In adhesive capsulitis (frozen shoulder), which pattern of shoulder motion is most characteristic?

• A. Global loss of motion in all directions with preserved shoulder strength
• B. Painful arc with isolated external rotation weakness
• C. Normal range of motion but severe night pain
• D. Pain only with overhead lifting

Answer: (A)

Adhesive capsulitis causes stiffness from capsule thickening, leading to loss of both active and passive motion in all directions while the shoulder muscles remain relatively strong. The loss follows a capsular pattern: external rotation is most limited, then abduction, then internal rotation, with flexion often affected to a lesser degree. Because the issue is noncontractile and capsular, strength testing is typically normal, helping distinguish it from rotator cuff or impingement problems that cause weakness or selective motion loss. The other patterns—painful arc with isolated external rotation weakness, normal motion with severe night pain, or pain only with overhead lifting—fit other shoulder conditions rather than frozen shoulder.