Adhesive capsulitis develops following rotator cuff tendonitis, usually supraspinatus, with severe contracture of the rotator cuff and shoulder capsule. The shoulder capsule is extremely loose to allow a large movement range and forms a fold at the bottom of the shoulder joint. In adhesive capsulitis the opposing surfaces of this fold adhere together. It begins with a dull ache which often has no initial injury, where movement aggravates the pain. The chronic cycle results in rotator cuff and capsular restriction which limits movement in all directions.
Adhesive capsulitis is usually self-limiting and lasts 6-18 months, with many patients having restoration of full movement. However some patients have prolonged disabilities and pain with the shoulder not returning to its previous state.
Physiotherapy may involve pain reducing modalities and restoring mobility in the shoulder. In the early stages physiotherapy is often not effective and it is only when the capsulitis starts to resolve that we can start improving the range of motion