Frozen shoulder

Rizk, Tewfik E.; Pinals, Robert S.

doi:10.1016/0049-0172(82)90030-0

Cited by 124 publications

(72 citation statements)

References 36 publications

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“…103 A greater than 50% reduction in passive external rotation or less than 30° of external rotation, when measured with the arm at the side, is a common finding in individuals with frozen shoulder. 8,15,18,24,39,78,96,100,107,119,121 Although authors of textbooks have described patients with frozen shoulder as having normal strength and painless resisted motions, 24 authors of recent studies, using handheld dynamometry, have revealed significant weakness of the shoulder internal rotators 53,59 and elevators 53,59,111 in these patients. The shoulder internal rotators were significantly weaker in patients with frozen shoulder compared to patients with rotator cuff tendinopathy; however, significant weakness of the external rotators and abductors was also found relative to the uninvolved side.…”

Section: Level 5 J Orthop Sportsmentioning

confidence: 99%

“…100 Although the precise etiology remains unclear, recent evidence identifies elevated serum cytokine levels as part of the process. 19,49,101 Cytokines and other growth factors facilitate tissue repair and remodeling as part of the inflammatory process.…”

Section: Level 5 J Orthop Sportsmentioning

confidence: 99%

“…With frozen shoulder, the examination of the shoulder typically reveals significant limitation of both active and passive elevation, usually less than 120°1 8,80,95,100 ; but motion limitations are stage dependent. Scapular substitution frequently accompanies active shoulder motion.…”

Section: Level 5 J Orthop Sportsmentioning

confidence: 99%

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Frozen Shoulder: Evidence and a Proposed Model Guiding Rehabilitation

Kelley¹,

McClure²,

Leggin³

2009

J Orthop Sports Phys Ther

207

171

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Frozen shoulder, or adhesive capsulitis, describes the common shoulder condition characterized by painful and limited active and passive range of motion (ROM). Frozen shoulder is reported to affect 2% to 5% of the general population, 4,13,64,88 increasing to 10% to 38% in patients with diabetes and thyroid disease. 4,5,13,64,71,88 Individuals with primary frozen shoulder are commonly between 40 and 65 years old, 79,82,83 and the incidence appears higher in females than males. 4,9,43,64,71,109 The occurrence of frozen shoulder in 1 shoulder increases the risk of contralateral shoulder involvement by 5% to history, clinical presentation, and recovery. Codman 22 described frozen shoulder as "a condition difficult to define, difficult to treat, and difficult to explain from the point of view of pathology." Nevaiser 80 introduced the term adhesive capsulitis to describe the inflamed and fibrotic condition of the capsuloligamentous tissue. The term frozen shoulder will be used, because it encompasses both primary frozen shoulder (adhesive capsulitis) and secondary frozen shoulder related to systemic disease and extrinsic or intrinsic factors, excluding cerebral vascular accident, proximal humeral fracture, and causative rotator cuff or labral pathology. This paper will present an overview of the classification, etiology, pathology, examination, and plan of care for frozen shoulder.T he absence of standardized nomenclature for frozen shoulder causes confusion in the literature. Lundberg 64 first described a classification system identifying primary frozen shoulder as idiopathic and secondary frozen shoulder as posttraumatic. Nash and Hazelman 77 expanded the classification system by including diseases such as diabetes mellitus, myocardial infarction, or various neurologic disorders under secondary frozen shoulder. Zuckerman 128 proposed a classification schema where primary 34%, and simultaneous bilateral shoulder involvement occurs as often as 14% of the time. 16,39,64,107 To date, the etiology of frozen shoulder remains unclear; however, patients typically demonstrate a characteristic Frozen shoulder or adhesive capsulitis describes the common shoulder condition characterized by painful and limited active and passive range of motion. The etiology of frozen shoulder remains unclear; however, patients typically demonstrate a characteristic history, clinical presentation, and recovery. A classification schema is described, in which primary frozen shoulder and idiopathic adhesive capsulitis are considered identical and not associated with a systemic condition or history of injury. Secondary frozen shoulder is defined by 3 subcategories: systemic, extrinsic, and intrinsic. We also propose another classification system based on the patient's irritability level (low, moderate, and high), that we believe is helpful when making clinical decisions regarding rehabilitation intervention. Nonoperative interventions include patient education, modalities, stretching exercises, joint mobilization, and corticosteroid injections. Gle...

