Adhesive capsulitis or frozen shoulder as it is sometimes called occurs in 2-5% of the population. About 20-30% of people have it in one shoulder and may also develop symptoms in the other. It more commonly affects females. There is no known mechanism of injury.
Sometimes it comes on out of nowhere, and other times it can happen following a trauma or surgery to the shoulder or arm. It presents as a stiff and painful shoulder, particularly with external rotation.
Clinical assessment consists of comparison, active and passive range of motion, where the movement of the shoulder is limited by stiffness and not by pain or muscle dysfunction. Patients will often hitch their shoulder as the gleno-humeral joint isn’t able to stretch and rotate in its socket, so the patient tries to get the extra movement by hitching and moving their shoulder girdle.
Physiotherapy is only effective in the management of adhesive capsulitis after the so-called “thawing” period has begun. Up until that point, therapy is limited to maintaining range of motion and optimising function as well as pain management. However, after that, soft tissue massage, manual therapy techniques, working on movement and then a progression to strengthening can be really helpful.
Medical management can consist of a corticosteroid injection or hydrodilatation procedure or surgical intervention, but generally, this is a self-limiting condition, which will gradually start to resolve after up to 12 months or 18 months to 2 years.
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