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Retractile capsulitis of the shoulder: how is it treated?

Retractile capsulitis is a pathology of the shoulder corresponding to a limitation of active and passive amplitudes of movement of the glenohumeral joint, with radiographs that rule out lesion involvement (1). 

What to do in case of shoulder capsulitis?

The joint capsule is a set of organic tissues surrounding the joint (2). It forms the joint between the two bones of a joint, particularly in the knee or shoulder. When this capsule shrinks, movements gradually become stiff and painful. At the onset of retractile capsulitis, pain increases steadily and constantly until it is present even at rest or during sleep. This pain then progresses to the symptom known as "frozen shoulder", where the pain subsides slightly, but movement becomes limited or impossible in all planes of space (3). This condition is particularly disabling and long-lasting.

Causes of retractile shoulder capsulitis

This capsule retraction may betraumatic in origin, resulting from tendon damage (tendonitis, for example), direct or indirect impact, cuff pathology or surgery. But it can also be ofprimitive origin, i.e. without any notable antecedents.

The disease mainly affects patients between the ages of 40 and 60, particularly women. It is favored by diabetes (20% of diabetics are affected), hypothyroidism, breast cancer and heart problems.

The different stages of the disease

The complexity of this condition is that it is initially painful. The pain is located at the stump of the shoulder, and can extend down the arm or even into the hand. It is particularly present at night, and can even be insomniac. At the onset of the disease, there is no impediment to movement. As the disease progresses, pain diminishes as joint mobility decreases. This evolution can be disturbing for the patient. There is an inflammatory phase during the first three months, when pain sets in. Then, between three and nine months, the capsule reduction begins to heal, generating severe pain. From the ninth to the fifteenth month, stiffness sets in and pain diminishes considerably. This is known as the "frozen shoulder". This is followed by a recovery phase in which amplitudes increase slightly again, without any major pain.

What exercises can help with shoulder capsulitis?

Retractile capsulitis of the shoulder does not require major surgery or intervention. Treatment begins with cortisone injections to reduce pain, and a search for the initial causes if any. Treatment consists of intensive and prolonged rehabilitation, aided by painkillers (4).

There are exercises you can do at home to self-educate your shoulder, alongside specialized support.

An example of anexercise for shoulder capsulitis is to lie on the floor, knees bent. Put your hands together on your stomach, raise them to eye level by stretching your arms, then lower them behind your head. Hold for a few seconds, then bring your hands back down to your stomach, reversing the movement. The same exercise can be performed sitting on a chair, starting with your legs, then raising your hands above your head(5).

Retractile capsulitis sometimes leaves motor sequelae: reduced active amplitude in rotation, anterior or lateral elevation with effective passive amplitude.

Supported by the Allyane Method

These after-effects, which are managed in rehabilitation, can also be improved with the Allyane method.

Neuromotor reprogramming will be used to complement rehabilitation sessions with a physiotherapist. We will work on the motor inhibitions that have set in during the phase of amplitude limitation.

These motor inhibitions will prevent the muscles from functioning correctly, whether in terms of strength, quality of movement and/or by compensating for other muscles which are often antagonistic to the action to be performed.

Most often, we find a lack of recruitment of the scapula-fixing muscles (rhomboids, serratus anterior, latissimus dorsi, inferior trapezius ...), as well as the muscles that enable the specific movement the patient would like to achieve.

The Allyane method will therefore enable us to recover a motor automatism forgotten by prolonged immobilization (6).

Are you a healthcare professional with questions about the Allyane method? Do not hesitate to contact our team by telephone on 04 28 29 48 14 or by email on contact@allyane.com

Do you have any questions about the Allyane sessions? Contact our medical secretary on 04 28 29 58 10 or on contact@allyane.com