Adhesive Capsulitis

Adhesive capsulitis is a physical condition that affects both the range of motion and the overall function of the shoulder. This affliction is also known as "frozen shoulder," which is a general description of the sensation commonly associated with the condition. Adhesive capsulitis is often difficult to diagnose, especially among athletes, as the physical symptoms are very similar to those of rotator cuff tendinitis, bursitis, tendinitis of the bicep tendon (which attaches the muscles of the upper arm to the shoulder joint), and more generalized arthritis complaints.

The shoulder is one of the most complex muscu-loskeletal structures in the body. The humerus bone (upper arm), the scapula (shoulder blade), and the clavicle (collarbone) are the bones that form the shoulder joints. The rotator cuff, a four-muscle formation positioned on the top of the shoulder, is responsible for the degree of motion available for upward arm movement. The joint that is most vulnerable to injury is the scapulohumoral joint, the largest of the shoulder joints, which has a joint capsule in which it is encased. The capsule encases a small amount of synovial fluid, which assists the smooth, friction-reduced movements of the bones within the joint.

The precise cause of adhesive capsulitis is not well understood. The limitations in shoulder movement are often attributed to a formation of scar tissue in the scapulohumeral joint, often the result of the individual having sustained a previous injury. The medical name of the condition is attributed to the fact that the joint capsule tissue adheres to the head of the humerus bone where it meets the scapula. The condition is typically first noted by a person when the shoulder becomes stiff, followed by a loss of range of motion in the joint and a significant degree of pain that accompanies any vigorous movement, such an attempts to throw an object or to lift any significant weight. The mechanism that causes frozen shoulder is unique to the shoulder structure, as no other human joint has an equivalent disorder.

Statistically, approximately 70% of adhesive cap-sulitis cases occur among women, most often in the non-dominant shoulder (the shoulder of their opposite hand). It is also a condition that rarely reoccurs once it has apparently completed its progression from stiff to frozen to thaw. Once the initial stiffness is noted in shoulder movement (a sensation that may persist for between three to six months), the frozen shoulder phase may also continue for a similar period.

The ultimate thawing of the shoulder is a further process of usually three to four months. Treatments will often consist of stretching exercises that seek to gradually extend the available range of motion in the joint. The administration of corticosteroids will provide a measure of anti-inflammatory benefit in some cases.

SEE ALSO Musculoskeletal injuries; Shoulder anatomy and physiology; Shoulder injuries; Tendinitis and ruptured tendons.