Multimodal Physiotherapy in Right Frozen Shoulder: A Case Report
DOI:
https://doi.org/10.35451/jkf.v9i1.3658Keywords:
Frozen Shoulder, Physiotherapy, Infrared, TENS, Shoulder StiffnessAbstract
Background: Frozen shoulder, or adhesive capsulitis, is a condition characterized by pain and limited range of motion in the shoulder joint that can interfere with daily functional activities. Multimodal physical therapy is necessary to manage pain, improve mobility, and restore shoulder function. Objective: To determine the effectiveness of physical therapy management using Infrared (IR), Transcutaneous Electrical Nerve Stimulation (TENS), and scapular mobilization in a patient with stiffness of the right shoulder due to frozen shoulder. Methods: This study is a case report of a 61-year-old male patient who had complained of pain and limited movement in his right shoulder for two weeks prior to examination. Physical therapy interventions were administered twice weekly over four sessions, including 15 minutes of mild-intensity IR, 10 minutes of conventional TENS at 80–100 Hz, and scapular mobilization exercises consisting of shoulder shrug exercises performed 8–10 repetitions in 2–3 sets. Evaluation was conducted using range of motion (ROM) measurements, the Numeric Rating Scale (NRS), and Manual Muscle Testing (MMT). Results: There was an improvement in range of motion, particularly in shoulder flexion from 50° to 80°, as well as improvements in abduction and rotation, although these were not significant. Pain decreased from a score of 7/10 to 5/10 after four therapy sessions. However, muscle strength did not show a significant improvement.
Downloads
References
[1] Kuhn I, Erber B, Goller SS. Capsulitis adhaesiva. Die Radiologie 2024;64:119–24. https://doi.org/10.1007/s00117-023-01217-5.
[2] Sabrina D, Puspadewi TW, Zahrah SA, Alya RN, Azis WR, Pristianto A. Perbedaan Pengaruh Manual Therapy Dengan Strengthening Exercise Terhadap Peningkatan Kemampuan Fungsional Individu Pada Frozen Shoulder: Systematic Review. Indonesian Journal of Health Research Innovation 2024;1:175–86. https://doi.org/10.64094/qd64cm18.
[3] Ricci M. Adhesive capsulitis. Jaapa 2021;34:12–4. https://doi.org/10.1097/01.JAA.0000800236.81700.d4.
[4] Edwards O, Counihan M, Li X. Epidemiology of frozen shoulder. Frozen Shoulder, Elsevier; 2024, p. 53–7. https://doi.org/10.1016/B978-0-443-15995-4.00011-8.
[5] Millar NL, Meakins A, Struyf F, Willmore E, Cmpbell AL, Kirwan PD, Akbar M, Moore L, Ronquillo J, Murrell G, rodeo S. Frozen shoulder. Nat Rev Dis Primers 2022;8:59. https://doi.org/10.1038/s41572-022-00386-2.
[6] Brindisino F, Turgut E, Struyf F. Frozen shoulder: exploration of terminology and classification. Frontiers in Rehabilitation Sciences 2024;5. https://doi.org/10.3389/fresc.2024.1498263.
[7] Gacaferi H, Geurkink TH, van Adrichem RA, Driel PB, Vermeulen HE, Nagels J. [Frozen shoulder: A long-lasting and misunderstood clinical problem]. Ned Tijdschr Geneeskd 2022;166.
[8] Kuhn I, Erber B, Goller SS. Capsulitis adhaesiva. Die Radiologie 2024;64:119–24. https://doi.org/10.1007/s00117-023-01217-5.
[9] Koll S, Gnauert A, Seidel W. Die Integrative Behandlung der Frozen Shoulder. Zeitschrift Für Komplementärmedizin 2019;11:12–8. https://doi.org/10.1055/a-0877-1964.
[10] Itoi E, Arce G, Bain GI,Diercks RL, Guttamann D, Imhoff AB, Mazzocca AD, Sugaya H, Yoo YS. Shoulder Stiffness: Current Concepts and Concerns. Arthroscopy 2016;32:1402–14. https://doi.org/10.1016/j.arthro.2016.03.024.
[11] Brindisino F, Girardi G, Crestani M,Assenza R, Andriesse A, Giovannico G, Pellicciari L, Salomon M, Venturin D. Rehabilitation in subjects with frozen shoulder: a survey of current (2023) clinical practice of Italian physiotherapists. BMC Musculoskelet Disord 2024;25:573. https://doi.org/10.1186/s12891-024-07682-w.
[12] Pristianto A, Windi Aulia N, Syofwatin Ni F, Anggraini A, Muttaqqin Z, Shabrina ZN. Upaya Mengatasi Peningkatan Resiko Nyeri Punggung Bawah Pada Pekerja Cleaning Service Tenaga Outsourcing Di Gedung Induk Siti Walidah. Communnity Development Journal 2023;4.
[13] Rismayanti R, Hutabarat HA, Alpiah DN. Effectiveness of Trancutaneus Electrical Nerce Stimulation On Frozen Shoulder (TENS): Literatur Review. International Journal of Social Research 2024;2:87–92. https://doi.org/10.59888/insight.v2i2.25.
[14] Al-Abdulrahman AMM, Alsaleem RI, Aljarallah SA, Attamimi MR. Comparative Efficacy of Physiotherapy Modalities in the Treatment of Frozen Shoulder: Stretching, Mobilization, and Ultrasound Therapy. International Journal of Innovative Research in Engineering & Multidisciplinary Physical Sciences 2016;4:1–10.
[15] Upadhyay VJ, Sutaria S. A Study to Compare the Effectiveness of Scapular Mobilization v/s Shoulder Mobilization in Patients with Frozen Shoulder. Int J Health Sci Res 2022;12:42–5. https://doi.org/10.52403/ijhsr.20221206.
