shoulder acap Flashcards
what is the prevalence for Acap
2-3% of general population
what are the risk factors for Acap
- systemic illness such as DM or thyroid disease
- age 40-65
- females more than males
- history of frozen shoulder
- dupuytren’s contractures are related to thyroid, DM and cap
what is the typical time course for Acap
-12-18 months, but can last up to 4 years
what red flag conditions could refer pain to the shoulder
- digestive disease
- Upper arm fractures
- vascular injuries
- neoplasm
- Osteoporosis
what clinical findings would you expect with Acap
- age between 40-65
- gradual onset and progressive worsening
- pain and stiffness that limits function
- GH PROM is limited in multiple directions
- ER most limited particularly in abduction
- IR and ER decrease with greater degrees of abduction
- PROM produces primary pain
- GH joint mobility limitations
why is Acap PROM decreased into abduction
takes slack out of the capsule
what are the Acap stages
stage 1: early and looks like an impingement problem
stage 2: painful freezing
stage 3: frozen
stage 4: thawing
** level of irritation is also classified **
describe stage 1
- up to three months long
- sharp end range pain
- achy pain at rest
- sleep disturbances
- early loss of ER with intact RTC strength
Describe the patho-anatomy of stage 1
synovial reaction no adhesions or contractures
describe the stages of irritability
HIGH
- high pain levels, consistent pain at night or rest, high self reported disability, pain before end range, AROM significantly less than PROM
MODERATE
- moderate pain levels, intermittent night or rest pain, moderate self reported disability, pain at end ranges of active and passive, AROM=PROM
LOW
- minimal pain (4or less), no night or rest pain, pain with overpressure PROM, AROM=PROM
