Adhesive Capsulitis (Frozen Shoulder) is a condition characterized by progressive pain and loss of both active and passive glenohumeral motion due to fibroblastic proliferation and thickening of the joint capsule. Common in 40-60 years age group. Higher prevalence in females. Associated with Diabetes Mellitus and thyroid disorders.

• Stage 1 — Freezing (Painful): 2-9 months. Severe pain, gradual ROM loss
• Stage 2 — Frozen (Adhesive): 4-12 months. Less pain, significant stiffness
• Stage 3 — Thawing (Recovery): 5-24 months. Gradual ROM recovery

Capsular Pattern: ER > ABD > IR (most to least restricted)

• Insidious onset of dull ache in shoulder
• Night pain — unable to sleep on affected side
• Unable to comb hair, wear clothes, reach behind back
• Muscle atrophy in chronic cases
• SPADI and DASH scores elevated

• Subjective: Onset, aggravating factors, functional limitations
• Observation: Hiked shoulder, protective posturing
• ROM: ER most restricted, ABD second, IR least
• Special Tests: Shoulder Shrug Sign, Hand-to-Back test
• Outcome Measures: SPADI score, DASH questionnaire

• Phase 1 (Freezing): TENS/IFT for pain, Codman's pendulum exercises, Grade I-II Maitland
• Phase 2 (Frozen): Grade III-IV mobilization, Posterior capsule stretch, Pulley exercises
• Phase 3 (Thawing): PNF D1/D2 patterns, Progressive strengthening, Functional training
• Electrotherapy: Ultrasound to capsule before stretching, SWD for deep heating

DM patients take 2X longer to recover. Avoid aggressive stretching in freezing phase. Watch for compensatory scapular elevation. Patient education and graded exposure essential for recovery.