Frozen Shoulder (Adhesive Capsulitis)

  • Insidious onset of shoulder pain and restriction where the cause is in debate. Some believe it is inflammation, others believe it is an autoimmune response (the body attacking itself), or immobility after an injury. 

  • The posterior joint capsule thickens and tightens, along with the subacromial bursa, the coracohumeral ligament and some of the muscles (mainly subscapularis). This causes a great reduction in external rotation along with other shoulder movements. 

  • It can be primary with unknown cause, but may be associated with other diseases such as diabetes mellitus, systemic diseases such as thyroid diseases, and Parkinson’s Disease

  • It can be secondary, which can occur after shoulder injuries or immobilizations, surgeries, or a stroke.

  • Characterized by 3 phases

  1. Freezing: Pain is the most severe, especially at night. ROM is beginning to be limited and difficult to reach overhead 

  2. Frozen- less painful but the shoulder becomes tighter and more difficult to move 

  3. Thawing - shoulder improves over time and begins to return to its prior level 

  • It is important to try to walk as normal as possible, use good posture, and use the shoulder as much as tolerable

  • Staying active is important

  • Improving or maintaining good nutrition and drinking a lot of water

  • Getting at least 7-8 hours of sleep or more to promote healing

  • There is a 20-30% rate of occurrence in the opposite shoulder, maintaining motion on the opposite side is important