Adhesion of shoulder joint capsule

Shoulder capsule adhesion was divided into four stages according to the relevant clinical practice guidelines of the international classification of function, disability and health of the orthopaedic branch of the American Physical Therapy Association.

Phase 1 symptom description:

It may last for 3 months. During this period, patients are usually described as sharp pain when the range of motion of the joint is close to the end, pain at rest, and affected sleep.

Phase 2 symptom description:

It is generally called “pain period” or “gradual freezing period”, which is usually characterized by a gradual decline in multidirectional activity caused by pain. This period lasts for 3-9 months. Arthroscopy showed an active angiogenic phase of synovitis and partial loss of joint range of motion under anesthesia.

Phase 3 symptom description:

It is generally called “freezing period”, which is mainly characterized by pain and decreased joint mobility. This period lasts for 9-15 months.

Phase 4 symptom description:

Commonly known as the “thawing period”, it is characterized by the beginning of pain relief. However, severe stiffness will continue until 15-24 months after the onset of symptoms This level usually develops gradually until the pain disappears, but limited activity still exists. In addition, diabetes patients suffering from shoulder joint capsule adhesion may have longer rehabilitation time and poor prognosis.

Therefore, we advocate early rehabilitation treatment to reduce or control the occurrence of joint capsule adhesion as much as possible. Water rehabilitation can make use of the physical properties of water and hydrostatic pressure to help patients with pain and limited or improve their function, especially in warm water.

Practice sharing

After a water rehabilitation treatment, the range of motion of a patient with limited shoulder movement for 9 months was significantly improved, and the pain was reduced from vas: 2 to VAS: 0. Vas is widely used for pain assessment in China. The basic method is to use a swimming scale with a length of about 10cm. One side is marked with 10 scales, and the two ends are “0” and “10” respectively. 0 represents no pain, and 10 represents the most unbearable pain.

Treatment plan

1. Water massage: relax the tense shoulder muscles in the water environment to improve their mobility;

2. Stretching in water: stretching in water can effectively reduce the irritation of pain;

3. Shoulder muscle training.