Adhesive Capsulitis

Adhesive capsulitis of the shoulder is a common problem that is generally idiopathic in nature but is sometimes associated with subacromial bursitis, rotator cuff tendinitis or trauma. The patient presents with pain and immobility but is differentiated from impingement by a passive restriction of glenohumeral joint motion. The capsule becomes severely shortened and internal and external rotations are generally most affected.

This problem needs to be addressed aggressively. Local heat and ultrasound help warm the capsule and surrounding soft tissue making it more elastic. This is followed with a graded, active but more importantly, manual joint mobilization. Joint mobilization is a technique utilizing arthrokinematic motion of the joint. The therapist is capable of gliding, spinning or rolling the bones at their articulation, allowing very specific stretching of the joint capsule. Many patients realize significant improvements in mobility and function within two to four weeks. Strengthening of the entire shoulder girdle, emphasizing the rotator cuff, stabilizers of the scapula and glenohumeral elevators is implemented.

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