Frozen Shoulder Painful, significant restriction of active and passive ROM at the shoulder Most frequently in abduction and external rotation Frozen shoulder theories Subacromial bursitis, biceps tendon pathology, disuse, supracapsular nerve entrapment leading to muscle dysfunction, small rotator cuff tears Joint capsule is primarily involved, with secondary involvement of the surrounding structures Close association among frozen shoulder, referred neck pain, rotator cuff tears and impingement syndrome Normally, the superior joint capsule attaches proximal to the greater tuberosity of the humerus and runs medially to the bony rim of the glenoidd fossa of the scapula Inferior joint capsule hangs in the fold or pleat called the “auxiliary recess” This fold is stretched out when the humerus is abduct Contractures have been noted in the coracohumeral ligament, which may limit external rotation Idiopathic frozen shoulder may also be d/t hyperkyphosis causing an alterati
Bursitis Inflammation of a bursa Cause Overuse of structures surrounding the bursa, leading to excessive friction and inflammation of the bursa walls Usually secondary to other conditions such as tendinitis Contributing factors are mxl imbalances, poor biomechanics, postural dysFCN such as scoliosis or hyperkyphosis and a lack of flexibility Overuse of the shoulder, especially with the arm in an overhead position is the most common cause Common location Types of bursitis More details on individual bursa (page 449-452) Acute SXS Inflammation, heat, swelling Pain is deep and burning, at rest or on activity ROM is restricted Contraindication : Acute bursitis: Avoid compressing the bursa or applying tech that place a drag on the surrounding tissues On-site tech are contraindicated with acute bursitis If infective (or Septic) bursitis is suspected,the client is referred for medical attention Assessment Observation and palpation Swell