MANUAL MOBILIZATION TECHNIQUES FOR FROZEN SHOULDER: A NARRATIVE REVIEW

Background: Frozen shoulder, also known as adhesive capsulitis, is a common musculoskeletal disorder characterized by pain and a progressive loss of shoulder motion. Manual therapy is frequently employed in physiotherapy management, with various mobilization techniques developed to restore range of motion (ROM), reduce pain, and improve function. Objective: To compare the efficacy of four manual therapy techniques, Kaltenborn, Mulligan Mobilization with Movement (MWM), Gong’s Mobilization, and Spencer Technique in managing frozen shoulder through review. Methods: The evidence from two clinical trials: one comparing Kaltenborn and Mulligan mobilizations, and another comparing Gong’s and Spencer techniques, both using Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI), and goniometric ROM measurements as outcome tools were reviewed. Kaltenborn uses graded traction based on joint mechanics, while Mulligan incorporates pain-free accessory glides during active movement. Gong’s method emphasizes end-range posterior gliding and sustained stretching, and Spencer’s technique involves rhythmic capsular mobilization in multiple joint planes. Results: Mulligan mobilization was found to significantly improve pain, ROM (especially flexion, abduction, external and internal rotation), and SPADI scores over Kaltenborn. Similarly, Gong’s technique showed superior improvement in pain, ROM (notably medial rotation), and function when compared to the Spencer technique. These findings suggest that techniques incorporating active movement and sustained posterior gliding may offer greater clinical benefits. Conclusion: Among the manual therapy approaches reviewed, Mulligan and Gong’s mobilizations appear more effective than Kaltenborn and Spencer techniques, respectively, in reducing pain and improving shoulder mobility in frozen shoulder patients. Further research with larger sample sizes and long-term follow-up is warranted to confirm these results and refine treatment protocols.