Case study – Online Physiotherapy and Frozen Shoulder

A 65-year-old female client’s chief complaint was a stiff and very painful left shoulder. She had very limited movements in all directions especially reaching up and behind her back.

During the online session, after taking a history and understanding more about the symptoms and behavior, her standing alignment was evaluated. In standing, her neck appeared short and compressed and the bumps on her upper chest indicated rotated, mal-aligned ribs 2 and 3. Her left shoulder was held forward with her arm stuck to her body to avoid pain.

After some test corrections which she did to herself, it was found that lifting up or decompressing her neck gave the most relief, followed by correcting the mal-aligned ribs in the front of her chest. This likely took pressure off nerves that originated in the neck and upper thoracic spine and traveled to her arm. The history had revealed that she suffered whiplash from a few car accidents.

She was taught massage, release and stretch techniques to soft tissues of her neck and chest to open and create space in these areas. This was her homework for the week. These techniques gave her immediate relief from the resting pain and increased her shoulder range of motion by 20 degrees.

By the second session, her pain had subsided by 50%. We worked on the neck and rib treatment, reviewing and fine-tuning. Once her pain had subsided even further, she then proceeded to release bound up muscles, ligaments and the capsule of the left shoulder. This further increased her shoulder mobility to forward flexion 135 degrees from 110 degrees previously.

After 2 online sessions in 10 days, she was delighted at the rapid progress. She no longer had any resting pain and compared her status to the equivalent of gains made after previous in-person physio visits twice a week for 5 months.

She attributed the progress to getting educated and learning how to treat herself so that she could repeat the techniques frequently in a day. This new habit took the pain away considerably so that by the next online session, she was ready to make another leap forward. This case study shows the power of consultative physiotherapy using a virtual platform without any hands-on touch with a motivated client.