A stiff and painful shoulder can make everyday activities such as dressing, reaching overhead or putting your hand behind your back difficult. When the stiffness is severe and does not improve with appropriate non-surgical treatment, surgery may sometimes be considered.

Arthroscopic capsular release is a minimally invasive operation used to release the tight tissues around the shoulder joint and restore movement.

What is arthroscopic capsular release?

The shoulder joint is surrounded by a flexible layer of tissue that allows the joint to move freely.

In a very stiff shoulder, this tissue can become tight and restrict movement.

During arthroscopic capsular release, a small camera is inserted into the shoulder through a small cut. Special instruments are then used to carefully release the tight areas around the joint.

The aim is to free the shoulder and restore movement while causing as little damage to the surrounding tissues as possible.

When is arthroscopic capsular release needed?

Most stiff shoulders are first treated without surgery. Treatment may include pain-relieving medicines, exercises, physiotherapy and, in selected patients, an injection into the shoulder.

Surgery may be considered when:

• Shoulder movement remains severely restricted

• Pain and stiffness continue despite appropriate treatment

• The stiffness is significantly affecting daily activities

• The shoulder has remained stiff for a prolonged period

• Other non-surgical treatments have not provided sufficient improvement

The decision depends on the cause and severity of the stiffness and the condition of the shoulder.

What happens during the operation?

The operation is performed using a small camera and instruments inserted through small cuts around the shoulder.

The surgeon first examines the inside of the shoulder and identifies the areas that are restricting movement.

The tight tissues around the joint are then carefully released.

The shoulder is gently moved during the operation to check that movement has improved.

If another problem is found that needs treatment, such as a damaged tendon or other abnormal tissue, it may sometimes be treated during the same operation.

What are the benefits?

When appropriately selected, arthroscopic capsular release can:

• Improve shoulder movement

• Reduce pain caused by a stiff shoulder

• Make everyday activities easier

• Improve the ability to reach overhead

• Improve the ability to reach behind the back

• Help the patient progress more effectively with exercises and rehabilitation

One of the important advantages of the procedure is that the tight tissues are released through small cuts rather than through a large surgical opening.

What is recovery like?

Recovery after capsular release is different from many other shoulder operations because early movement is particularly important.

Shoulder exercises are usually started soon after surgery to help maintain the movement gained during the operation.

Recovery generally includes:

• Pain and swelling control

• Early shoulder movement

• Regular exercises

• Gradual strengthening

• Continued physiotherapy when required

• Gradual return to normal activities

The amount of improvement and the speed of recovery vary between patients. Regular exercises are important because the shoulder can become stiff again if movement is not maintained.

Can the shoulder become stiff again?

There is a possibility that some stiffness may return after surgery, particularly in patients who are more prone to developing a stiff shoulder.

The amount of movement regained and the chance of stiffness returning also depend on regular physiotherapy and following the recommended exercise programme. Regular movement after surgery is important to maintain the improvement achieved during the operation.

Your recovery therefore depends not only on the surgery, but also on consistent participation in physiotherapy and exercises during the recovery period.

What are the risks?

Arthroscopic capsular release is commonly performed, and serious complications are uncommon.

Possible problems include:

• Infection

• Bleeding

• Temporary increase in pain

• Continued stiffness

• Shoulder weakness

• Numbness or irritation of nearby nerves

• Injury to the surrounding tissues

• The shoulder becoming stiff again

• The need for further treatment

Following your surgeon's advice and keeping up with your exercises and physiotherapy can help support a smooth recovery and reduce the chance of problems.

Frequently Asked Questions

How soon can I move my shoulder after surgery?

Movement is generally started early because maintaining the movement gained during surgery is an important part of recovery. Your exercise programme will be adjusted according to your pain and progress.

How long does it take to recover?

Improvement in movement may be noticed early, but recovery continues over several weeks to months. The final result depends on the cause and severity of the stiffness and how well the shoulder responds to rehabilitation.

Will I get completely normal shoulder movement?

The aim is to improve movement significantly, but a completely normal range of movement cannot be guaranteed. The result depends on the cause of stiffness, the condition of the shoulder and the duration of the problem.