Effect of MWM (Mulligan Technique) on Pa Shoulder

BACKGROUND:- This case study is to evaluate the effectiveness of Mulligan mobilization technique in Peri Arthritis shoulder.

CASE DESCRIPTION:- A 58 years old female homemaker experiencing difficulty in shoulder movement (Flexion, extension, abduction, adduction, external and internal rotations) from last 2 months. Her complaints are she is not able to perform daily personal activities like grooming, house hold works, etc due to movement restrictions including pain.

FINDINGS:- Assessment on 13/12/2022 revealed that her shoulder is anteriorly displaced which is called anteversion. Severe pain is present at anterior and superior part of shoulder which is 9/10 VAS during movement above restriction. VAS is 3/10 while touching.

ACTIVE ROM is Flexion 90 degrees, extension 5 degrees, abduction 90 degrees, external rotation 5 degrees.

PASSIVE ROM is Flexion 110 degrees, extension 10 degrees, abduction 100 degrees, external rotation 10 degrees.

SCALES USED- Numerical rating scale for pain measurement and Goniometry measurements for ROM

Discussion:- Peri arthritis shoulder means inflammation of shoulder joint due to calcium crystal deposits or degeneration of gleno-humeral articulating surfaces due to excess calcium in blood or calcium deficiency in bones. This can lead to joint stiffness, difficulty in smooth movements, severe pain, tenderness, joint displacements, etc.

ANTEVERSION Is anterior displacement of humerus over glenoid labrum due to which flexion, extension, abduction and external rotation movements will be limited because greater tubercle is being restricted by acromion process while performing ROM over 100 degrees angle. In most of the people joint will become stiff due to immobilisation and will be displaced due to muscle and joint structures weakness.

MWM (Mulligan mobilization technique):- Mulligan’s technique combines the sustained application of a manual “gliding” force to a joint, with the aim of repositioning bone positional faults while enabling concurrent physiological (osteo-kinematic) motion of the joint.

The patient was treated for 2 days with this technique and ROM of active Flexion is 110 degrees, Abduction is 115 degrees and External rotation is 10 degrees, which is an effective improvement with joint flexibility.

CONCLUSION Hence Mulligan technique works very effectively in P.A shoulder, Slap tear injuries, Labrum displacement injuries, etc to relocate the joint structure to normal.

REFERENCES:

Gokhan Doner et al. J Rehabil Med. 2013 Jan.

Topic- Evalution of Mulligan's technique for adhesive capsulitis of the shoulder.

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