Adhesive Capsulitis Abduction Test

The Adhesive Capsulitis Abduction Test is not a single named test but refers to the clinical assessment of shoulder abduction range of motion (ROM) to screen for adhesive capsulitis, also known as frozen shoulder. This test helps determine whether there is a loss of both active and passive abduction at the shoulder joint, which is a hallmark of adhesive capsulitis.

How the Test is Performed

• Client position: Sitting or standing, arm relaxed at side.

• The therapist requests or helps the client to slowly abduct the arm (raise it sideways away from the body) as high as possible.

  • Active abduction: Client attempts movement independently.

  • Passive abduction: Therapist gently moves the client’s arm through abduction if the client has active limitation.

• Observation: Note any pain, degree of restriction, changes in scapulohumeral rhythm, or visible compensation (shrugging, leaning).

• Positive Test for Adhesive Capsulitis: Loss of both active and passive abduction—often accompanied by global loss of shoulder motion (“capsular pattern”: external rotation most limited, followed by abduction, then internal rotation/flexion).

  • Early stages are painful with movement; later stages remain restricted but pain lessens.

Clinical Significance

• A positive abduction test (loss of motion, both active and passive) strongly suggests adhesive capsulitis, especially when combined with pain and a similar loss in external rotation and internal rotation.

• Rotator cuff tears/tendinopathy or subacromial bursitis may have limited active movement but relatively preserved passive movement.

• Adhesive capsulitis typically shows a globally limited ROM, most notably in external rotation and abduction.

• Muscle spasm and diffuse tenderness are common around the upper trapezius and shoulder girdle, but neurological function remains intact.

Assessment

• Use this test in clients with:

  • Gradual-onset shoulder stiffness or pain

  • Difficulty with daily activities (dressing, overhead reach)

  • Night pain, especially lying on the affected side

• Document degrees of active and passive abduction, scapular compensation, pain levels, and progression over time.

• Compare results to the unaffected shoulder and consider the entire ROM/capsular pattern.

Treatment

• If adhesive capsulitis suspected (positive test):

  • Avoid forcible stretching, aggressive joint mobilization, or painful manual therapy during the acute/painful stage.

  • Focus on gentle soft tissue techniques, pain reduction, maintaining functional ROM, and patient education about the natural course and staged progression of frozen shoulder.

  • As pain subsides and in more chronic stages, introduce gradual, pain-free mobilization and stretching.

  • Encourage scapular strengthening, postural work, and active-assisted exercise as tolerated.

• Reassess frequently and avoid overtreatment that could worsen irritation or spasm.

Safety and Referral

• Refer for medical/orthopedic assessment if there is:

  • Severe/progressive loss of function

  • Marked night pain

  • Suspected secondary causes (infection, fracture, systemic disease)

• Multidisciplinary management (physiotherapy, medical, possible injection or imaging) is often required in moderate/severe or non-resolving cases