Adhesive Capsulitis

Occurs when the joint capsule of the shoulder becomes inflamed and stiff, making the joint difficult to move, often after prolonged immobilization of the shoulder. Pain is usually a constant and dull ache, worse at night, in colder weather, and during certain movements. This is not the same as arthritis or impingement syndrome.

Symptoms typically develop slowly and in three stages

  • Stage 1. The "freezing" or painful stage – pain occurs with any movement of your shoulder, limiting range of motion; may last from six weeks to nine months
  • Stage 2. The "frozen" or adhesive stage – may be a slow improvement marked by a diminish in pain, but stiffness remains; may last four to nine months
  • Stage 3. The "thawing" or recovery stage – shoulder motion slowly returns to normal; may last five to 26 months

Risk Factors

  • Aging – almost always found in the 40–70 age range
  • Posture – rounded shoulders can cause shortening of ligaments of the shoulder
  • Diabetes – glucose molecules stick to fibers in the joint capsule
  • Hormonal – more commonly in females about the same time as menopause
  • Immobilization / splinting
  • Surgery
  • Muscular imbalances
  • Direct Trauma
  • Long term disuse or misuse

Physical therapy treatments including specific exercises, modalities, and manual treatments can speed recovery and maximize range of motion and strength gains. Therapists can also educate about posture and ergonomics to prevent future recurrences. Sometimes an orthopedic surgeon can recommend a manual manipulation under anesthesia to hasten the recovery process since rehabilitation can be long and frustrating to some patients.