Manual therapy considerations for adhesive capsulitis in the breast cancer population: a clinical perspective

Adhesive capsulitis (AC) is common in women aged 40-60, overlapping with the population at higher risk for breast cancer. Many breast cancer survivors develop shoulder dysfunction, including AC, due to cancer treatments such as surgery, chemotherapy, and radiation, leading to pain, limited mobility, altered biomechanics, and soft tissue contracture. Despite the prevalence of AC in this population, clinical guidelines for its management remain underexplored. Manual therapy can play a key role in improving quality of life for these individuals.Understanding the pain mechanisms - nociceptive, neuropathic, and nociplastic - can inform appropriate treatment strategies for breast cancer survivors with AC. This clinical perspective integrates manual therapy principles into the evaluation and management of AC in this population. As breast cancer cases continue to rise, clinicians must recognize the impact of cancer treatment sequelae on orthopedic conditions to optimize patient care.