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Adhesive Capsulitis: “Frozen Shoulder”

Adhesive capsulitis is a disorder in which the shoulder capsule and the connective tissue surrounding the joint becomes stiff and inflamed. Many patients are often frustrated because of the level of pain and the lengthiness of the recovery. This condition can last up to 24 months. Approximately 70% of frozen shoulder patients are women, although males with frozen shoulder seem to take longer to recover.

RISK FACTORS

  • Diabetes

  • Stroke

  • Accidents

  • Lung disease

  • Connective tissue disorders

  • Heart disease

SYMPTOMS

  • Shoulder pain, usually constant and may increase at night; painful activities include hair care and reaching for the seatbelt

  • Restricted mobility in shoulder

TREATMENTS FOR THE THREE PHASES

1. Freezing: Painful Phase

Goal: Reduce pain and maintain mobility in the shoulder

Techniques:

  • Ultrasound or iontophoresis to reduce inflammation

  • Passive range of motion (therapist moves the patient) to assist with mobility; effective way to prevent adhesions (tissues stuck together) and maintain current range of motion

2. Frozen: Stiff Phase/Pain Decreases

Goal: Increase mobility in the shoulder

Techniques:

  • Heat

  • Joint mobilization

  • Active and passive motion

3. Thawing: Less Painful Phase

Goal: Continue to improve mobility in the shoulder

Techniques:

  • Strengthening exercises

  • Manipulation by a doctor under anesthesia if mobility still restricted; can help break up adhesions and scar tissue