Adhesive Capsulitis (Frozen Shoulder)

What is a frozen shoulder?
                * adhesive capsulitis
                * glenohumeral stiffness resulting from capsular adhesions
                * external rotation & flexion are restrict
                * occurs between 40 & 60 years of age
                * more common in women & sedentary workers

• immobility
• diabetes mellitus
• trauma
• cervical disc disease
• TB
• ischemic heart disease
• CVA
• Surgery
• thyroid disorders

Findings:

        * no point tenderness
        * muscle atrophy
        * decreased AROM (abduction, external rotation, flexion)
        * pain on forced movement

Stages: Pain or Freezing Period
      *    subscapularis bursa, biceps sheath involvement
        * shoulder capsule tightness
        * pain worse at night
        * pain decreases with decreased arm use

Stiffness or Frozen Period
        * no improvement in joint mobility (external rotation, internal rotation, abd)
        * decreasing pain
        * decreased ADL (dressing, washing hair)

Spontaneous Recovery or Thawing Period
        * gradual return of external rotation, abd, internal rotation
        * decreased pain, increased ROM

Treatment:
        * pain management (heat, cryotherapy, TENS, myofascial release)
        * PROM, stretching, releases,
        * strengthening exercises/activities

 References:

http://gasbone.herston.uq.edu.au/~ortho/regsum/Regional/13SHOULD/Frozen.html

De Las Pozas, G., Kugel, A., Richards, S. (1997). The Shoulder: A Clinical-Oriented Manual for Occupational Therapy Students. FIU. Miami, FL.