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ADHESIVE CAPSULITIS or FROZEN SHOULDER

Adhesive Capsulitis, or a frozen shoulder, is a poorly understood condition in which the deepest layers of soft tissue, called the joint capsule, become diseased. In frozen shoulder, inflammation in the joint makes the normally loose parts of the joint capsule stick together. This seriously limits the shoulder's ability to move and causes the shoulder to freeze. No one fully understands why this condition occurs so suddenly. Frozen shoulder may begin after a shoulder injury, fracture, or surgery. It can also start if the shoulder is not being used normally. This can happen after a wrist fracture, when the arm is kept in a sling for several weeks. For some reason, immobilizing a joint after an injury seems to trigger the autoimmune response in some people. Frozen shoulder has also been known to occur after surgery unrelated to the shoulder, even after recovering from a heart attack. Other shoulder problems like bursitis, rotator cuff tears, or impingement syndrome can end up causing a frozen shoulder. Doctors theorize that the underlying condition may cause chronic inflammation and pain that make you use that shoulder less. This sets up a situation that can create frozen shoulder. Usually, the frozen shoulder must be treated first to regain its ability to move before the underlying problem can be addressed.

Symptoms 

The symptoms of frozen shoulder are primarily shoulder pain and a very reduced range of motion in the joint. The range of motion is the same whether you are trying to move the shoulder yourself or someone else is trying to move the arm for you. There comes a point in each direction of movement where the motion simply stops, as if something is blocking it. At this point, the shoulder usually hurts. The shoulder can also be quite painful at night. The tightness in the shoulder can make it difficult to do regular activities like getting dressed, combing your hair, or reaching across a table. 

Treatment 

Physical therapy consisting of patient education, mobility exercises, stretching, joint mobilization, therapeutic exercise and a home exercise program can help speed recovery. These techniques have been found to be effective in improving the range of motion by directly improving the mobility of the joint capsule and by lubricating the shoulder joint through specific manual techniques and therapeutic exercises.