is a tightening in the shoulder joint. It decreases the range of motion in the shoulder and causes pain. The shoulder does not have full range of motion even when a therapist tries to move the shoulder. This condition is also known as
frozen shoulder. It is caused by tightening of the soft tissue and formation of scar tissue.
During closed manipulation, the doctor moves the arm at the shoulder joint. This is done to break up adhesions and loosen the stiff joint.
The goal of the procedure is to improve range-of-motion by breaking up scar tissue.
Your doctor may recommend closed manipulation if other methods of relief have failed. This procedure can relieve pain and stiffness for some patients. In others, there is still some pain and swelling in the shoulder joint. If the closed manipulation is not successful, you may need
Complications are rare, but no procedure is completely free of risk. If you are planning to have a shoulder manipulation, your doctor will review a list of possible complications, which may include:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Prior shoulder surgery may also increase the risk of complications.
Your doctor may do the following:
Leading up to the procedure:
Your doctor may choose either:
The doctor will twist and move your shoulder upward and outward. The actions will break up scar tissue to improve range of motion.
If you had general anesthesia, the nurses will monitor you in the recovery room.
You will feel no pain during the procedure. You will have soreness after the procedure. The doctor will give you pain medicine.
Once you recover from the anesthesia, you will be able to go home.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
You will have pain and swelling for 1-2 weeks after the surgery. Your doctor may instruct you to begin physical therapy.
After you leave the hospital, contact your doctor if any of the following occurs:
American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Adhesive capsulitis. American Academy of Family Physicians website. Available at:
http://www.aafp.org/afp/20030315/1323ph.html. Accessed November 18, 2008.
Adhesive capsulitis. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated September 2008. Accessed December 3, 2008.
Adhesive capsulitis (frozen shoulder). Palo Alto Medical Foundation website. Available at:
http://www.pamf.org/sports/king/adhesive_caps.html. Accessed December 3, 2008.
Adhesive capsulitis: physical therapy. EBSCO Publishing Nursing Reference Center website. Available at:
http://www.ebscohost.com/pointOfCare/nrc-about. Updated June 2007. Accessed November 18, 2008.
Examination under anesthesia. University of Washington Orthopaedics and Sports Medicine website. Available at:
http://www.orthop.washington.edu/uw/examination/tabID__3376/ItemID__207/PageID__425/Articles/Default.aspx. Accessed November 21, 2008.
Frozen shoulder. EBSCO Publishing Patient Education Reference Center website. Available at:
http://www.ebscohost.com/pointOfCare/perc-about. Updated March 2008. Accessed November 19, 2008.
Outpatient surgery. Cleveland Clinic website. Available at:
http://my.clevelandclinic.org/florida/weston/hospital/outpatient_surgery.aspx. Accessed November 21, 2008.
Warner JP. Frozen shoulder: diagnosis and management.
J Am Acad Orthop Surg.
Your shoulder surgery. American Academy of Orthopaedic Surgeons website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00066. Updated August 2007. Accessed November 20, 2008.
Last reviewed December 2012 by John C. Keel, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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