Adhesive capsulitis is also known as frozen shoulder as it causes stiffness and pronounced
limitations in movement of the shoulder joint. Adhesive capsulitis refers to the capsule around
the shoulder joint forming adhesions. In other words, the soft tissue structure surrounding the
shoulder becomes thickened and tight. This prevents the bones from moving to the degree that
they normally do. The condition progresses gradually over time, reaches a plateau and then
improves, lasting up to 1-3 years. The three stages of the condition is characterised firstly by
progressive stiffness and pain (freezing stage), then by stiffness and limited motion without pain
(frozen stage), and lastly by improvement in stiffness (thawing stage).
Adhesive capsulitis affects 2-5% of the population at some point in their life, and is commonly
seen in people after immobilisation of the shoulder, such as after mastectomies, after a person
had a stroke, after a rotator cuff injury or after a fracture in the arm. It is also more common in
people with diabetes, women and people over 40 years of age. The exact mechanism and
reason for the development of the condition is still poorly understood. In 5-34% of people it will
occur in the other shoulder as well.

● Pain and stiffness in the shoulder
● Pain can disrupt your sleep at night
● Decreased passive and active shoulder movement
● Progressive stiffness

A full history will be taken as well as a range of physical tests will be performed to aid in the
diagnostic process. Any associated factors, such as muscle strength and posture, will also be
assessed. Based on the evaluation findings, your physiotherapist will plan your treatment
strategy to address your goals. Physiotherapists work with a healthcare team to ensure that all
aspects of treatment are met, and this will improve your outcome. Physiotherapy treatment for
adhesive capsulitis may include shoulder mobilisations, stretches, strengthening, posture
corrections, ergonomic setup for work, massage, dry needling, and a home exercise
programme. Pain can be managed well with the right techniques and by adapting some
movements. Compliance with the treatment plan is important to improve the outcome of this

Other treatment options include pain medications or anti-inflammatory drugs prescribed by your
doctor, injections or surgery, and these are most effective when performed in conjunction with