Primary Adhesive Capsulitis –
Characterized by an idiopathic, progressive, and painful loss of active and passive shoulder motion, particularly ER
Inflammation and pain can cause muscle guarding of the shoulder muscles, without true fixed contracture of the joint capsule.
Disuse of the arm results in a loss of shoulder mobility, whereas continued use of the arm through pain can result in development
of sub-acromial impingement.
Secondary or Idiopathic Adhesive capsulitis-
Characterized by substantial restriction of both active and passive shoulder motion that occurs in the absence of a known intrinsic
shoulder disorder.
Two clinical forms are recognized:
1. One form is defined as when the pain is more noticeable than the motion restriction. This condition is self-limiting and
the patient spontaneously recovers within 6 months a year.
2. The other form is defined as when the pain, which can radiate below the elbow, is as noticeable as the restriction. The
patient complains pain at rest and is unable to sleep on the involved side. ER of the G-H joint is usually affected more than
abduction or flexion.
ADHESIVE CAPSULITIS Age >40 years old
Trauma
Other Names Diabetes
ADCAP Thyroid disease
Frozen Shoulder Stroke or myocardial infarction and the comorbidity
Periarthritis of autoimmune disease.
Definition Epidemiology:
Adhesive capsulitis is an enigmatic condition Occurs in approximately 2% to 5% of the general
characterized by painful, progressive, and disabling population a
loss of active and passive glenohumeral joint range of The onset is insidious and usually occurs between the
motion in multiple planes ages of 40 and 60 years.
In 1934, Codman described frozen shoulder as a Middle age women and diabetic patients appear to be
“pattern of glenohumeral stiffness difficult to define, at a higher risk for spontaneous idiopathic adhesive
difficult to treat, and difficult to explain from the capsulitis.
point of view of pathology.” F>M
Grading / Types / Classification ANATOMIC CONSIDERATIONS
Stage Name Duration Signs and Symptoms Rotator Cuff
1 Pre- 1-3 months Painful shoulder The rotator cuff is the name given to the tendons of
Adhesive movement, minimal the subscapularis, supraspinatus, infraspinatus,
restriction in motion and teres minor muscles, which are fused to the
2 Freezing 3-9 months Painful shoulder underlying capsule of the shoulder joint.
movement, progressive The cuff plays a very important role in stabilizing the
loss of GH jt. motion shoulder joint.
3 Frozen 9-15 Reduced pain with sh. The tone of these muscles assists in holding the head
months movement, severely of the humerus in the glenoid cavity of the scapula
restricted GH jt. motion during movements at the shoulder joint.
4 Thawing 15-24 Minimal pain, progressive The cuff lies on the anterior, superior, and
months normalization of GH jt. posterior aspects of the joint. The cuff is deficient
motion inferiorly, and this is a site of potential weakness.
Etiology
Diabetes Mellitus JOINTS
Immobility
Arthritis
1. STERNOCLAVICULAR JOINT
Trauma
Idiopathic (most common)
saddle type of synovial joint but functions as a ball-and-
Predisposing Factors / Risk Factors socket joint
Prolonged immobilization following injuries RESTING POSITION:
Characterized by an idiopathic, progressive, and painful loss of active and passive shoulder motion, particularly ER
Inflammation and pain can cause muscle guarding of the shoulder muscles, without true fixed contracture of the joint capsule.
Disuse of the arm results in a loss of shoulder mobility, whereas continued use of the arm through pain can result in development
of sub-acromial impingement.
Secondary or Idiopathic Adhesive capsulitis-
Characterized by substantial restriction of both active and passive shoulder motion that occurs in the absence of a known intrinsic
shoulder disorder.
Two clinical forms are recognized:
1. One form is defined as when the pain is more noticeable than the motion restriction. This condition is self-limiting and
the patient spontaneously recovers within 6 months a year.
2. The other form is defined as when the pain, which can radiate below the elbow, is as noticeable as the restriction. The
patient complains pain at rest and is unable to sleep on the involved side. ER of the G-H joint is usually affected more than
abduction or flexion.
ADHESIVE CAPSULITIS Age >40 years old
Trauma
Other Names Diabetes
ADCAP Thyroid disease
Frozen Shoulder Stroke or myocardial infarction and the comorbidity
Periarthritis of autoimmune disease.
Definition Epidemiology:
Adhesive capsulitis is an enigmatic condition Occurs in approximately 2% to 5% of the general
characterized by painful, progressive, and disabling population a
loss of active and passive glenohumeral joint range of The onset is insidious and usually occurs between the
motion in multiple planes ages of 40 and 60 years.
In 1934, Codman described frozen shoulder as a Middle age women and diabetic patients appear to be
“pattern of glenohumeral stiffness difficult to define, at a higher risk for spontaneous idiopathic adhesive
difficult to treat, and difficult to explain from the capsulitis.
point of view of pathology.” F>M
Grading / Types / Classification ANATOMIC CONSIDERATIONS
Stage Name Duration Signs and Symptoms Rotator Cuff
1 Pre- 1-3 months Painful shoulder The rotator cuff is the name given to the tendons of
Adhesive movement, minimal the subscapularis, supraspinatus, infraspinatus,
restriction in motion and teres minor muscles, which are fused to the
2 Freezing 3-9 months Painful shoulder underlying capsule of the shoulder joint.
movement, progressive The cuff plays a very important role in stabilizing the
loss of GH jt. motion shoulder joint.
3 Frozen 9-15 Reduced pain with sh. The tone of these muscles assists in holding the head
months movement, severely of the humerus in the glenoid cavity of the scapula
restricted GH jt. motion during movements at the shoulder joint.
4 Thawing 15-24 Minimal pain, progressive The cuff lies on the anterior, superior, and
months normalization of GH jt. posterior aspects of the joint. The cuff is deficient
motion inferiorly, and this is a site of potential weakness.
Etiology
Diabetes Mellitus JOINTS
Immobility
Arthritis
1. STERNOCLAVICULAR JOINT
Trauma
Idiopathic (most common)
saddle type of synovial joint but functions as a ball-and-
Predisposing Factors / Risk Factors socket joint
Prolonged immobilization following injuries RESTING POSITION:
