Shoulder Injuries – Adhesive Capsulitis

Last week we addressed a question from a person who sustained a shoulder injury after falling when ice skating. We discussed that her condition may be a shoulder bursitis, adhesive capsulitis, or a rotator cuff syndrome. Last week we discussed the pathology of a shoulder bursitis. This week we will be discussing Adhesive Capsulitis.

Adhesive Capsulitis or frozen shoulder is a condition in which a patient has severe limitation in the shoulder joint. This condition may come from a fall, or could come on for no apparent cause and effect relationship. It is not uncommon for a person to have a frozen shoulder in one shoulder and months later after the condition is corrected, their other shoulder is affected. Sometimes a lung and or shoulder tumor may mimic itself as a frozen shoulder. Often times these tumors will not show up on x-rays initially, but will usually be evident on a MRI. Frozen shoulder syndromes are usually divided into three phases: the freezing phase with severe aching; the frozen phase with progressive stiffness in most directions; and finally the thawing phase, where the range of shoulder motion slowly recovers.

When a patient has this condition, their complaint is more of a restriction verses pain, except when forcing the shoulder in a direction it is restricted in. The doctor or patient is unable to raise their extremity due to adhesions in the joint capsule that limits their mobility. This is in contrast to a shoulder bursitis and rotator cuff syndrome in which mobility can usually be obtained, even though it is painful.

A frozen shoulder could take weeks to months to rehabilitate, even with the best of treatment. When a patient has this condition, identifying and treating this early on could greatly shorten the duration of the impairment.

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