How many points did he average per game that NBA season?

1. How many points did he average per game that NBA season?

2. Flexibility

3. Who is he?

4. Adhesive Capsulitis

5. What is it?

6. Adhesive Capsulitis • Painful restricted ROM • Early loss of ER • Normal x-rays • Occurs in middle-age –aged females greater than males

8. What is the etiology?

9. Adhesive Capsulitis • Usually idiopathic • Associated with diabetes mellitus, inflammatory arthritis, trauma, prolong immobilization, thyroid disease , stroke, myocardia infarction, or autoimmune disease • May also occur secondary to rotator cuff disease

12. Name the three stages ?

13. Stage one • First 1 to 3 months • Pain with little motion loss initially

14. Stage 2 • Months 3 – 9 with reduce pain but increase loss of motion particularly ER

15. Stage 3 • Months 9 to 15 with gradual improvement of loss of ROM

16. Adhesive Capsulitis • X-rays normal • Arthrogram shows a reduce in capsule volume • Pathology thought to be due to inflammation in the rotator cuff greater than global capsule, causing capsule tightening

17. Adhesive Capsulitis • Stages one and two use modalities, analgesics and NSAD and glenohumeral joint injections to reduce inflammation and pain • Facilitate rehabilitation and shorten the duration of the condition. • Avoid aggressive exercise because this will exacerbate the condition

18. Codman’s Exercise

19. Passive relax ROM

20. Spencer’s

21. Spencer technique • The Spencer technique is a standardized series of shoulder treatments with broad application in diagnosis, treatment, and prognosis. • The evolution of this technique is traced from 1916 to date to try to identify factors in the development of manipulative methods.

22. Spencer technique • Twenty-nine elderly patients with preexisting shoulder problems voluntarily enrolled as subjects in this study, which was undertaken to determine the efficacy of osteopathic manipulative treatment (OMT) in an elderly population to increase functional independence, increase range of motion (ROM) of the shoulder, and decrease pain associated with common shoulder problems. • Each subject had chronic pain, decreased ROM, and/or decreased functional ability in the shoulder before entering the study. • Subjects were randomly assigned to either a treatment (OMT) group or a control group for 14 weeks. • Over the course of treatment, both groups had significantly increased ROM (P < .01) and decreased perceived pain (P < .01). • All subjects continued on their preexisting course of therapy for any concurrent medical problems. • After treatment, those subjects who had received OMT demonstrated continued improvement in their ROM, while ROM in the placebo group decrease

26. Adhesive Capsulitis • Generally near normal function over a 12 – 14 month period. • Patient not improve after 4 to 6 months may benefit from manipulation under anesthesia or arthroscopic lysis of adhesions