Adhesive Capsulitis

Question 1

What is adhesive capsulitis and how does it present?

Answer 1

• Fibrosing of the capsule possibly by an inflammatory process - Restricted ROM in AROM and PROM - Loss of ROM in capsular pattern - Gradual insidious onset - Rotator cuff affected - Incidence unknown

Question 2

What are the stages of adhesive capsulitis?

Answer 2

1. Freezing - painful phase (severe pain and reduction in ROM) 2. Frozen - stiff phase (pain may be present) 3. Thawing - improvement phase (minimal pain and increased ROM)

Question 3

How would you treat adhesive capsulitis in each stage?

Answer 3

1. Freezing - reduce pain (NSAIDS, injection) and maximise ROM 2. Frozen - maximise ROM and function (mobs, self management programme) 3. Thawing - maximise ROM to restore function (mobs, active exercise prog, stretching)