Primary adhesive capsulitis results from a chronic inflammatory response with fibroblastic proliferation, which may actually be an abnormal response from the immune system. Idiopathic (“primary”) adhesive capsulitis occurs spontaneously without a specific precipitating event. Although the exact pathophysiologic cause of this pathology remains elusive, there are two types identified in the literature: idiopathic and secondary adhesive capsulitis. Approximately 70% of frozen shoulder patients are women 3 however, males with frozen shoulder are at greater risk for longer recovery and greater disability 3– 4. 2 The most common limitations in range of motion are flexion, abduction, and external rotation. Patients typically describe onset of shoulder pain followed by a loss of motion. 1 He concluded that frozen shoulder was not periarthritis, but a “thickening and contraction of the capsule which becomes adherent to the humeral head” that he termed, “adhesive capsulitis.” 1 Adhesive capsulitis is characterized by pain, stiffness, and limited function of the glenohumeral joint, which adversely affects the entire upper extremity. The “frozen shoulder” diagnosis has been used for many years in describing shoulder pain and limited motion, and was originally thought to be “periarthritis.” Nevasier was the first to identify the pathology through histological and surgical examination of frozen shoulder patients.

Frozen shoulder exercises