Yoga therapy versus Physical therapy as a supplement to treatment of frozen shoulder: A randomized controlled study in the Indian Populace

Adhesive Capsulitis/Frozen shoulder is often a self–limiting disease that globally restricts the shoulder movements. There would be active and passive limitation of movements mainly affecting forward flexion and external rotation with no abnormal joint involvement. This study focuses on patients with frozen shoulder who will receive conservative treatment along with either yoga therapy or physical therapy for a period of 3 months with regular interval follow- up and assess the pain and stiffness symptoms improvement. It will also compare the outcomes between the two groups.  The treatment modalities of Frozen shoulder include medication, local steroid injection, physiotherapy, hydrodistension, manipulation under anesthesia, arthroscopic capsular release and open capsular release(1). There is no consensus on the most efficacious treatment for this condition.

Physiotherapy is an initial therapy for idiopathic frozen shoulder, which encourages active assisted ROM exercise along with gentle passive stretching exercises including forward elevation, internal and external rotation and cross body adduction. These exercises are to be performed five to six times per day with each movement. Yogasana, which is a psychosomatic posture also impacts on the musculoskeletal system that helps in providing toned muscular strength, flexibility and coordination. Yoga postures also activate scapular stabilizing muscles along with shoulder mobility and flexibility.

Physical therapy will be localised to only individual muscle movement in the shoulder, whereas yoga therapy will focus on a group of muscles associated with adjacent structures (shoulder with chest and upper back).  Standard therapy for Frozen shoulder in the initial stages is mobilization of the joint, which is accomplished in both groups and hence does not compromise the patient care in both groups. However, the question remains: Is there any difference between physiotherapy and yoga therapy in improving the stiffness in patients with frozen shoulders? Hence, this study investigates their effectiveness.