Flexibility

Adhesive Capsulitis

What is it?

Adhesive Capsulitis

• Painful restricted ROM• Early loss of ER• Normal x-rays• Occurs in middle-age –aged

females greater than males

What is the etiology?

Adhesive Capsulitis

• Usually idiopathic

• Associated with diabetes mellitus, inflammatory arthritis, trauma, prolong immobilization, thyroid disease , stroke, myocardia infarction, or autoimmune disease

• May also occur secondary to rotator cuff disease

Name the three stages ?

Stage one

• First 1 to 3 months• Pain with little motion loss initially

Stage 2

• Months 3 – 9 with reduce pain but increase loss of motion particularly ER

Stage 3

• Months 9 to 15 with gradual improvement of loss of ROM

Adhesive Capsulitis

• X-rays normal• Arthrogram shows a reduce in capsule

volume• Pathology thought to be due to inflammation

in the rotator cuff greater than global capsule, causing capsule tightening

Adhesive Capsulitis

• Stages one and two use modalities, analgesics and NSAD and glenohumeral joint injections to reduce inflammation and pain

• Facilitate rehabilitation and shorten the duration of the condition.

• Avoid aggressive exercise because this will exacerbate the condition

Codman’s Exercise

Passive relax ROM

Spencer’s

Adhesive Capsulitis

• Generally near normal function over a 12 – 14 month period.

• Patient not improve after 4 to 6 months may benefit from manipulation under anesthesia or arthroscopic lysis of adhesions