Adhesive capsulitis, also known as frozen shoulder, is a common condition of the shoulder defined as a pathologic process in which contracture of the gleno-humeral capsule is a hallmark. Clinically, it presents as pain, stiffness, and dysfunction of the affected shoulder. Adhesive capsulitis is thought to afflict between 2 and 5% of the general population, with women affected more frequently than men. Individuals of middle age are most often affected, typically during the 5th to 7th decades of life.~Muscle energy techniques is a manual therapy that uses the gentle muscle contractions to relax and lengthen muscles and normalize joint motion. It is a class of soft tissue osteopathic manipulation consisting of isometric contraction designed to improve musculoskeletal function and reduce pain. The application of MET relaxes and improves biomechanics and result in improving functional ability.~Although conventional physical therapy treatment are used to treat frozen shoulder and effectiveness of muscle energy technique is proven, but the effect of first rib mobilization and MET has not been studied.
This study will be a randomized control trial. Study will be conducted in 40 patients in the age range 40-70 years, which will be selected by using non proability convenient sampling technique. Subjects will be divided in 2 groups. Group A will receive first rib mobilization along with METS and conventional treatment, group B will receive METS and conventional physical therapy treatment only. Treatment will be given thrice per week for 3 weeks. Data will be collected pre and post treatment, for data collection numeric pain rating scale, shoulder pain and disability index (SPADI) will be used. Joint range of motion will be measured using goniometer. After collection data from defined study setting, data will be entered and analyzed at Riphah International University, Lahore.