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Adhesive capsulitis or frozen shoulder. A pretty common thing that is often mistaken for a rotator cuff tear or impingement. The hallmark is just capsular tightness and lack of motion. Usually they will lose internal rotation first and then eventually they will lose forward flexion or abduction. It can follow some type of trauma or repetitive use of the arm. Some people feel that in females it has something to do with hormone changes and you will see them in females who have had a hysterectomy or some females who are going through menopause. They have progressive pain. They will describe pain at night and they will also notice that they have some loss of motion. On examination, you are going to pick up the loss of motion. Generally they don’t have a lot of rotator cuff weakness although they may have some pain with forceful stress testing of the rotator cuff. Adequate x-rays. Don’t send someone out with a diagnosis of frozen shoulder until you are sure that they don’t have some type of
Treatment for this. Anti-inflammatory medicines. I like to use a Prednisone taper for about eight days and physical therapy for stretching but you don’t want to
You don’t want to have the therapist really crank on them because you can actually make them
So a lot of times a self directed stretching program is helpful. If they fail to progress over three to six months and they are having significant pain, you may need to talk to them about a manipulation or