Adhesive Capsulitis PROTOCOLS
BACKGROUND
` • Description
o Typically between ages of 40-65
o Thickening of the capsule around the
shoulder
• Causes:
o Previous shoulder injury
o Immobilization
o Diabetes
o Thyroid problems
• Progression
o 1st Stage “Freezing” stage
Increased pain, decreased motion
Can last 1-9 months
o 2nd Stage “Frozen” stage
• Conservative treatment
Decreased pain, but stiffness
o Symptoms typically resolve
remains
on their own, regardless of
Can last 4-9 months
treatment or no treatment.
o 3rd Stage “Thawing” stage
o Physical therapy
Slow return of motion
o Medication
Can last 5 months to 2 years
o Injections
Stretching exercises
1 Passive Forward Flexion
Using a broom or rod, grasp the end with hand 1 and the other end
with hand 2
Use hand 2 to passively raise hand 1 up until a stretch is felt
Hold the position for 10 seconds and return to starting position
Frequency: 3 sets of 10 reps. 2-3 times a day.
1 2 2 Goal: Increase/maintain shoulder range of motion
Passive Abduction
1
Grasp the end of the rod with hand 1 and the other end with hand 2
Use hand 2 to passively raise hand 1 up to the side until a stretch is
felt
Hold the stretch for 10 seconds and returns to starting position
Frequency: 3 sets of 10 reps. 2-3 times a day.
2 Goal: Increase/maintain shoulder range of motion.
1 2
Passive External Rotation
Grasp the end of the rod with hand 1 and the middle of the rod with
hand 2
Use hand 2 to passively rotate hand 1 to the side while keeping the
elbow in
1 1 Hold the stretch for 10 seconds and returns to starting position
2
2 Frequency: 3 sets of 10 reps. 2-3 times a day.
Goal: Increase/maintain shoulder range of motion.
UCSF Orthopaedic Institute | 1500 Owens Street Ste 170 | San Francisco, CA 94158 | Phone: 415-353-2808 | Fax: 415-353-7593 | orthosurg.ucsf.edu
Adhesive Capsulitis PROTOCOLS
Stretching exercises
Forward Wall Climbers
Patient stands facing the wall 2 feet from the wall
Slowly walk fingers up the wall as high as possible
Hold at the top for 10 seconds then slowly lower
Frequency: 5 times. 2-3 times per day
Goal: Increase/maintain shoulder range of
motion.
Side Wall Climbers
Patient stands with their involved shoulder 2 feet from the
wall
Slowly walk fingers up the wall as high as possible
Hold at the top for 10 seconds then slowly lower
Frequency: 5 times. 2-3 times per day
Goal: Increase/maintain shoulder range of
motion.
SHOULDER STRENGTH EXERCISES:
Isometric: Flexion / Extension
Stand with good posture, squeeze shoulders back.
Bend and hold elbow at 90°.
Flexion: Push hand into wall.
Extension: Push elbow into wall.
Hold 5 sec. Repeat TEN times.
Frequency: 1 set. Three times a day.
Goal: Increase strength of Deltoid Muscles.
Isometric: ABduction / ADduction
Stand with good posture, squeeze shoulders back.
Bend and hold elbow at 90°.
ABduction: Start hand on stomach.
Pull hand away from your stomach.
ADduction: Start hand away from stomach.
Pull hand into your stomach.
Hold 5 sec. Repeat TEN times.
Frequency: 1 set. Three times a day.
Goal: Increase strength of Rotator Cuff Muscles.
UCSF Orthopaedic Institute | 1500 Owens Street Ste 170 | San Francisco, CA 94158 | Phone: 415-353-2808 | Fax: 415-353-7593 | orthosurg.ucsf.edu
Adhesive Capsulitis PROTOCOLS
SHOULDER STRENGTH EXERCISES:
Scapular Retraction (Shoulder Blade Squeezes)
Relax head and neck.
Stand with good posture, squeeze shoulders back.
Avoid shrugging shoulders. Keeps abs tight.
Hold 10 sec.
Relax shoulder. Repeat 10 times.
Frequency: 1 set. Three times a day.
Goal: Increase strength of scapular stabilizing
muscles.
Scapular Elevation (Shoulder Shrugs)
Relax head and neck.
Stand with good posture.
Squeeze shoulder up towards your ears.
Keep abs tight and hold 10 sec.
Relax shoulders. Repeat 10 times.
Frequency: 1 set. Three times a day.
Goal: Increase strength of scapular stabilizing
muscles.
External Rotation
Attach theraband to a stable object at waist level.
Roll shoulder back and down and maintain this position.
Place towel between elbow and side.
Slowly rotate hand AWAY from the abdomen.
Hold 5 sec. Repeat 10 times
Frequency: 1 set. Three times a day.
Goal: Increase strength of rotator cuff muscles.
Internal Rotation
Attach theraband to a stable object at waist level.
Roll shoulder back and down and maintain this position.
Place towel between elbow and side.
Slowly rotate hand TOWARDS the abdomen.
Hold 5 sec. Repeat 10 times
Frequency: 1 set. Three times a day.
Goal: Increase strength of rotator cuff muscles.
Side note:
Do not perform exercises that increase your pain during or after the exercise.
UCSF Orthopaedic Institute | 1500 Owens Street Ste 170 | San Francisco, CA 94158 | Phone: 415-353-2808 | Fax: 415-353-7593 | orthosurg.ucsf.edu
