MSK pathology- adhesive capsulitis of the shoulder Flashcards
(19 cards)
what is adhesive capsulitis caused by?
adhesive fibrosis and scarring between the capsule, rotator cuff, subacromial bursa and deltoid
adhesive capsulitis results in…
loss of active and passive shoulder ROM due to soft issue contracture
in adhesive capsulitis, adhesive fibrosis and scarring occurs between what structures (4) of the shoulder?
capsule
rotator cuff
subacromial bursa
deltoid
what is the onset of adhesive capsulitis related to?
a direct injury or may begin insidiously
peak incidence of adhesive capsuilitis occurs between __-__ years of age, with __ being affected more than __
40-60
females more than males
patients with what condition have an increased incidence of adhesive capsulitis?
diabetes
adhesive capsuilitis is a condition that is self-limiting in nature, what does this mean?
it typically resolves on its own in the absence of specific treatment/intervention
adhesive capsuilitis typically resolves in __-__ years
1-2
although adhesive capsulitis typically resolves in 1-2 years, some individuals have residual __ __ __
loss of motion
what are the signs and symptoms (4) of adhesive capsulitis?
insidious onset of localized pain often extending down the arm
subjective reports of: stiffness, night pain and/or restricted ROM in a capsular pattern
what is the focus of physical therapy treatment of adhesive capsulitis? what interventions are generally incorporated?
focus of tx is increasing shoulder ROM with…
GHJ mobilizations
ROM exercises
palliative modalities
when treating adhesive capsulitis, the physical therapist and patient should avoid..
overstretching
elevation of pain
when treating adhesive capsulitis, why should the physical therapist and patient avoid overstretching and elevation of pain?
it can result in further ROM loss
what are the surgical options for adhesive capsulitis?
suprascapular nerve block
closed manipulation under anesthesia
according to the CPG, physical therapy interventions for adhesive capsulitis should include (2)…
shoulder mobility/stretching exercises (most effective when combined with corticosteroid injection)
education on: disease course, activity modification to encourage functional, pain-free ROM and stretching intensity that matches level of tissue irritibility
according to the CPG for adhesive capsulitis, shoulder mobility and stretching exercises are most effective when combined with what other intervention?
corticosteroid injections
according to the CPG, physical therapy interventions for adhesive capsulitis may include (3)…
GHJ mobilization
US or e-stim when combined with stretching exercises
according to the CPG for adhesive capsulitis, ultrasound or estim may be used when combined with what other intervention?
stretching exercises
what is a potential differential diagnosis to consider when assessing a patient with suspected adhesve capsulitis?
acute subacromial bursitis
