Everything Pointed to Frozen Shoulder – Until This Happened.
This case study was written by Danya Sadler, Student Physical Therapist, during her clinical rotation at Nick Rinard Physical Therapy. Names and identifying details have been modified to protect patient privacy.
When Shoulder Pain Isn’t What It Seems
During my first week at the clinic, we had a patient come in with intense shoulder and neck pain with occasional extreme headaches and a tingling sensation down the arm. They even had an episode that sent them to the ER. When they came in, they were 60–70% functionally limited in activities like sleeping, looking down, and turning to the left. This patient also had a lot of limitations with their range of motion which made it hard to complete everyday tasks like reaching to a shelf.
When they came into Nick Rinard Physical Therapy, we tested their range of motion and resisted strength and found something interesting. This patient demonstrated limitations in both active and passive range of motion, yet their resisted strength remained intact. Based on these findings, adhesive capsulitis (frozen shoulder) became our leading hypothesis.
The Test That Changed Everything
One of the biggest mistakes in healthcare is stopping your assessment once something seems to fit. Good clinicians continue testing to make sure the diagnosis truly holds up. The patient performed a repeated passive shoulder extension movement which, if this was truly frozen shoulder, would not be expected to change their range of motion. To our surprise, range of motion improved by 10°, disproving the frozen shoulder hypothesis.
A Better Answer, Better Results
Over subsequent visits, we continued addressing the range of motion deficits, functional limitations, headaches, and arm tingling. Within five appointments, the patient reported no arm tingling, fewer headaches, improved range of motion, better functionality, and generally feeling much better.
Why the Right Assessment Matters
A key takeaway from this case is that symptoms can sometimes mimic a more serious or long-term condition, but the right assessment can uncover a more treatable cause.
If this sounds familiar—whether in your shoulder, back, or elsewhere—a thorough movement assessment may help identify what’s really driving your symptoms.