The literature is inconclusive about which aspect of shoulder joint movement gets restricted first. However, it does indicate that, in the acute phase, pain is reported at the extreme of movements (which could be in any axis or plane).
By way of elucidation, adhesive capsulitis progresses through three overlapping clinical phases:
Acute/freezing/painful phase: Gradual onset of shoulder pain at rest with sharp pain at extremes of motion, and pain at night with sleep interruption which may last anywhere from 3-9 months.
Adhesive/frozen/stiffening phase: Pain starts to subside, progressive loss of glenohumeral motion in capsular pattern (lateral rotation, abduction and medial rotation). Pain is apparent only at extremes of movement. This phase may occur at around 4 months and last til about 12 months.
Resolution/thawing phase: Spontaneous, progressive improvement in functional range of motion which can last anywhere from 1 to 3.5 years.
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