Can a thoracic spine manipulation assist a patient with a diagnosis of adhesive capsulitis?
Answer
There have been a number of studies that have looked at thoracic manipulation and shoulder pathology. Most of what I have seen has been regarding impingement rather than adhesive capsulitis. That being said, I think that given the posture of these patients and most patients that we see with shoulder pathology, thoracic spine mobilization and/or manipulation, as long as the patient does not have any contraindications to the techniques, is very appropriate. Again, is it imparting change on the capsule itself? No. Is it changing them from one stage to another? No, but we know that there are concomitant changes with thoracic mobility with these shoulder patients. We know that there are changes in their posture. I think that it is an area that can be very helpful especially in the earlier stages, because we know that there is a pain mediation response with manipulation and we cannot be very aggressive with our direct shoulder glenohumeral techniques. My decisions on manipulation versus mobilization are determined by the overall health of the patient as well as osteoporosis and fracture risk, etc. However, with the vast majority of my shoulder patients, I am looking and doing something at the thoracic spine, and these patients are no different. I have not seen a lot of literature as far as looking at short-term or long-term effects specific to this group.
David Nolan, PT, DPT, MS, OCS, SCS, CSCS
Dr. Nolan is an Associate Clinical Professor at Northeastern University in the Department of Physical Therapy, Movement and Rehabilitation Sciences as well as a Graduate Lecturer in the College of Professional Studies in the transitional Doctor of Physical Therapy Program at Northeastern University. David is also a Clinical Specialist at the Mass General Sports Physical Therapy Service and the Director of the MGH / Northeastern University Sports Physical Therapy Residency Program.
Dr. Nolan is a board certified Orthopedic Clinical Specialist and Sports Clinical Specialist through the American Board of Physical Therapy Specialties and a Certified Strength and Conditioning Specialist through the National Strength and Conditioning Association. He is a past recipient of the “Excellence in Clinical Teaching” award from the New England Consortium of Academic Coordinators of Clinical Education as well as the award for Outstanding Achievement in Clinical Practice by the Massachusetts Chapter of the APTA. In 2019, Dr. Nolan received the Lynn Wallace Clinical Educator Award from the American Academy of Sports Physical Therapy. In 2022, Dr. Nolan received the Richard Kessler Memorial Award from the APTA of Massachusetts. Dr. Nolan was also presented with the APTA Academy of Physical Therapy Education Distinguished Menor in Residency/Fellowship Education Award in 2022.
Related Courses
1https://www.physicaltherapy.com/pt-ceus/course/management-of-adhesive-capsulitis-4438Management of Adhesive CapsulitisAdhesive capsulitis is characterized by a painful, gradual loss of motion which may lead to significant functional limitations. This session reviews the epidemiology, classification, and differential diagnosis associated with adhesive capsulitis. Current evidence related to conservative physical therapy management utilizing exercise and joint mobilization is reviewed. Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comManagement of Adhesive CapsulitisAdhesive capsulitis is characterized by a painful, gradual loss of motion which may lead to significant functional limitations. This session reviews the epidemiology, classification, and differential diagnosis associated with adhesive capsulitis. Current evidence related to conservative physical therapy management utilizing exercise and joint mobilization is reviewed. Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.4438OnlinePT120M
Adhesive capsulitis is characterized by a painful, gradual loss of motion which may lead to significant functional limitations. This session reviews the epidemiology, classification, and differential diagnosis associated with adhesive capsulitis. Current evidence related to conservative physical therapy management utilizing exercise and joint mobilization is reviewed.
Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.
