Glenoid Fracture = Adhesive Capsulitis?

[MrPhysio+]

Hello Adam,
PhysioBob has given you some good answers. As you do not mention any problems with the other damaged areas, you obviously have a good healing capacity!
I am interested in the hydrodilatation history. I have been involved with hydrodilatations in Melbourne (or nearby) since 1991, shortly after the original technique was described in the American Journal of Orthopaedics. It is worth noting that the majority of these procedures are now undertaken by radiologists rather than Doctors or surgeons and that results vary widely. There is only one clinic in Melbourne that seems to have consistently good results via guided injection of the saline mix. The original technique, in my experience, works much better. In fact, one Doctor that I introduced the technique to has had Orthopaedic surgeons comment that the results were the best that they had seen (and this was related to some patients that had received multiple failed guided hydrodilatations).

Having commented upon the hydrodilatation process, it remains to be seen as to whether you actually have capsular adhesions and if you do whether other problems co-exist. PhysioBob is correct to comment that the rotator cuff musculature will require retraining to ensure the scapulat moves correctly upon the rib cage and the humeral head is correctly stabilised in the glenoid.

It sounds to me that you may also have some bicep tendon sheath adherence, possible sub deltoid bursal impingement and poor scapulo-humeral rhythm.
Thanks for providing all the information as it is helpful, but examination may provide even more relevant treatment direction.
Has anyone discussed glenoid labral tears with you?

I would try to strengthen the shoulder retractors and depressors, address the bicep long head tendon sheath, check the teres muscles and sub deltoid bursa and question the type of hydrodilatation technique. Given your history, a thorough check of your Cx to rule out some nerve root involvement or Cx facet joints (lower) contribution to the shoulder range of movement control would also be in order.

I have tried to cover the obvious areas - this is not to say that any of the above is occurring or that the list is fully comprehensive. Further assessment may bring forth more important findings. I hope the above helps to generate further comments that could be of assistance to you.

One more thing. The behaviour of your symptoms during daily activity and therapy sessions can often provide clues to the cause of your problem.

MrPhysio+