Patients with adhesive capsulitis will be limited in both active and passive range of motion, regardless of whether or not they have pain. Therefore, accurate measurements of active and passive range of motion are needed. The examination is performed in the supine position with the scapula locked in position by gravity against the table. The range of motion testing is performed with flexion, abduction, and then abducted internal and external rotation, with the humerus abducted to 90°. (Normal abducted external rotation is 90°, normal abducted internal rotation is approximately 75°.) The differences in motion between the affected shoulder and the contralateral shoulder, as well as the relative loss of external and internal rotation on the affected side, are important to note. There may be pain at the limitations of motion, which signifies capsular tightness, synovitis, and irritation.
It is important to differentiate between scapulothoracic and glenohumeral range of motion. Patients with adhesive capsulitis will have limited motion of the glenohumeral joint, and may attempt to compensate for this by moving the arm via scapulothoracic motion. A physical examination will establish where the motion is occurring. The glenohumeral joint will have restricted range of motion. One way to isolate this from scapulothoracic motion is by placing the patient in a supine position, which locks the scapula against the bed and the chest wall. The humerus is then moved and the scapula stabilised to isolate glenohumeral motion.
Patients with adhesive capsulitis will be limited in both active and passive range of motion, regardless of whether or not they have pain. Therefore, accurate measurements of active and passive range of motion are needed. The examination is performed in the supine position with the scapula locked in position by gravity against the table. The range of motion testing is performed with flexion, abduction, and then abducted internal and external rotation, with the humerus abducted to 90°. (Normal abducted external rotation is 90°, normal abducted internal rotation is approximately 75°.) The differences in motion between the affected shoulder and the contralateral shoulder, as well as the relative loss of external and internal rotation on the affected side, are important to note. There may be pain at the limitations of motion, which signifies capsular tightness, synovitis, and irritation.It is important to differentiate between scapulothoracic and glenohumeral range of motion. Patients with adhesive capsulitis will have limited motion of the glenohumeral joint, and may attempt to compensate for this by moving the arm via scapulothoracic motion. A physical examination will establish where the motion is occurring. The glenohumeral joint will have restricted range of motion. One way to isolate this from scapulothoracic motion is by placing the patient in a supine position, which locks the scapula against the bed and the chest wall. The humerus is then moved and the scapula stabilised to isolate glenohumeral motion.
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