Lysis of Adhesions

By: Ehren Allen, PT, Certified Orthopedic Manual Therapist

Image of the Shoulder JointLysis of Adhesions of the Shoulder.

What is a Lysis of Adhesions in the Shoulder?

The quick answer is that lysis of adhesions is a surgical procedure used to increase mobility and Range of Motion in the shoulder.  It is usually an arthroscopic procedure and is minimally invasive.  When the shoulder is injured, the body can deposit collagen to heal the tissue.  In some cases, the collagen can scar the tissue together and limit joint movement. In cases of severe stiffness with scar tissue or adhesions, a lysis procedure can eliminate the adhesions and allow the joint to move.   By cutting the adhesions, the joint capsule is loosened to allow movement.

What is Frozen Shoulder?

The quick answer is a Frozen shoulder is a condition in which the shoulder becomes stiff.  The stiffness may be in response to inflammation.  Inflammation in the shoulder can trigger the muscle to tighten and limit movement.  If the shoulder remains in the stiff position for a long period, the inflammation can cause the body to lay down excess collagen in attempt to heal the shoulder.  If the shoulder is not moving, the limit collagen can bind the fibers of the joint capsule together and limit motion.  This can be very painful and limit function of the shoulder.
Frozen shoulder is often referred to as Adhesive Capsulitis.  Adhesive Capsulitis can also occur after surgery if the patient does not allow movement of the shoulder.  It may also occur in patients who tend to scar quickly.

If you would like to learn more about Frozen Shoulder, check out this video.

When do you need a Lysis of Adhesions?

Conservative treatment is usually recommended to treat stiffness in the shoulder.  This typically includes physical therapy for manual stretching and mobilization and exercise.   If the patient is compliant with the home exercise program, they usually improve.

In severe cases, a Manipulation under anesthesia (MUA) may be performed. This involves placing the patient under general anesthesia and manually moving the arm to break the adhesions in the shoulder.  The shoulder is usually painful when the patient wakes up.  

If this does not work, or there is surgery already planned, a lysis of adhesions procedure may be performed to free the capsule from adhesions.  

Both manipulation under anesthesia and lysis of adhesions require aggressive physical therapy afterwards. Most of the time, patients begin therapy the next day.  They may receive PT daily for the first 2 weeks after the procedure to prevent adhesions from returning.

How long does it take to recover from a Lysis of Adhesions?

With a Lysis of Adhesions procedure, the healing process is similar to any other minimally invasive procedure. This may be different if a tendon or labrum repair is performed during the procedure.  But, if there is not, healing from the procedure should occur in 4 to 8 weeks.  However, the rehabilitation process may take longer. Typically, the purpose of the Lysis of Adhesions procedure is to increase mobility and range of motion in the shoulder.  Gaining full range of motion and strength after the procedure may take more time.  Everyone responds differently.  Compliance with physical therapy and home exercises can help to accelerate the recovery time.

If you want to read other articles about the shoulder, please go to our Shoulder Trending Section.

If you have shoulder stiffness that will not improve, the Jacksonville Orthopedic Institute can help!  JOI is your one stop shop from conservative physical therapy to advanced surgery.

If you want to schedule an appointment with an Orthopedic Shoulder Specialist, please call JOI-2000 or click below. 

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