College of Massage Therapists of British Columbia (CMTBC) Practice Exam

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

1. Flexion, extension, abduction

2. External rotation, abduction, internal rotation

3. Internal rotation, flexion, extension

4. Adduction, external rotation, extension

The correct answer is: External rotation, abduction, internal rotation

The capsular pattern of restriction in frozen shoulder, also known as adhesive capsulitis, is characterized primarily by limitation in external rotation, followed by abduction, and finally a restriction in internal rotation. This pattern reflects the typical progression of the condition, where the shoulder joint becomes increasingly stiff and the range of motion becomes more compromised. In frozen shoulder, the most significant limitation is in external rotation due to thickening and stiffness of the shoulder joint capsule, which impacts the structures surrounding the glenohumeral joint. As the condition progresses, abduction becomes restricted, reflecting the functional movements that rely on external rotation for optimal shoulder mechanics. Internal rotation is also affected, but typically to a lesser extent compared to the other two movements. The other patterns listed in the options do not accurately represent the specific limitations seen in frozen shoulder, highlighting that they are not reflective of the typical capsular pattern described in clinical practice. Therefore, recognizing the correct sequence of restriction in frozen shoulder is crucial for understanding its mechanics and for planning appropriate treatment strategies.