[16] Nakandala P, Nanayakkara I, Wadugodapitiya S, Gawarammana I. The efficacy of physiotherapy interventions in the treatment of adhesive capsulitis: A systematic review. J Back Musculoskelet Rehabil 2021;34:195–205. https://doi.org/10.3233/BMR-200186.
[17] Challoumas D, Biddle M, McLean M. Comparison of Treatments for Frozen Shoulder. JAMA Netw Open 2020;3:e2029581. https://doi.org/10.1001/jamanetworkopen.2020.29581.
[18] Andhika Fatir Ath-Thariq, Isnaini Herawati, Warih Sri Widodo. Penatalaksanaan Fisioterapi pada Kasus Frozen Shoulder: a Case Report. Jurnal Medika Nusantara 2025;3:145–51. https://doi.org/10.59680/medika.v3i1.1683.
[19] Johnson M, Mulcahey MJ. Interrater Reliability of Spine Range of Motion Measurement Using a Tape Measure and Goniometer. J Chiropr Med 2021;20:138–47. https://doi.org/https://doi.org/10.1016/j.jcm.2021.09.003.
[20] Beshara P, Davidson I, Pelletier M,Wals WR. The Intra- and Inter-Rater Reliability of a Variety of Testing Methods to Measure Shoulder Range of Motion, Hand-behind-Back and External Rotation Strength in Healthy Participants. Int J Environ Res Public Health 2022;19. https://doi.org/10.3390/ijerph192114442.
[21] Chamorro C, Arancibia M, Trigo B, Poblete LA, Mayorga DJ. Absolute reliability and concurrent validity of hand-held dynamometry in shoulder rotator strength assessment: Systematic review and meta-analysis. Int J Environ Res Public Health 2021;18. https://doi.org/10.3390/ijerph18179293.
[22] Radiah N, Arista Pratama I, Pahmi K. Studi Penggunaan NSAID (Nonsteroidal Anti Inflamantory Drugs) Pasien Osteoarthritis Usia Lanjut di Rumah Sakit X Sumbawa Barat. Journal Syifa Sciences and Clinical Research 2023;5. https://doi.org/10.37311/jsscr.v5i3.23723.
[23] Wawrzyniak N, Gramza-Michałowska A, Pruszyńska-Oszmałek E, Sassek M, Suliburska J. Effects of Calcium Lactate-Enriched Pumpkin on Calcium Status in Ovariectomized Rats. Foods 2022;11:2084. https://doi.org/10.3390/foods11142084.
[24] Bellew JW, Michlovitz SL, Nolan.Thomas P. Modalities for therapeutic intervention. vol. 6. Philadelphia, PA: F.A. Davis Company; 2016.
[25] Uma B, Clement DrI. Gate Control Theory of Pain. IDC International Journal 2020;7:54–7. https://doi.org/10.47211/idcij.2020.v07i03.014.
[26] Mokhtari T, Ren Q, Li N, Wang F, Bi Y, Hu L. Transcutaneous Electrical Nerve Stimulation in Relieving Neuropathic Pain: Basic Mechanisms and Clinical Applications. Curr Pain Headache Rep 2020;24:14. https://doi.org/10.1007/s11916-020-0846-1.
[27] Ibrahim OI, Abdel-Majid SF, Mohamed WR, Sarhan MA. Comparative Study of the Combined Effect of Therapeutic Exercises and Mobilization between Stage II and Stage III Frozen Shoulder. Med J Cairo Univ 2020;88:1531–7. https://doi.org/10.21608/mjcu.2020.116244.
[28] Firnadia Septika Rahajeng, Arif Pristianto, Nilam Nur Hamidah. Effectiveness Of Shoulder Rom Exercises in Post Breast Cancer Surgery: Case Report. JTH: Journal of Technology and Health 2024;2. https://doi.org/10.61677/jth.v2i3.358.
[29] Nugraha FM, Pristianto A, Zakaria RF. Scapula Mobilization For Improving Functional Ability In Frozen Shoulder Conditions: Case Study. Fisio Mu: Physiotherapy Evidences 2024. https://doi.org/10.23917/fisiomu.v4i3.5049.
[30] Wati WT, Santoso TB, Nur Efendi EN. Manajemen Fisioterapi Pada Kasus Frozen Shoulder Dextra (A Case Report). Journal of Innovation Research and Knowledge; https://doi.org/10.53625/jirk.v2i7.4247
[31] Rice D, Lewis G, McNair P. Impaired Regulation of Submaximal Force after ACL Reconstruction: Role of Muscle Spindles. Int J Sports Med 2020. https://doi.org/10.1055/a-1292-4461.
[32] ACSM. ACSM’s Guidelines for Exercise Testing and Prescription. 12th ed. Philadelphia PA; 2021.
[33] Kawabata M, Miyata T, Naoi D,Miyatake K. Ultrasound-Guided Rotator Cuff Re-education for Residual Dysfunction After Shoulder Manipulation Under Ultrasound-Guided Cervical Nerve Root Block: A Case Report. Cureus 2025. https://doi.org/10.7759/cureus.92237.
[34] Sofia AS, Triyanita M. Physiotherapy Management of Right Frozen Shoulder: A Case Report. Majalah Ilmiah Fisioterapi Indonesia 2025;13:567–74. https://doi.org/10.24843/mifi.000000376.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Ariq Windra Nugraha, Arif Pristianto, Kingkinarti, Endah Agus Trisnaningtyas

This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright in each article is the property of the Author.























