Injury Tip Sheet: Adhesive Capsulitis

Bryan Christie

Bryan Christie

Injury Tip Sheet: Adhesive Capsulitis

Learn what you need to know about adhesive capsulitis

Kathy Weber, M.D., M.S. Daphne R. Scott, PT, Dsc Chicago, IL

Fast facts

  • Also known as Frozen Shoulder
  • Occurs most often in people between the ages of 40-70
  • Nearly 70% of frozen shoulder sufferers are women
  • Generally occurs in three stages (see below)

What you need to know

What is adhesive capsulitis?

  • A capsule encases the shoulder joint and helps protect all of the bones, ligaments, and tendons of the shoulder joint.  When this capsule swells or thickens, it tightens and restricts movement.
  • Adhesive capsulitis refers to the feeling of ‘adhesion’ or contraction that limits range of motion as the capsule tightens around the shoulder joint.
  • There are three general stages to frozen shoulder. The first is the painful stage when the pain is intense, motion of the shoulder begins to be limited, there is typically pain associated with movement.  The second, adhesive stage, involves less pain and shoulder motion is significantly restricted.  The last stage is the recovery stage when pain decreases further and range of motion improves.

Signs & symptoms

  • Inability to lift the shoulder
  • Pain and stiffness in the shoulder
  • Difficulty sleeping on your side
  • Loss of range of motion

When should I see a doctor or other professional?

  • You should see a doctor if the pain keeps you from your normal routine or awakes you at night
  • If pain does not improve after two or three weeks of self-treatment
  • If you notice that the range of motion of your shoulder is starting to decrease


  • Many cases of frozen shoulder occur as a result of a prior injury such as bursitis or tendinitis
  • Long periods of inactivity where the shoulder has remained immobile and motion over the head has been avoided
  • Many cases have no clear reason for the development of the adhesive capsulitis

Risk factors

  • There is a strong correlation between cases of frozen shoulder and people with diabetes.  It is thought that there might be an autoimmune component of frozen shoulder.
  • People with a history of shoulder injuries are more at risk of developing frozen shoulder

What you can do


  • The key to avoiding frozen shoulder is to maintain flexibility and range of motion
  • If you are recovering from a shoulder injury which requires long periods of inactivity your doctor may refer you to Physical Therapy to address limitations with pain and range of motion.

Recommendations for treatment and rehab

  • Frozen shoulder is treated by slowly trying to regain range of motion
  • Pain and inflammation are treated with ice and if appropriate anti-inflammatory medications
  • Massage therapy can also be used to help relax muscles and improve blood flow in the shoulder region

What can I do to stay active?

  • Any exercise is allowed that does not increase pain beyond a tolerable level in the shoulder
  • Cardiovascular activities such as walking, use of the stationary bicycle, or the elliptical trainer is appropriate
  • Swimming should only be performed if performed without overhead movements

Follow these exercises to help treat adhesive capsulitis. [swfobj src="" width="500" height="500"]


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