Adhesive capsulitis, commonly known as frozen shoulder, is a condition of the shoulder joint and surrounding soft tissue structures including the capsule. No definitive causes are known, however, several risk factors for predisposition to this condition include a history of Type I or Type II diabetes, thyroid disease, and being of the female population.1
Adhesive capsulitis signs and symptoms include: pain in the shoulder, decreased mobility of the joint capsule that surrounds the glenohumeral / shoulder joint, both of which result in decreased motion of the arm overhead and behind the head (external rotation). Functional limitations present may include difficulty lying on the affected side, difficulty with fixing hair and grooming, and difficulty reaching behind the back for putting on coat, etc.1
Adhesive capsulitis progresses through a series of stages. The first stage hallmarks sharp pain with movement of the shoulder with minimal limitations in mobility of the shoulder.1 The second stage presents with a progressive decrease in mobility due to pain, however, the third stage presents with an objective decrease in mobility due to changes in the capsule surrounding the joint.1 The final stage occurs with gradual resolution of symptoms including a decrease in pain and gradual improvement in range of motion.1 A patient can naturally progress through these stages in about 18-24 months without intervention, however, physical therapy can help progress a patient through these stages in a quicker amount of time.
Physical therapy treatment includes education, glenohumeral / shoulder joint mobilization in order to improve capsular mobility, passive and active range of motion, stretching exercises, postural retraining exercises, and electrical stimulation and heat for pain relief.
If you have any questions regarding adhesive capsulitis or any other shoulder condition, please stop by or call your local ApexNetwork Physical Therapy clinic. You can also visit our website at
1Kelley, Martin J. et al. “Shoulder Pain and Mobility Deficits: Adhesive Capsulitis Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health From the Orthopaedic Section of the American Physical Therapy Association”. J Orthop Sports Phys Ther. 2013: 43 (5): A1-A3.