Frozen Shoulder Case Study: Holistic Physiotherapy Treatment

Explore a comprehensive physiotherapy case study on Frozen Shoulder (Adhesive Capsulitis) using the ICF model, including assessment and SMART treatment goals.

#physiotherapy#case-study#frozen-shoulder#adhesive-capsulitis#rehabilitation#icf-model#clinical-reasoning#physical-therapy

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CASE STUDY _ WEEK 5 Frozen Shoulder (Adhesive Capsulitis)

Laisve, Cristina Morillo

A clean medical illustration of the human shoulder joint (humerus and scapula), anatomical style, photorealistic, with the shoulder joint capsule area highlighted in a soft glowing red to indicate inflammation, white background.

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ICF Model Overview

• International Classification of Functioning (ICF)
• Health condition (Disorder/Disease)
• Body functions & structures (Impairments)
• Activities (Limitations)
• Participation (Restrictions)
• Environmental & Personal factors

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ICF: Health Condition

• Frozen Shoulder (Adhesive Capsulitis)
• Post-traumatic onset after a fall
• Right shoulder affected
• X-ray: no abnormalities (fractures ruled out)

A comparison medical illustration showing a normal shoulder joint on the left and a frozen shoulder led Adhesive Capsulitis on the right with a thickened, tight gray-white joint capsule, 3d render style, clean background.

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ICF: Body Functions & Structures

An anatomical illustration focusing on the shoulder glenohumeral joint capsule, with the capsule highlighted in reddish textures to show inflammation and fibrosis, detailed biological diagram.

• Impairments:
• Shoulder and upper arm pain
• Progressive stiffness
• Reduced AROM and PROM
• Capsular tightness
• Secondary muscle weakness
• Night pain and sleep disturbance

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ICF: Activity Limitations

• Difficulties with:
• Dressing (upper body)
• Reaching overhead
• Washing hair
• Lifting objects
• Performing basic ADLs

An older woman attempting to put on a cardigan or reach for an overhead shelf, wincing slightly in discomfort holding her shoulder, photorealistic style, soft indoor lighting.

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ICF: Participation Restrictions

• Reduced independence
• Limitations in household tasks (cleaning, cooking)
• Reduced participation in recreational activities
• Decreased quality of life due to functional loss

A woman in a home environment standing in a kitchen looking at a task she cannot perform due to arm pain, pensive and frustrated expression, realistic style.

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ICF: Contextual Factors

Environmental Factors
• Access to healthcare (Facilitator)
• Night pain and bed positioning (Barrier)
• Home layout requiring overhead reach (Barrier)

Personal Factors
• Age: 63 years
• Female
• Widow
• Possible fear of movement (Fear-avoidance)

A clean biopsychosocial model diagram showing three overlapping circles labeled Biological, Psychological, and Social facilitating holistic healthcare, medical blue and teal colors.

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Patient Information

• 63-year-old female
• Widow
• Right arm affected
• Mechanism: Fell while walking her dog
• Symptoms present for 3 weeks

An older woman walking a dog outdoors on a peaceful path, viewed from behind or side, portraying an active person before an injury, photorealistic.

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Anamnesis / Subjective Assessment

• Increasing shoulder and upper arm pain
• Progressive shoulder stiffness
• Pain aggravated by overhead activities
• Restricted ADLs
• Significant night pain when lying in bed

A patient sitting up in bed at night in a dimly lit blue-tinted room, holding her shoulder in pain, indicating sleep disturbance, photorealistic.

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Screening for Red Flags

A high-quality medical X-ray image of a normal healthy shoulder joint, posterior-anterior view, showing correct alignment of the humerus and glenoid, blue backlight.

• No fracture or dislocation (X-ray confirmed normal)
• No neurological symptoms (e.g., numbness, tingling)
• No systemic symptoms (fever, night sweats, unexplained weight loss)
• Conclusion: Safe to proceed with physiotherapy

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Clinical Reasoning: Hypothesis

• Post-traumatic shoulder condition
• Pain combined with global stiffness
• Loss of active and passive ROM in multiple planes
• Presentation consistent with Frozen Shoulder

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Physical Assessment

• NPRS: Pain scale (0–10)
• AROM and PROM assessment (goniometry)
• Functional movements: Hand-to-neck, Hand-to-scapula
• Isometric strength testing (as tolerated)

A physiotherapist gently assessing a patient's shoulder range of motion in a clinic, professional setting, the patient is an older woman, physio is supportive.

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Expected Findings

A diagram comparing a normal shoulder's full range of motion arc versus the restricted short arc of a frozen shoulder, schematic medical illustration, clear labels.

• Marked reduction of AROM and PROM
• Capsular pattern limitation:
External Rotation > Abduction > Internal Rotation
• Pain at end range of motion
• Muscle weakness due to pain inhibition

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Possible Diagnosis

Frozen Shoulder (Adhesive Capsulitis)

• Structural damage (fracture/tear) ruled out by imaging and assessment.
• Diagnosis is clinical, based on global restriction and history.

Side-by-side medical comparison render. Left: Normal healthy shoulder joint capsule. Right: Frozen shoulder capsule, shrunken and inflamed. Labels 'Normal' and 'Frozen Shoulder'.

