Effects of Gong's Mobilization With and Without Nielasher Technique on in Adhesive Capsulitis

It is performed in a side-lying position.

• The therapist will stand on the affected side of the patient and push the head of humerus of the affected side in anterior to posterior direction parallel to the joint plane with the palm of his hand, simultaneously, with the other hand, the therapist will push the scapula from posterior to anterior direction realigning and stabilizing the humeral head within correct position.
• The patient is asked to quickly and powerfully perform abduction while keeping the elbow straight. Meanwhile, the therapist will keep pressing the humeral head along the long axis of the humerus, maintaining the oscillatory glide in Maitland's grade (III, IV), following the movement of the patient's shoulder during abduction.
• The speed of the movement is kept constant by the therapist while maintaining a little distraction at the Glenohumeral joint.
• Therapist will accelerate the movement at the end range to gain Glenohumeral ROM.

It is performed in a side-lying position.

• The therapist will stand on the affected side of the patient and push the head of humerus of the affected side in anterior to posterior direction parallel to the joint plane with the palm of his hand, simultaneously, with the other hand, the therapist will push the scapula from posterior to anterior direction realigning and stabilizing the humeral head within correct position.
• The patient is asked to quickly and powerfully perform abduction while keeping the elbow straight. Meanwhile, the therapist will keep pressing the humeral head along the long axis of the humerus, maintaining the oscillatory glide in Maitland's grade (III, IV), following the movement of the patient's shoulder during abduction.
• The speed of the movement is kept constant by the therapist while maintaining a little distraction at the Glenohumeral joint.
• Therapist will accelerate the movement at the end range to gain Glenohumeral ROM.

1. In Niel-Asher technique, the patient was made to lie sideways and several deep strokes with your hand, from elbow to humeral head were applied. Apply sustained pressure over the embedded nodules or over the fibrous band which you may feel when you move upwards. 2. Apply deep sustained pressure on the tender point over the posterior joint capsule area (teres minor). 3. Perform circumduction of shoulder with bent elbow repeatedly several times from small to large complete circles.

4. Release the fascia up the long head biceps tendon and move upwards only. Pause on the nodules along the tendon; these are fascial tethering and may be inflamed. As you approach the shoulder, near the biceps tendon joins the capsule, hold the trigger point for up to three minutes until it is completely pain free. 5.In supine lying position, the middle fingers of your hand, presses deeply on the trigger point in the middle of the shoulder blade (infraspinatus)

Universal goniometer is tool in orthopedics used to precisely measure angles at joints.

Goniometer demonstrates good intra-rater and inter-rater reliability when used consistently with proper technique. It will measure the ranges at shoulder joint (Abduction, Adduction, Flexion, Extension, Internal rotation, External rotation