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Section: Level 5 J Orthop Sportsmentioning

confidence: 99%

Section: Level 5 J Orthop Sportsmentioning

confidence: 99%

See 1 more Smart Citation

Frozen Shoulder: Evidence and a Proposed Model Guiding Rehabilitation

Kelley¹,

McClure²,

Leggin³

2009

J Orthop Sports Phys Ther

207

171

View full text Add to dashboard Cite

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“…The frozen shoulder may in fact be a forme fruste of the shoulder-hand syndrome (9). The association of hyperthyroidism with either lends further support to the notion that they are related.…”

Section: Brief Report Frozen Shoulder In Hyperthyroidism Jeffrey R Wmentioning

confidence: 51%

“…Stroke, spinal cord injury, and diabetes are prominent among the conditions that predispose to frozen shoulder (9) and the shoulder-hand syndrome (10). Dysfunction of the autonomic nervous system is thought to be of pathogenic importance.…”

Section: Brief Report Frozen Shoulder In Hyperthyroidism Jeffrey R Wmentioning

confidence: 99%

Frozen shoulder in hyperthyroidism

Wohlgethan

1987

Arthritis & Rheumatism

110

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A patient who presented with bilateral frozen shoulders and unrecognized hyperthyroidism is described. Both frozen shoulder and the related shoulderhand syndrome may occur in this setting. These poorly understood rheumatic conditions often are complications of stroke, spinal cord injury, or diabetes. Dysfunction of the autonomic nervous system is thought to be of pathogenic importance. It is postulated that the close resemblance of hyperthyroidism to activation of the sympathetic nervous system may underlie its association with frozen shoulder and shoulder-hand syndrome.Thyroid disease may have rheumatic complications (1). A patient with bilateral frozen shoulders who had unrecognized hyperthyroidism prompted a review of this infrequently encountered association.Case report. The patient, a 62-year-old man, was referred for evaluation of restricted motion of the shoulders. Six months earlier he had begun losing weight, in spite of a good appetite. While moving into a new house, he noted unusual difficulty lifting boxes and furniture, and found he was having trouble getting out of a car. He discovered that he could not raise his arms beyond 90" and had discomfort over the anterior shoulder region when reaching backward. His weight, Submitted for publication August 20, 1986; accepted in revised form November 18, 1986. which had been 160 pounds, reached a low of 129, and then rose to 136 pounds. At the time of the visit, he was feeling well; his only complaints concerned the failure to regain all of his lost weight, and the restriction of shoulder motion. There was no history of shoulder problems, and no personal or family history of diabetes.An extensive diagnostic evaluation had been fruitless. On 2 occasions, serum levels of muscle enzymes were normal. A random serum glucose level was 101 mgldl and a fasting level was 96 mgldl. Radiographs of the shoulders, chest, and gastrointestinal tract gave normal results. Nerve conduction studies and electromyographic study of both upper extremities disclosed no evidence of neuropathy, myopathy, or radiculopathy. Muscle biopsy was not believed to be indicated. Thyroid tests were not done.At physical examination, he was a calm man who appeared exceedingly thin, but not ill. The blood pressure was 120/70 mm Hg, with an irregularly irregular pulse rate of 120 beats per minute. The hands were steady, and his skin was of normal texture. There was no exophthalmos, and no lid lag. His thyroid was not palpable. Both shoulders were limited to 45" of passive glenohumoral abduction, with virtually no internal or external rotation, and there was atrophy of the shoulder girdle musculature (Figure 1). Proximal strength was diminished in the upper, as well as the lower, extremities, but was still at or above 4/5 in all muscle groups. The deep tendon reflexes were normal.The remainder of the examination results were unremarkable.An electrocardiogram (EKG), obtained a few minutes later, showed sinus rhythm at a rate of 90;

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Chronic Pain

Newton¹

1984

Geriatric Medicine

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Frozen shoulder

Cited by 124 publications

References 36 publications

Frozen Shoulder: Evidence and a Proposed Model Guiding Rehabilitation

Frozen Shoulder: Evidence and a Proposed Model Guiding Rehabilitation

Frozen shoulder in hyperthyroidism

Chronic Pain

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