Glenoid Fracture = Adhesive Capsulitis?

[physiobob]

Hi again, Looking at your second image of the surgeon demonstrating external rotation it looks like there is only about 5% when you are under the general anaesthetic. A quick glance makes it look more but that is due to the lax pec and the retracted scapula position which is giving a false sense of external rotation.

When the humerus moves on the glenoid it required a rotation and a slide movement to keep it centered on the glenoid surface. This is usually controlled by the rotator cuff muscles which right now will need some balancing. It also requires a smooth articular surface. on both the humerus and the glenoid. I'd suspect that there is also a type of Hill–Sachs lesion that accompanied the fracture (i.e. a dent in the humeral head). This is also an articular surface deformation to consider when assessing the normal roll and slide movements.

Maybe you can ask you physio to provide some mobilization type assistance to the humeral head while you are working on your external rotation and also some depression when you are working on abduction (or better scaption) movements. Get them to look into what are know as NAGS, SNAGS and MWMs for the glenohumeral joint.

[adamd9]

Thanks Physiobob - I'll suggest this to my physio. I might even see if he knows about this forum - it seems like a good resource for physio's looking for a place to share & bounce off ideas.

You're right about the ER photo while I was under genreal anaesthetic - when he showed me this and said he achieved 70 deg I felt it was quite disingenuous, which is partly why changed surgeons soon after.

The only other thing I find odd about my situation is that the physio & surgeon both seem to expect me to feel a "tightness" at the front of the shoulder when at the end of my external rotation, but I feel almost nothing when mobilising except a pain down the front of my bicep (almost to my elbow). If I (or the physio) push it quite hard this pain becomes very sharp. The pain doesn't seem to remain afterwards. I'm told this is referred pain, but could it be something else?