Codman's paradox in adhesive capsulitis

Abstract

Background: Even though, it is said that adhesive capsulitis is a self-limiting condition, many subjects remain with long-term sequelae. Codman's paradox is commonly used in manipulation under anesthesia technique for adhesive capsulitis of shoulder, which composes of a specific pattern of motion at the shoulder joint leading to an indirect humeral rotation without placing a rotational torque on the humerus. In this case study, Codman's paradox movement was modified and performed within pain tolerable range and without anesthesia in a subject with adhesive capsulitis. Aim and Objective: This case study analyses the effect of modified Codman's paradox movement in a 50-year-old male diagnosed with symptoms of adhesive capsulitis for more than 6 months. Materials and Methods: A single case study design was used. The study duration was 4 weeks. Baseline and posttest outcomes measures of shoulder range of motion (ROM) (flexion, extension, abduction, external rotation, and internal rotation) were measured using a universal goniometer and Shoulder Pain and Disability Index (SPADI) questionnaire. Results: Posttest measures of numerical pain rating scale, shoulder ROM and SPADI showed improvement, proving that modified Codman's paradox is effective in adhesive capsulitis. Conclusion: This study result concludes that modified Codman's paradox is effective in improving shoulder ROM among subjects with adhesive capsulitis.