Speed’s Test
Bicipital Tendonitis
Drop Arm Test
Supraspinatus Involvement
Empty/Full Can Test
Supraspinatus Involvement
External Rotation Lag Sign (ERLS)
Infraspinatus Involvement
Lift Off Test
Subscapularis Involvement
Adhesive Capsulitis
“A pathologic continuum
initiated by synovial
inflammation with resultant
capsular fibrosis”
It’s Inflammatory &
Fibrosing
Adhesive Capsulitis
Patient Profile:
• Females > Males
• > 40 years of age
• Correlated with DM
• Associated with Thyroid and
Autoimmune Diseases
• Associated with CVA and MI
• History of prolonged
immobilization
Adhesive Capsulitis
4 Stages Include: (1 – 3 years)
•
•
•
•
1 - First 3 months, pain limits rom
2 - The “freezing” Phase, months 3 - 9
3 - The “frozen” Phase, months 9 -14
4 - The “Thawing” Phase, after month 14
Types
• Primary – idiopathic
• Secondary – Acquired from a known
cause
Adhesive Capsulitis
• Treatment
• Medication for pain
• Positioning for comfort
• Education about the disease
process
• Gentle rom exercise in the early
stages within established pain
parameters
• Reassure , Reassure & Reassure
Considerations For
Referral
• Traumatic vs. Insidious
• Acute vs. Chronic
• Patient’s Age & Activity Level
• Acromion Type
• Structural Deformity
• Severity of Limitations
• Patient’s Overall Health
• Compliance History (In LCR)
Physical Therapy
Considerations
• What is the movement system diagnosis
(independent of the pathophysiologic
diagnosis)?
• Are there movement abnormalities that are
correctable?
• What corrective exercise/postural reeducation would benefit this patient?
• Compensatory strategies?
• Is this patient compliant?
Bibiliography
1. Davies, George J., Wilk, Kevin, Ellenbecker, Todd,
Et Al., Current Concepts of Orthopaedic Physical
Therapy, 2nd Edition, The Shoulder: Physical
Therapy Patient Management Utilizing Current
Evidence. APTA, Orthopaedic Section, 2006.
2. Magee, David J., Orthopedic Physical Assessment,
Fourth Edition. Philadelphia, Saunders, 2002.
3. Neumann, Donald A., Kinesiology of the
Musculoskeletal System, Foundations for Physical
Rehabilitation. St. Louis, Mosby, 2002.
4. Sahrmann S. Diagnosis and Treatment of Movement
Impairment Syndromes. St. Louis, Mosby, 2002.