(Active Motion Physiotherapy, 2009)

Adhesive capsulitis, also called frozen shoulder, is a very painful condition, results in a severe loss of motion in the shoulder.

It may follow an injury, or it may arise gradually with no injury or warning.

In frozen shoulder, inflammation in the joint makes the normally loose parts of the joint capsule stick together, and the capsule is scarred and tightened. This seriously limits the shoulder’s ability to move, and causes the shoulder to freeze.

The symptoms of frozen shoulder are primarily shoulder pain and a very reduced range of motion in the joint. The range of motion is the same in active and passive motion.

There comes a point in each direction of movement where the motion simply stops, as if something is blocking it. At this point, the shoulder usually hurts. The shoulder can also be quite painful at night.

The tightness in the shoulder can make it difficult to do regular activities like getting dressed, combing your hair, or reaching across a table.

In the shoulder, the capsular pattern dictates that motion restrictions occur first in rotation, then in abduction. Nevertheless and abduction is only up to 80-90 degree possible.

If an individual has a significant limitation to abduction, but no problem with rotation, this would be considered a non-capsular pattern and is probably not primarily a joint capsule pathology. A much more likely cause would be some type of external structure causing the movement restriction such as an impingement problem under the acromion process.

Treatment:

  • Reduce the inflammation in tendons, bursae, and capsule
  • Ease the pain
  • Massage the adhered and shortened capsule
  • Relax muscles, tendons, and ligaments
  • Stretch the shoulder
  • Increase the range of motion
  • Get the shoulder function back

Frozen shoulder or rotator cuff tear?

With frozen shoulder, the shoulder motion is the same whether the patient or the therapist moves the arm.

With a rotator cuff tear, the patient cannot move the arm. But when someone else lifts the arm it can be moved in a nearly normal range of motion.

 

Reference:

Active Motion Physiotherapy. (2009). Adhesive Capsulitis. Retrieved from http://www.activemotionphysio.ca/Injuries-Conditions/Shoulder/Shoulder-Issues/Adhesive-Capsulitis/a~363/article.html