2https://www.physicaltherapy.com/pt-ceus/course/managing-foot-and-ankle-pathology-4455Managing Foot and Ankle Pathology in the Distance RunnerRunning related injury is a common presentation in physical therapy practice. Some studies report over 50% of runners will experience an injury that limits participation at some point. The majority of injuries specific to distance runners will occur in the lower quarter and many of these will involve the lower leg and foot and ankle complex. This course will review the epidemiology of selected running related injuries and provide evidence-based recommendations for examination and treatment.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comManaging Foot and Ankle Pathology in the Distance RunnerRunning related injury is a common presentation in physical therapy practice. Some studies report over 50% of runners will experience an injury that limits participation at some point. The majority of injuries specific to distance runners will occur in the lower quarter and many of these will involve the lower leg and foot and ankle complex. This course will review the epidemiology of selected running related injuries and provide evidence-based recommendations for examination and treatment.4455OnlinePT120M
'Dr Nolan's courses are phenomenal! There is so much incredible evidence based information, and his teaching style is incredibly conducive to immediate retention'Read Reviews
Running related injury is a common presentation in physical therapy practice. Some studies report over 50% of runners will experience an injury that limits participation at some point. The majority of injuries specific to distance runners will occur in the lower quarter and many of these will involve the lower leg and foot and ankle complex. This course will review the epidemiology of selected running related injuries and provide evidence-based recommendations for examination and treatment.
3https://www.physicaltherapy.com/pt-ceus/course/management-patellofemoral-pain-syndrome-differential-4997Management of Patellofemoral Pain Syndrome: Differential Diagnosis and Treatment StrategiesAn advanced exploration of up-to-date, evidence-based PT practice for this common condition. Enhance your skills for exceptional patient results by exploring therapeutic exercise interventions backed by research and gaining comprehensive insights for optimal patient outcomes.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comManagement of Patellofemoral Pain Syndrome: Differential Diagnosis and Treatment StrategiesAn advanced exploration of up-to-date, evidence-based PT practice for this common condition. Enhance your skills for exceptional patient results by exploring therapeutic exercise interventions backed by research and gaining comprehensive insights for optimal patient outcomes.4997OnlinePT120M
An advanced exploration of up-to-date, evidence-based PT practice for this common condition. Enhance your skills for exceptional patient results by exploring therapeutic exercise interventions backed by research and gaining comprehensive insights for optimal patient outcomes.
4https://www.physicaltherapy.com/pt-ceus/course/rotator-cuff-lesions-conservative-and-5040Rotator Cuff Lesions: Conservative and Post-Operative ManagementRotator cuff pathology is common in the general population, as well as among overhead athletes and workers. This presentation aims to provide an evidence-based review of current physical therapy practice for the conservative and post-operative management of rotator cuff pathology.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comRotator Cuff Lesions: Conservative and Post-Operative ManagementRotator cuff pathology is common in the general population, as well as among overhead athletes and workers. This presentation aims to provide an evidence-based review of current physical therapy practice for the conservative and post-operative management of rotator cuff pathology.5040OnlinePT120M
Rotator cuff pathology is common in the general population, as well as among overhead athletes and workers. This presentation aims to provide an evidence-based review of current physical therapy practice for the conservative and post-operative management of rotator cuff pathology.
5https://www.physicaltherapy.com/pt-ceus/course/complex-and-chronic-impairment-in-4353Complex and Chronic Impairment in ConcussionThis webinar will include an exploration of the various etiologies of dysfunction following mTBI, including, headache, visual/oculomotor impairment, chronic dizziness, and pain. The challenging issue of prioritizing intervention and appropriate referral to other medical practitioners will be discussed. This course is directly related to the practice of physical therapy and athletic training and is therefore appropriate for the PT/PTA and AT. Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for .5 hour of general and 1.5 hour of Direct Access CE credit.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comComplex and Chronic Impairment in ConcussionThis webinar will include an exploration of the various etiologies of dysfunction following mTBI, including, headache, visual/oculomotor impairment, chronic dizziness, and pain. The challenging issue of prioritizing intervention and appropriate referral to other medical practitioners will be discussed. This course is directly related to the practice of physical therapy and athletic training and is therefore appropriate for the PT/PTA and AT. Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for .5 hour of general and 1.5 hour of Direct Access CE credit.4353OnlinePT120M
This webinar will include an exploration of the various etiologies of dysfunction following mTBI, including, headache, visual/oculomotor impairment, chronic dizziness, and pain. The challenging issue of prioritizing intervention and appropriate referral to other medical practitioners will be discussed. This course is directly related to the practice of physical therapy and athletic training and is therefore appropriate for the PT/PTA and AT.
Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for .5 hour of general and 1.5 hour of Direct Access CE credit.
