From the Research
After arthroscopic capsular release for frozen shoulder, scar tissue can begin forming within days, with significant reformation potentially occurring within 6-12 weeks if proper rehabilitation is not followed. This is why immediate and consistent physical therapy is crucial following surgery, typically starting within 24-48 hours 1. The rehabilitation protocol usually involves daily passive and active range of motion exercises for at least 6-8 weeks to prevent adhesion reformation. Patients may be prescribed NSAIDs like ibuprofen (400-600mg three times daily) to manage inflammation, and in some cases, a short course of oral steroids like prednisone (starting at 20mg daily with tapering) might be recommended.
Some key points to consider in the rehabilitation process include:
- The importance of early mobilization to prevent scar tissue formation and promote proper collagen fiber alignment 2
- The use of continuous passive motion machines in the immediate post-operative period to maintain range of motion
- The role of patient education in ensuring compliance with the rehabilitation protocol and promoting optimal outcomes
The biological process of scar formation involves inflammatory cells depositing collagen and forming adhesions, which is why maintaining motion through the healing process is essential to ensure the collagen fibers align properly without restricting movement 3. Without proper rehabilitation, patients risk returning to a frozen state similar to or worse than their pre-surgical condition. A study published in 2023 found that arthroscopic capsular release can lead to significant improvements in range of motion and function, with better outcomes expected when the etiology is idiopathic 1.
In terms of specific rehabilitation protocols, a study published in 2018 highlighted the importance of sufficient release of the long head of the biceps (LHB) and the coracohumeral (CH) ligament, as well as the need for careful patient selection and preoperative evaluation 3. By prioritizing proper rehabilitation and patient education, healthcare providers can help optimize outcomes and reduce the risk of complications following arthroscopic capsular release for frozen shoulder.