Adhesive capsulitis, fibrosis "stage 3"
Why would the capsule become fibrotic? It is often a long term adaptation by the CNS to reduce movement of the joint that the body perceives as dangerous to the joint. In our experience, in diagnoses of frozen shoulder and adhesive capsulitis, the GH joint is under a barrage of referral pain from trigger points in the glenohumeral and scapular stabilizing muscles. The joint is also often mechanically stressed by the scapula not rotating properly to allow glenohumeral flexion and abduction. When the body first feels pain in the shoulder, it will start reducing movement to avoid pain and protect the joint. The GH adductors are recruited to reduce GH abduction and the scapular stabilizers start reducing scapular movement. The body uses trigger points in muscles to provide an energy efficient way to reduce movement and "splint" the joint. Adhesive capsulitis is an end result of this situation, a reaction to pain, not the source. In CTB we understand this pain response and the therapy involves disrupting the process and reversing it. CTB therapists have a solid track record of helping people with this diagnosis but it does take multiple therapist sessions and self care work to down-regulate the situation.