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Shoulder stiffness

  • Initial pre-referral workup

    Clinical history

    • previous trauma
    • congenital differences in other areas

    Physical examination

    Check for difference between active and passive range of motion.



    GP management

    Elbow stiffness can have multiple causes. It can occur following normal healing of fractures but may also be due to malunions or missed injuries.

    If healing on x-ray is appropriate, and patient has just come out of cast, then a few weeks of stiffness is expected. Physiotherapy can be helpful in most cases.

    Indications for specialist referral


    • arthrofibrosis (excessive joint scarring), without evidence of missed injury or malunion of previous fractures, not responding to physiotherapy
    • malunited fracture
    • congenital malformations in elbow
    • osteochondritis dissecans of the elbow