Immediate Effects of Positional Stretching of Coracohumeral Ligament in Individuals with Adhesive Capsulitis

Adhesive capsulitis (AC) is a condition of uncertain etiology, characterized by a progressive loss of both active and passive shoulder range of motion. The latest findings have concurred with involvement of coracohumeral ligament (CHL) and rotator interval in AC wherein the CHL undergoes fibroblast proliferation and thickening¹². It is stated that thickening and contracture of glenohumeral ligament and rotator interval acts a check rein which prevents external rotation and causes global loss of active and passive movements¹⁰. Various physiotherapy intervention has been applied in treating adhesive capsulitis not considering the importance of primary pathology of CHL. Stretching according to the anatomical fibre orientation of CHL can be used to improve the extensibility of the connective tissue. Therefore, an attempt is made to examine the immediate effects of positional stretch of CHL in improving range of motion in subjects with AC (stage 2).

A pre-test post-test study design was conducted on 16 subjects fulfilling the inclusion criteria. Pre-test measurements were recorded with digital goniometer followed by intervention which included stretching of CHL in the position of maximum external rotation, and 30º extension with 30º adduction of the shoulder. Post test results were obtained immediately after the positional stretch with the digital goniometer. Student paired ‘t’ test was used to determine whether there was a statistical difference between the mean scores of ROM pre and post stretch.

The results obtained in the study, shows ‘p value’< 0.05 in all the variables of ROM, indicating that there is statistically significant improvement in the passive range of motion following the intervention session. The stretching procedure included in this study has the potential to stretch the coracohumeral ligament. Hence, it is necessary to incorporate stretching position of the CHL in individuals with AC for effective results in improving range of motion.