Humeroscapular elevation of less than 90 degrees indicates stiffness especially if it is less than the contralateral normal shoulder. Specific ranges of humeroscapular elevation and rotation can be measured by determining the positions that the humerus can attain in relation to the four palpable scapular reference points. The patient should remain relaxed during this examination to assure that muscle contraction is not limiting motion. Then proceed to determine the humeroscapular range by stabilizing the scapula with one hand and putting the humerus through a passive range of motion with the other. Click to enlargeįigure 5 - Age of patients with idiopathicįrozen shoulders presenting to our serviceįigure 6 - Patients with frozen shouldersįirst obtain a quick assessment of the overall shoulder motion by examining the maximal ranges of elevation external rotation internal rotation and cross body adduction. Patients with frozen shoulders had greatest difficulty sleeping comfortably on the affected side putting their hands behind their heads with the elbow out to the side lifting 8 pounds to the level of the top of their head without bending their elbow and throwing overhand. Patients with frozen shoulders may have substantial functional losses. The age of patients with idiopathic frozen shoulders presenting to our service is typically between 43 and 63 years. In post-traumatic stiff shoulders the relationship of loss of motion to previous surgery or injury becomes evident from the history. In evaluating stiff shoulders it is essential to establish the circumstances surrounding the onset of stiffness the duration of the condition any tendency toward worsening or improvement and the possible existence of risk factors such as a period of immobilization metabolic disease (such as diabetes) or referred pain from the neck chest or abdomen. Scapulothoracic range of motion can be limited by such factors as sternoclavicular arthritis acromioclavicular arthritis contracture rib or scapular fracture post-traumatic scarring tumor dislocation or other factors disrupting the scapulothoracic motion interface.Ībout the Mechanics of Shoulder Stability: The capsule The shoulder can become stiff because the joint surfaces have lost their normal smoothness-as in arthritis.įinally shoulder motion can be restricted by limited scapulothoracic motion (motion between the shoulder blade and the chest wall).

Shoulder stiffness can also result when the normal gliding surfaces of the shoulder become scarred after injury or surgery-a condition known as post-traumatic stiff shoulder. Frozen shoulders can be particularly severe in individuals with diabetes. A frozen shoulder can also come on for no apparent reason at all. Frozen shoulders can come on after a period of disuse of the arm. The normally supple capsule around the joint can become stiff-a condition known as frozen shoulder. Most of the common causes of shoulder stiffness are related to problems between the humerus and scapula. Orthopaedics and Sports Medicine Bulletin.Resident Research - Intake and Travel Award Forms.Orthopaedic Surgery and Sports Medicine Interest Group.Residents Portal and Digital Curriculum.

Abduction of shoulder