🧾 Condition Snapshot

Adhesive capsulitis is characterized by progressive pain and stiffness of the glenohumeral joint due to capsular inflammation and fibrosis. It typically presents in three phases—freezing (painful), frozen (stiffness), and thawing (gradual return of motion).

The condition significantly impacts shoulder range of motion, particularly external rotation, abduction, and flexion, limiting functional reach and participation in daily activities.

🧠 Occupational Profile Prompts

• What daily tasks are most limited by shoulder movement (dressing, grooming, reaching)?

• How is pain affecting sleep and rest?

• What roles or routines are being avoided due to shoulder limitations?

• What compensatory strategies are currently being used?

⚠️ Precautions

• Avoid aggressive stretching in early (painful) phase

• Respect pain levels—do not push into high irritability

• Monitor for compensatory movement patterns

• Be mindful of secondary shoulder impingement

🧠 OT Considerations

• Match intervention to phase of condition (pain vs stiffness focus)

• Pain often limits participation more than ROM early on

• Emphasize function within available range

• Prevent maladaptive compensations (e.g., trunk substitution)

• Sleep disruption can significantly impact recovery

🛠️ Intervention Considerations

Pain Management (Freezing Phase)

• Gentle ROM within tolerance

• Modalities (heat, positioning)

• Education on activity modification

Mobility & ROM (Frozen Phase)

• Gradual, controlled stretching

• Active-assisted and active ROM

• Functional reaching tasks

Functional Integration

• Task-specific reaching (grooming, dressing)

• Gradual exposure to overhead activities

• Encourage use of affected UE in meaningful tasks

Education & Pacing

• Set expectations for recovery timeline (can be prolonged)

• Encourage consistency over intensity

• Avoid overexertion → flare-ups

📊 Common Assessments

• Goniometry (Shoulder ROM)
  Type: Impairment (Mobility)
  Why: Quantifies limitations in shoulder movement (ER, ABD, flexion)
  When: Baseline and progress tracking

• Pain Scale (VAS/NPRS)
  Type: Symptom
  Why: Assesses pain severity impacting function and sleep
  When: Initial evaluation and ongoing monitoring

• Functional Reach / Task Observation
  Type: Functional (Performance)
  Why: Identifies impact of ROM limitations on daily activities
  When: During functional task analysis

• QuickDASH
  Type: Functional (Self-Report)
  Why: Captures perceived difficulty with upper extremity tasks
  When: Baseline and outcome tracking

📚 EBP Snapshot

• Early phases prioritize pain management over aggressive stretching

• Gradual, sustained stretching improves ROM in later phases

• Functional, task-based movement supports carryover

• Recovery is often prolonged but generally favorable over time

🔗 Evidence & Resources (Optional)

• Adhesive Capsulitis (Clinical Review) → outlines phases and treatment progression

• Shoulder Stretching Interventions (Systematic Review) → supports gradual mobility work

• Pain Management in Shoulder Conditions → highlights importance of irritability-based approach

• Functional Rehabilitation of Shoulder Disorders → supports task-based intervention

👉 (You hyperlink titles like your system)

🎯 Clinical Anchor

Match the intervention to the phase—manage pain early, restore motion gradually, and prioritize function throughout.

🎨 IMAGE (OTCC STYLE — BASELINE + FUNCTIONAL)

Baseline Concept:

• Shoulder joint highlighted (capsule tightness)

• Limited arc of motion visual

• Clean labels: pain / stiffness / capsule

• OTCC logo top left

Functional Concept:

• Person struggling with overhead reach (e.g., putting on shirt / reaching cabinet)

• Callouts:

  • Limited ROM

  • Pain with movement

  • Compensatory trunk lean

  • Difficulty dressing

  • Sleep disruption