What is the capsular pattern of restriction in frozen shoulder/adhesive capsulitis?

In the context of frozen shoulder, also known as adhesive capsulitis, the capsular pattern of restriction is characterized by specific limitations in joint movement. The correct answer highlights that the greatest restriction occurs in external rotation (ER), followed by abduction (ABD) and then internal rotation (IR).

Understanding this pattern is crucial for both diagnosis and treatment of frozen shoulder. Patients typically experience significant difficulty in performing movements that involve these motions, particularly external rotation, which is often severely impaired. As the condition progresses, the limitation in abduction becomes apparent, followed by restrictions in internal rotation, though to a lesser degree.

Recognizing this pattern assists healthcare professionals in differentiating frozen shoulder from other shoulder pathologies that may present with pain or movement restrictions but do not follow the same capsular pattern. It also informs rehabilitation strategies, allowing practitioners to prioritize restoring external rotation first, followed by abduction and internal rotation as part of the therapeutic plan.