Restricted shoulder movement: capsular contracture or cervical referral - a clinical study.

When shoulder movements become restricted in all directions, the literature reports that contracture of the joint capsule is not present in every case. These findings suggest a different underlying pathology in some cases, which restricts shoulder movements in a manner resembling contracture. In order to investigate the concept of another mechanism, fourteen patients were selected with a specific pattern of shoulder stiffness: a gross restriction of lateral rotation associated with only moderate restrictions of abduction and medial rotation. The patients were treated with mobilization of the lower cervical spine, which resulted in an improvement in the range of lateral rotation of the shoulder, the most restricted movement. These results suggest a correlation between the cervical spine and shoulders with this pattern of movement restrictions.