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Adhesive Capsulitis

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 donít have a lot of rotator cuff weakness although they may have some pain with forceful stress testing of the rotator cuff. Adequate x-rays. Donít send someone out with a diagnosis of frozen shoulder.

Treatment for this. Anti-inflammatory medicines. I like to use a Prednisone taper for about eight days and physical therapy for stretching but you donít want to

You donít want to have the physical therapist really crank on them because you can actually make them worse.

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