In the early phase of adhesive capsulitis, which shoulder movement is particularly limited?

• A. Abduction
• B. Flexion
• C. External rotation
• D. Internal rotation

Answer: (C)

Adhesive capsulitis, or frozen shoulder, tightens the joint capsule enough that range of motion becomes limited, and this restriction hits external rotation the hardest in the early stage. The posterior aspect of the capsule and the rotator interval become inflamed and fibrotic, which especially blocks turning the arm outward away from the body. Flexion and abduction often become limited later, and internal rotation may be relatively preserved early on, so the first movement people notice as most reduced is external rotation. Clinically, you’d see a marked decrease in passive external rotation compared with other motions, even while strength remains relatively intact.