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Frozen Shoulder – Adhesive Capsulitis


Frozen shoulder or adhesive capsulitis is a condition where the shoulder joint becomes stiff and painful and the normal range of movement is reduced. The condition can range from significant loss of range of movement to just the last ten degrees in external rotation, flexion and abduction. The patient often reports difficulty sleeping on the affected shoulder (Mac Auley, 2013).

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Key facts:

  • Caused by thickening of the joint capsule.

  • Painful arc of movement.

  • Passive and active range of movement is significantly restricted (Jayson, 1981). 

  • Linked diabetes, heart disease, shoulder trauma, inflammatory disease, cervical injury, and hyperthyroidism.

  • Common during middle age and in women.

  • Normally affects the non-dominant arm (Mac Auley, 2013).

  • Tissue becomes dense and the fibres thicken in the folds of the capsule.

  • The capsule becomes short preventing external rotation of the shoulder, which then restricts abduction because the greater tuberosity will not clear the coracoacromial arch (Hendrickson, 2009).

  • Can lasts for two years and has three phases; the acute inflammatory phase; the stiffening phase and finally, the thawing phase where range of movement is recovered (Hendrickson, 2009).

Can be linked to;

  • Supraspinatus tendonitis.

  • A damaged infraspinatus resulting in thickening of the posterior capsule.

  • Thoracic kyphosis maybe a causative factor due to affecting the scapulohumeral alignment (Hertling & Kessler, 2006).

Shoulder load and shift test.jpg


  • Exercises and analgesics can reduce the pain (Griggs, Ahn, & Green, 2000).

  • Injection of corticosteroids drugs into the joint (Rizk, Pinals,& Talaiver, 1991).

  • In extreme cases, surgery to reduce the thickening of the capsule (Baums, Spahn, Nozaki, Steckel, Schultz, & Klinger, 2006).

  • Manual therapy is used to reduce pain & increase range of movement.


Manual therapy techniques, if used early enough, can significantly reduce the time and pain associated with this condition. 

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