Frozen Shoulder/Adhesive Capsulitis

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5 Terms

1
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frozen shoulder/adhesive capsulitis + treatment

progressive loss of shoulder/glenohumeral ROM (especially external rotation, followed by abduction and internal rotation) 2/2 adhesion of the glenohumeral joint capsule and coracohumeral ligament

  • idiopathic (unknown cause) or secondary to trauma or surgery

  • treatment

    • primary treatment is compensatory strategy training and environmental modification; e.g.,

      • ADL modifications

      • AE for ADLs

      • workstation modifications

    • stretches (abduction, external/internal rotation)

      • take care not to cause inflammation with overstretching, especially during the freezing phase (you can make things worse)

    • encourage regular movement through comfortable range

    • encourage pain-free AROM and to work around it until it thaws on its own— i.e., naturally resolves

      • “if there’s an iceberg in your way, keep moving to stay warm and go round it”

    • operative: manipulation (under anesthesia) and arthroscopic release of the glenohumeral capsule ligaments


<p>progressive loss of shoulder/glenohumeral ROM (especially external rotation, followed by abduction and internal rotation) 2/2 adhesion of the glenohumeral joint capsule and coracohumeral ligament</p><ul><li><p>idiopathic (unknown cause) or secondary to trauma or surgery</p></li><li><p>treatment </p><ul><li><p>primary treatment is compensatory strategy training and environmental modification; e.g., </p><ul><li><p>ADL modifications</p></li><li><p>AE for ADLs</p></li><li><p>workstation modifications </p></li></ul></li><li><p>stretches (abduction, external/internal rotation)</p><ul><li><p>take care not to cause inflammation with overstretching, especially during the freezing phase (you can make things worse)</p></li></ul></li><li><p>encourage regular movement through comfortable range</p></li><li><p>encourage pain-free AROM and to work around it until it thaws on its own— i.e., naturally resolves</p><ul><li><p>“if there’s an iceberg in your way, keep moving to stay warm and go round it”</p></li></ul></li><li><p>operative: manipulation (under anesthesia) and arthroscopic release of the glenohumeral capsule ligaments </p></li></ul></li></ul><p></p>
2
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3 phases of frozen shoulder/adhesive capsulitis

in total up to 4 years

  • freezing

  • frozen

  • thawing


3
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freezing phase

getting worse; losing more and more ROM; characterized by

  • shoulder pain interrupting sleep

  • pain with ADLs

  • pain at rest

  • ROM usually close to full, however, with pain often experienced before the end of motion


4
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frozen phase

ROM stays where it’s at for a while; movement patterns demonstrated as individuals attempt to compensate for lack of glenohumeral mobility

  • pain typically occurs with stretching at end of motion


5
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thawing phase

natural and gradual improvement + returning of ROM

  • lasts up to 26 months