The Effects of Tissue Flossing on Shoulder Range of Motion and Pain in Patients with Adhesive Capsulitis: A Case Study
Keywords:Tissue flossing, shoulder joint, adhesive capsulitis, range of motion.
Background and Purpose: The purpose of this case report is to describe the tissue flossing interventions for a
patient with adhesive capsulitis.
Case Description: The patient was a 56-year-old female, who presented with left shoulder pain and limited
range of motion (ROM) following a fall 9 months prior. The patient had a past medical history of thyroid.
The diagnosis of adhesive capsulitis was determined following radiographs, mechanism of injury, past medical
history, and physical therapy examination and evaluation.
Intervention: The patient was seen for a total of 15 physical therapy sessions over the span of 6 weeks.
Interventions included a tissue flossing, home exercise program, instruction in heat/ice use, mobilizations,
therapeutic exercises, ROM, stretching, and glides. Outcome measures included ROM measurements, pain
ratings, strength tests and the Shoulder Pain and Disability Index (SPADI).
Outcomes: Following 6 weeks of physical therapy intervention, tissue flossing and home exercise program, the
patient demonstrated increased shoulder ROM, decreased pain and improved function based on the improved
Discussion: Rationale for treatment was based on textbook information for shoulder interventions and research
articles. The treatment was altered based on patient’s response.
Conclusion: This case report is in concordance with the current research that shows flossing, strengthening,
mobilizations, a home exercise program and stretching are appropriate combinations of interventions for
individuals with adhesive capsulitis. This patient returned to his prior level of function following the above