NPTEFF Adhesive capsulitis

Diff between primary and secondary Fzn Shl

Primary: Insidious with no known causes

Secondary: RA, OA, trauma, immobilization can cause it

Initial onset stage

Gradual onset of pain, increases with movement and is present at night, loss of ER with intact RTC stretch. Duration is <3mo

Freezing stage

Persistent and increasing intensity of pain, motion limited in all directions. Duration is 3-9mo

Frozen stage

Characterized by pain with movement only, limited motion, substitutes mvmt with scap. Atrophy can be noted. Duration is 9-15months

Thawing stage

Characterized by minimal pain but significant capsular restrictions. Motion is gradually improved during this stage. Lasts 15-24 months or longer, potential to never regain normal ROM

Phase 1 rehab

Sling, PROM/AAROM in pain free range, grade 1-2 mobs (posterior inferior), pendulum exercise

Phase 2 rehab

AAROM, Mobilizations (grade III, IV), self mobs, manual/self stretch, correct posture, GH Rotation strengthening

Phase 3 rehab

Stretch/strength/mobs

What if posterior / inferior mobs hurt?

Mob in opposite direction until pain and irritability decreases