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Treatment Goals (SMART)

Short-term (0–6 weeks):
• Reduce pain intensity
• Improve sleep quality
• Maintain existing ROM
• Patient education on prognosis

Long-term (6+ weeks):
• Restore functional ROM
• Improve shoulder strength
• Return to full independence in ADLs

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Treatment Options

• Patient education and reassurance (Key)
• Pain management strategies
• Joint mobilisations (Low grade)
• Gentle stretching exercises
• Progressive strengthening (later stage)
• Home exercise programme compliance

A patient performed a gentle wall-walking shoulder exercise, looking focused, wearing comfortable clothing, in a bright physiotherapy space.

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Conclusion

• Post-fall shoulder pain and stiffness
• Structure intact (normal X-ray)
• Presentation consistent with Frozen Shoulder
• ICF model supports holistic assessment
• Structured physiotherapy is essential for recovery

An abstract medical illustration symbolizing recovery and healing, gentle curves ascending, soft blue and green colors, clean and hopeful.

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Thank you for your attention

Any questions?

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Frozen Shoulder Case Study: Holistic Physiotherapy Treatment

Explore a comprehensive physiotherapy case study on Frozen Shoulder (Adhesive Capsulitis) using the ICF model, including assessment and SMART treatment goals.

CASE STUDY _ WEEK 5 Frozen Shoulder (Adhesive Capsulitis)

Laisve, Cristina Morillo

ICF Model Overview

• International Classification of Functioning (ICF) • Health condition (Disorder/Disease) • Body functions & structures (Impairments) • Activities (Limitations) • Participation (Restrictions) • Environmental & Personal factors

ICF: Health Condition

• Frozen Shoulder (Adhesive Capsulitis) • Post-traumatic onset after a fall • Right shoulder affected • X-ray: no abnormalities (fractures ruled out)

ICF: Body Functions & Structures

• Impairments: • Shoulder and upper arm pain • Progressive stiffness • Reduced AROM and PROM • Capsular tightness • Secondary muscle weakness • Night pain and sleep disturbance

ICF: Activity Limitations

• Difficulties with: • Dressing (upper body) • Reaching overhead • Washing hair • Lifting objects • Performing basic ADLs

ICF: Participation Restrictions

• Reduced independence • Limitations in household tasks (cleaning, cooking) • Reduced participation in recreational activities • Decreased quality of life due to functional loss

ICF: Contextual Factors

Environmental Factors • Access to healthcare (Facilitator) • Night pain and bed positioning (Barrier) • Home layout requiring overhead reach (Barrier)

Personal Factors • Age: 63 years • Female • Widow • Possible fear of movement (Fear-avoidance)

Patient Information

• 63-year-old female • Widow • Right arm affected • Mechanism: Fell while walking her dog • Symptoms present for 3 weeks

Anamnesis / Subjective Assessment

• Increasing shoulder and upper arm pain • Progressive shoulder stiffness • Pain aggravated by overhead activities • Restricted ADLs • Significant night pain when lying in bed

Screening for Red Flags

• No fracture or dislocation (X-ray confirmed normal) • No neurological symptoms (e.g., numbness, tingling) • No systemic symptoms (fever, night sweats, unexplained weight loss) • Conclusion: Safe to proceed with physiotherapy

Clinical Reasoning: Hypothesis

• Post-traumatic shoulder condition • Pain combined with global stiffness • Loss of active and passive ROM in multiple planes • Presentation consistent with Frozen Shoulder

Physical Assessment

• NPRS: Pain scale (0–10) • AROM and PROM assessment (goniometry) • Functional movements: Hand-to-neck, Hand-to-scapula • Isometric strength testing (as tolerated)

Expected Findings

• Marked reduction of AROM and PROM • Capsular pattern limitation: External Rotation > Abduction > Internal Rotation • Pain at end range of motion • Muscle weakness due to pain inhibition

Possible Diagnosis

Frozen Shoulder (Adhesive Capsulitis) • Structural damage (fracture/tear) ruled out by imaging and assessment. • Diagnosis is clinical, based on global restriction and history.

Treatment Goals (SMART)

Short-term (0–6 weeks): • Reduce pain intensity • Improve sleep quality • Maintain existing ROM • Patient education on prognosis

Long-term (6+ weeks): • Restore functional ROM • Improve shoulder strength • Return to full independence in ADLs

Treatment Options

• Patient education and reassurance (Key) • Pain management strategies • Joint mobilisations (Low grade) • Gentle stretching exercises • Progressive strengthening (later stage) • Home exercise programme compliance

Conclusion

• Post-fall shoulder pain and stiffness • Structure intact (normal X-ray) • Presentation consistent with Frozen Shoulder • ICF model supports holistic assessment • Structured physiotherapy is essential for recovery

Thank you for your attention

Any questions?

physiotherapy
case-study
frozen-shoulder
adhesive-capsulitis
rehabilitation
icf-model
clinical-reasoning
physical-therapy

CASE STUDY _ WEEK 5 Frozen Shoulder (Adhesive Capsulitis)

ICF Model Overview

ICF: Health Condition

ICF: Body Functions & Structures

ICF: Activity Limitations

ICF: Participation Restrictions

ICF: Contextual Factors

Patient Information

Anamnesis / Subjective Assessment

Screening for Red Flags

Clinical Reasoning: Hypothesis

Physical Assessment

Expected Findings

Possible Diagnosis

Treatment Goals (SMART)

Treatment Options

Conclusion

Thank you for your attention

Any questions?

DESIGNER-MADE PRESENTATION, GENERATED FROM YOUR PROMPT

Frozen Shoulder Case Study: Holistic Physiotherapy Treatment

DESIGNER-MADE
PRESENTATION,
GENERATED FROM
YOUR PROMPT