Capsular Constraint Mechanism: Difference between revisions

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== Overview ==
== Overview ==


The concept of Capsular Constrained Mechanism can be applied to a tight join capsule of the shoulder where the humeral head translates in the direction opposite to that of the capsular tightness.
The concept of Capsular Constraint Mechanism can be applied to a tight join capsule of the shoulder where the humeral head translates in the direction opposite to that of capsular tightness.<ref>Kim Y, Lee G. Immediate effects of Angular Joint Mobilization (a new concept of joint mobilization) on Pain, Range of Motion, and Disability in a patient with Shoulder Adhesive Capsulitis: A Case Report. Am J Case Rep. 2017; 18: 148–156.</ref>
 
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== Clinical Significance ==
== Clinical Significance ==


Mobilization for a stiff or restricted shoulder traditionally follows Kaltenborns' Concave-Convex rule which states that when a convex surface moves over a concave surface the direction of glide or arthrokinematic movement must be opposite to that of the osteokinematic movements. Taking the example of frozen shoulder, capsular pattern restriction is seen with external rotation maximally restricted.This  would need an anterior glide to improve the restriction and range. However based on the capsule constrained mechanism the capsular restriction is at the anterior aspect hence rather than an anterior glide a posterior glide would rather strecth the thight capsule and s hence indicated.
Mobilization for a stiff or restricted shoulder traditionally follows Kaltenborns' Convex-Concave rule which states that when a convex surface moves over a concave surface the direction of glide or arthrokinematic movement must be opposite to that of the osteokinematic movement. Taking the example of [[Adhesive Capsulitis]], capsular pattern restriction is seen with maximal restriction of external rotation. An anterior glide would improve the restriction and range of motion. However based on the Capsule Constraint Mechanism, the capsular restriction is at the anterior aspect of the shoulder, hence, a posterior glide would stretch the tight capsule rather than an anterior glide.
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== Application ==
 
 
 
 
 
 
 
 


== Controversy surrounding Capsular Constraint Mechanism  ==





Revision as of 13:13, 15 February 2020

Overview[edit | edit source]

The concept of Capsular Constraint Mechanism can be applied to a tight join capsule of the shoulder where the humeral head translates in the direction opposite to that of capsular tightness.[1]

Clinical Significance[edit | edit source]

Mobilization for a stiff or restricted shoulder traditionally follows Kaltenborns' Convex-Concave rule which states that when a convex surface moves over a concave surface the direction of glide or arthrokinematic movement must be opposite to that of the osteokinematic movement. Taking the example of Adhesive Capsulitis, capsular pattern restriction is seen with maximal restriction of external rotation. An anterior glide would improve the restriction and range of motion. However based on the Capsule Constraint Mechanism, the capsular restriction is at the anterior aspect of the shoulder, hence, a posterior glide would stretch the tight capsule rather than an anterior glide.

Controversy surrounding Capsular Constraint Mechanism[edit | edit source]

A tight capsule can cause the humeral head to translate in a direction opposite to that of the area of tightness

  1. Kim Y, Lee G. Immediate effects of Angular Joint Mobilization (a new concept of joint mobilization) on Pain, Range of Motion, and Disability in a patient with Shoulder Adhesive Capsulitis: A Case Report. Am J Case Rep. 2017; 18: 148–156.