Shoulder

Frozen shoulder (adhesive capsulitis)

Mechanism

Fibrosis and shortening of the glenohumeral capsule, with the coracohumeral ligament and rotator interval affected first. Often without an identifiable trigger; diabetes and thyroid disorders raise the risk considerably.

Recognition

The capsular pattern of the shoulder is decisive: external rotation limited most, then abduction, then internal rotation, equally so actively and passively. Night pain is a constant feature.

Course

Runs in three phases: freezing with mainly pain, frozen with mainly stiffness, and thawing. Together that takes one to three years. Equal limitation of active and passive movement distinguishes it from a cuff problem.

Structures

• Coracohumeral ligament
• Glenohumeral ligaments (Superior, Middle, and Inferior / IGHL complex)

Joints involved

• Shoulder joint (glenohumeral joint)

Sources

• Magee DJ, Manske RC. Orthopedic Physical Assessment, 7e editie. Elsevier. 2021