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FOR ACCESS TO FREE VIDEOS AND ARTICLES AND THE LATEST NEWS ON UPCOMING trAInIngs, jOIn Ben On FACeBOOk At FACeBOOk.COM/drBenBenjAMIn. the back from arching (Image 10). Place your other hand at the elbow and gently lift the affected arm to a vertical position. From there, slowly stretch the shoulder joint toward passive elevation until you meet resistance, then add a pound of pressure and hold for 30–60 seconds. Bring the arm back down to allow the client to rest for a moment, and then repeat. Repeat 5–6 times. Overhead resistance stretch. Begin in the same position you used for the previous stretch. This time, you'll use the client's own resistance to help break the adhesions in the shoulder joint capsule (Images 11 and 12). Begin with the client's arm at an elevation that is relatively comfortable. Tell clients to push against you with 50 percent of their strength; then, after 8–10 seconds, tell them to let go. When they release, apply gentle pressure and move the joint a quarter-inch to a half-inch further into the stretch. Let the person rest a moment, and then begin again. Repeat this process for 3–5 minutes. Over time, the client will regain a normal range of motion, and the upper arm will lie flat on the table above the head. Lateral rotation adhesions stretch. Again, have the client lie supine (Image 13). Use one hand to hold the upper arm next to the body, and use the other hand, placed on the person's wrist, to gently stretch the shoulder in lateral rotation. Exert a constant mild pressure to gently increase the rotation. Hold this position for 30–60 seconds. Repeat 2–3 times. Lateral rotation resistance stretch. As in the previous stretch, use one hand to stabilize the upper arm next to the body and place your other hand on the wrist. Laterally rotate the shoulder to a relatively comfortable position (Image 14). Then ask clients to resist with medial rotation, using 50 percent of their strength, while you apply an equal and opposite pressure to prevent them from moving. Have them continue pushing for 8–10 seconds, and then release. When they let go, gently move the shoulder into slightly more lateral rotation, just a quarter- inch to a half-inch. Let the person rest for a moment, and then begin again. Continue for 2–3 minutes. The goal of this stretch is to bring the shoulder into full lateral rotation, with the lower arm at a 180-degree angle to the body. Once you've performed each of these four stretches, continue repeating both resisted stretches, alternating between the two for an additional 15–20 minutes. CONCLUSION Once you understand what it takes to treat adhesive capsulitis effectively, helping clients with this condition can be extremely satisfying. I've worked with many people who've endured great frustration and hardship because of this injury. Often they've received other treatment that wasn't quite sufficient. For these clients, getting connected to the right combination of treatments is a tremendous relief, with the promise of decreasing healing time from 9–12 months to 4–6 weeks. in education and sports medicine, and is founder of the Muscular Therapy Institute. He is the author of Listen to Your Pain (Penguin, 2007), Are You Tense? (Pantheon, 1978), and Exercise Without Injury (MTI, 1979), and coauthor of The Ethics of Touch (Sohnen-Moe Associates, 2003). He offers continuing education for massage therapists via webinars. He can be contacted at Ben@BenBenjamin.com. Ben E. Benjamin, PhD, holds a doctorate Editor's note: Massage & Bodywork is dedicated to educating readers within the scope of practice for massage therapy. Essential Skills is based on author Ben E. Benjamin's years of experience and education. The column is meant to add to readers' knowledge, not to dictate their treatment protocols. Boost your practice with ABMP's Website Builder—free for members on ABMP.com 99