There are 4 major reasons a stiff shoulder develops:
- Rotator Cuff tear – ( this is a dynamic muscular issue that is not related to our current topic but definitely limits overhead motion).
- Adhesive capsulitis (AKA “frozen shoulder”) – insidious onset with the adherence of the capsule causing contracture of the shoulder that results in significant range of motion loss in multiple planes. It has long-term restrictions that can last up to 18 months. It normally has three phases of progression: freezing, frozen, and thawing.
- Post-operative – more specific stiffness than adhesive capsulitis. This can be a natural process of the surgery and other times it can be a complication. E.g. patient wearing a brace/sling for several days/weeks after
rotator cuff surgery.
- Post-injury – any injured tissue or inflammatory process that does not allow for a full range of motion.
A stiff shoulder pathology can worsen if ignored in a minimal state of ROM loss. Continuing to use a shoulder with sub-optimal motion during activity can lead to further devastating results and injury. Cited in numerous case studies, treatment to the minimally “frozen” shoulder could have prevented long-head biceps and rotator cuff damage in the shoulder.