitis causes excessive scapular motion to compensate for the reduced gleno-humeral motion. The resulting tightness of upper trapezius and levator scapula causes an altered scapular position at rest. Restoring normal length of upper trapezius and levator scapulae will help to restore an optimal length-tension relationship and scapular position resulting in better improvement of glenohumeral range of motion.

Methods and measures: 60 male subjects with unilateral adhesive capsulitis were divided into group I and group II of 30 each. Baseline outcome measures assessed were shoulder ROM of flexion, abduction and external rotation and resting position of the scapula using the Lennie test. Group I received Muscle Energy Technique (MET) for upper trapezius and levator scapula along with Maitland joint mobilization for the glenohumeral joint. Group II received Maitland mobilization for the gleno-humeral joint. Outcomes were reassessed at 6 weeks.

Results: The results showed statistically significant improvement ROM in both groups with improvement being more in group I as compared to group II. However scapular position showed statistically significantly improvement only in group I with no improvement in group II.

Conclusion: Adding muscle energy techniques to the treatment of adhesive capsulitis gives better outcomes compared to treating with joint mobilization alone.