Adhesive Capsulitis (Frozen Shoulder)

Frozen shoulder is more than just a stiff joint. It’s a condition where the connective tissue surrounding the shoulder joint — the capsule — becomes inflamed, thickened, and tight. As this capsule contracts, it restricts movement and can make even simple tasks feel painful, frustrating, and limiting.

Most patients describe it as a deep ache with a sense of the shoulder being “stuck,” combined with pain that’s often worse at night. It tends to develop gradually, and without proper treatment, it can last months to years.

Why Does Frozen Shoulder Happen?

In many cases, adhesive capsulitis develops after:

• A period of reduced shoulder use (injury, surgery, or prolonged immobilization)

• Diabetes or thyroid conditions (which increase risk)

• After certain medical or neurologic conditions such as stroke

The capsule around the shoulder thickens, forms adhesions, and loses its elasticity — almost like a drawstring being progressively tightened.

Reducing Pain and Inflammation

Early in the process, we often use ultrasound-guided steroid injections or targeted anti-inflammatory strategies to help calm the joint. This can make it easier to begin gentle physical therapy and movement retraining.

But when stiffness is severe or has been present for months, simply reducing inflammation is often not enough.

Capsular Distention — My Specialty Procedure

One of the most effective treatments I offer is capsular distention (also known as hydrodilatation).

Using ultrasound guidance, I inject a high volume of fluid into the shoulder joint to gradually and safely stretch the capsule — much like filling a water balloon.

The goal is to:

• Increase space within the joint

• Break up adhesions

• Restore movement capacity

In many cases, this controlled distention helps release the tight capsule — and when followed by gentle manipulation, we can often see a rapid improvement in range of motion, right there in the office.