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Adhesive Capsulitis -- Closed Manipulation

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by Cresse M

(Frozen Shoulder—Closed Manipulation)



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.
Frozen Shoulder
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Possible Complications

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:
  • Smoking
  • Drinking
  • Chronic disease such as diabetes or obesity
  • Previous shoulder surgery
Prior shoulder surgery may also increase the risk of complications.

What to Expect

Prior to Procedure

Your doctor may do the following:
Leading up to the procedure:
  • Arrange for a ride to and from the hospital. Also arrange for help at home after the procedure.
  • The night before, eat a light meal. Do not eat or drink anything after midnight.


Your doctor may choose either:
  • General anesthesia —You will be asleep during the surgery.
  • Local anesthesia (less common)—The shoulder area will be numbed.

Description of the Procedure

The doctor will twist and move your shoulder upward and outward. The actions will break up scar tissue to improve range of motion.

Immediately After Procedure

If you had general anesthesia, the nurses will monitor you in the recovery room.

How Long Will It Take?

45-60 minutes

How Much Will It Hurt?

You will feel no pain during the procedure. You will have soreness after the procedure. The doctor will give you pain medicine.

Average Hospital Stay

Once you recover from the anesthesia, you will be able to go home.

Post-procedure Care

During your stay, the hospital staff will take steps to reduce your chance of infection such as:
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
There are also steps you can take to reduce your chances of infection such as:
  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions
You will have pain and swelling for 1-2 weeks after the surgery. Your doctor may instruct you to begin physical therapy.


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: Accessed November 18, 2008.

Adhesive capsulitis. EBSCO DynaMed website. Available at: Updated September 2008. Accessed December 3, 2008.

Adhesive capsulitis (frozen shoulder). Palo Alto Medical Foundation website. Available at: Accessed December 3, 2008.

Adhesive capsulitis: physical therapy. EBSCO Publishing Nursing Reference Center website. Available at: Updated June 2007. Accessed November 18, 2008.

Examination under anesthesia. University of Washington Orthopaedics and Sports Medicine website. Available at: Accessed November 21, 2008.

Frozen shoulder. EBSCO Publishing Patient Education Reference Center website. Available at: Updated March 2008. Accessed November 19, 2008.

Outpatient surgery. Cleveland Clinic website. Available at: Accessed November 21, 2008.

Warner JP. Frozen shoulder: diagnosis and management. J Am Acad Orthop Surg. 1997;5:130-140.

Your shoulder surgery. American Academy of Orthopaedic Surgeons website. Available at: Updated August 2007. Accessed November 20, 2008.


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