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Posterior capsular contracture of the shoulder
H Gregory Bach1, Benjamin A Goldberg
1Department of Orthopaedic Surgery, University of Illinois-Chicago, 60612, USA.
Summary
Posterior capsular contracture causes shoulder pain and limited motion. Treatment includes stretching, and surgery may be needed for persistent cases, especially in athletes to prevent further injury.
Area of Science:
- Orthopedics
- Sports Medicine
- Shoulder Surgery
Background:
- Posterior capsular contracture is a common cause of shoulder pain, characterized by restricted internal rotation and pain.
- It can mimic impingement syndrome but differs in range of motion.
- In athletes, it may lead to 'dead arm' syndrome, labral tears, and rotator cuff injuries.
Purpose of the Study:
- To summarize the presentation, management, and outcomes of posterior capsular contracture.
- To highlight the specific considerations for throwing athletes.
Main Methods:
- Review of clinical presentation and diagnostic features.
- Discussion of non-surgical and surgical management strategies.
- Analysis of outcomes in the general population and athletes.
Main Results:
- Non-surgical management with range-of-motion stretching is the initial approach.
- Arthroscopic posterior capsule release improves motion and pain in refractory cases.
- In athletes, posteroinferior capsular hypertrophy can limit internal rotation; selective capsulotomy can restore motion and prevent injury.
Conclusions:
- Posterior capsular contracture requires a tailored management approach, starting conservatively.
- Surgical intervention, including arthroscopic release or selective capsulotomy, is effective for persistent symptoms and in athletes.
- Addressing internal rotation deficits is crucial for athletes to prevent further pathology.
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