Frozen shoulder adhesive capsulitis



Adhesive capsulitis, most commonly referred to as frozen shoulder (FS), is an idiopathic disease with 2 principal characteristics: pain and contracture of the shoulder joint. It is known as idiopathic because it is a pathology that occurs for unknown reasons. The shoulder pain associated with FS is progressive and is felt mostly when the shoulder is moved close to the end of its range of motion (ROM) where it is stiff. The pain can be caused by certain combined movements of the shoulder, such as abduction and external rotation (eg, grooming one’s hair, reaching for a seatbelt overhead) or extension and internal rotation (eg, reaching for a back pocket or bra strap). The pain tends to be constant initially, and then mostly with shoulder use especially at end rom. In approximately 90% of patients with FS, this pain usually lasts 1-2 years before subsiding. The second characteristic of adhesive capsulitis is the adhesion formation of the shoulder joint capsule that restricts the rom of the shoulder. This restriction makes it very hard to move the arm in a full rom. The adhesions “lock” the shoulder joint down and can cause damage to the rotator cuff from abnormal movement over time.

What I see in the clinical setting when someone comes to me with adhesive capsulitis is a very painful shoulder that becomes more painful as it is forced into a stretch. The patient has a hard time lifting the arm overhead and behind the back because of stiffness and pain. As long as the patient does not lift the arm up, it tests out as strong when checking the muscles. The joint has a certain stiffness to it when taking it through passive range of motion. Manual therapy with osteopathic manipulation along with myofascial release techniques are very beneficial in the treatment of frozen shoulder. Using manual therapy can significantly help improve rom and reduce pain when done appropriately, which helps get the shoulder back to its normal function. To improve frozen shoulder in a quick manner, therapy has to include hands on manual techniques with prom and stretching. This is the problem with traditional therapy. Most of the time manual therapy is not performed due to the time restrictions set up by insurance companies. Manual therapy takes time and that is why I am a cash based therapist. I can get you better much quicker not being affiliated with insurance because I can have much longer treatment sessions. So, if you have frozen shoulder or any shoulder pain, call me for an appointment and get pain relief fast.