Retractile capsulitis is the most common type of shoulder injury. In fact, it affects 2% to 5.3% of the population. It occurs between the ages of 40 and 60, and mainly affects women.
Retractile capsulitis is, initially, an inflammation of the shoulder joint capsule, which will become complicated towards a fibrosis of the capsule. Indeed, during the inflammatory phase, complex enzymatic processes will disorganize the extra-cellular matrix creating a cross-linking of collagen causing the capsular structures to lose their elasticity.
3 phases are observed:
- The mild pain phase: pain can be confused with other shoulder pathologies. The ranges of motion are very slightly limited, but extreme ROM cause severe pain. At this stage, the diagnosis is difficult to establish.
- The “hot” phase: the pain is very intense, the inflammatory signs are present and the ROM begin to decrease.
- The “cold” phase: the pain starts to decrease but the ROM are limited in all directions.
The different causes highlighted are trauma to the shoulder, taking certain drugs (barbiturates, triple therapy…), diabetes, hypothyroidism, thorax surgery…
Even if the psychological context or an anxious ground has not been demonstrated, nevertheless, we observe with the current context a recrudescence of capsulitis.
On the other hand, another well-known cause of therapists taking care of women is the sequelae of breast cancer surgery with axillary curage.
When contraindications to the use of tecartherapy are ruled out, Winback will be able to optimize patient management for each phase of capsulitis.
Mild pain phase: The objective will be to maintain maximum ROM while remaining infra-painful. Winback energy, in gentle diathermy, with CET 1.0 and RET 1.0, will improve the nutrition and trophism of the enthesis and the capsule. In the case of the presence of axillary strings, the analytical work will be finer thanks to the bracelet.
Hot phase: During this stage, the therapist accompanies the patient to limit the progression and duration of the inflammatory phase. We will work with a 2.0 set-up with a sticky electrode placed on the scapula and a Fix pad RET on the arm. The athermia allows the biological and analgesic effect while controlling the inflammatory rebound.
Cold phase: This phase must be synonymous with a gain in amplitude, working on the fibrosis and thus restoring the elasticity of the capsular structures. A use in 3.0 will focus the Winback energy on the capsule and the strong diathermy will improve the collagen fibers alignment of the shoulder’s capsular structures.