Hypomobility

• 2 shoulder hypomobility conditions:

  • frozen shoulder (adhesive capsulitis)
  • osteoarthritis of the shoulder
• Triage:

  • when considering hypomobility conditions, need to ensure that its not a case of avascular necrosis
  • if you suspect avascular necrosis you need to refer on
• Stage & SIN:

  • SIN depends on the evolution of the pathology
  • common activities triggering acute stages of frozen shoulder and osteoarthritis will likely have high SIN factors
  • chronic conditions of the pathologies may have low SIN factors
  • there is a full spectrum of SIN factors depending on the acuteness and irritability of the shoulder
• Dominant Pain Mechanism:

  • most likely will be nociceptive as a primary driver
  • but if theres chronicity, there may also be nociplastic changes to the nervous system
• Structural Diagnosis:

  • usually able to make a structural diagnosis as its clear from examination if you have frozen shoulder or osteoarthritis
  • pts limitations vary, depends on the stage and the pain levels of the pts
  • compromised function will most likely come from the lack of movement and potential atrophy in the surrounding musculature from pain and disuse
• Prognosis:

  • may be slow, taking many months
  • healing and rehabilitation is never linear, so anticipate functional setbacks during recovery