{"id":7185,"date":"2025-12-24T10:50:05","date_gmt":"2025-12-24T09:50:05","guid":{"rendered":"https:\/\/kineaphp.fr\/?p=7185"},"modified":"2025-12-26T11:45:19","modified_gmt":"2025-12-26T10:45:19","slug":"capsulite-retractile","status":"publish","type":"post","link":"https:\/\/kineaphp.fr\/?p=7185","title":{"rendered":"Capsulite r\u00e9tractile"},"content":{"rendered":"\n<p>Autres d\u00e9nominations : capsulopathie enraidissante, \u00e9paule raide, \u00e9paule gel\u00e9e, frozen shoulder, adhesive capsulitis<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Introduction<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">D\u00e9finition<\/h3>\n\n\n\n<p>Restriction fonctionnelle des mouvements actifs et passifs de l\u2019\u00e9paule, pour laquelle les imageries de la GH sont\u00ab normales \u00bb \u00e0 l\u2019exception d\u2019une potentielle ost\u00e9op\u00e9nie ou tendinite calcifiante.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Absence de d\u00e9finition reconnue, c\u2019est avant tout une restriction fonctionnelle<\/li>\n\n\n\n<li>Ne prend pas en compte la douleur<\/li>\n\n\n\n<li>Gu\u00e9rit toujours<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Classification<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Primaire : idiopathique<\/li>\n\n\n\n<li>Secondaire : syst\u00e9mique, extrins\u00e8que, intrins\u00e8que (tendinopathie CDR, conflit, tendinopathie biceps, calcification tendon)<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Epid\u00e9miologie<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Femme &gt; Homme<\/li>\n\n\n\n<li>\u00c9paule gel\u00e9e primaire : 40-65 ans<\/li>\n\n\n\n<li>Atteinte controlat\u00e9rale : 5-34%<\/li>\n\n\n\n<li>Atteinte bilat\u00e9rale simultan\u00e9e : 14%<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Facteurs de risque<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Diab\u00e8te, hypothyro\u00efdie : 10-38%<\/li>\n\n\n\n<li>Histoire familiale, pr\u00e9disposition g\u00e9n\u00e9tique et ethnique<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Physiopathologie<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Facteurs inflammatoire : alt\u00e9ration de la matrice cellulaire, prolif\u00e9ration fibroblastiques et myofibroblastiques dans la capsule, alt\u00e9ration collag\u00e8ne de type III<\/li>\n\n\n\n<li>Volume de la capsule divis\u00e9 par 3, passant de 15-35cm3 \u00e0 5-6m3<\/li>\n\n\n\n<li>Epaississement, contracture et fibrose de la capsule<\/li>\n\n\n\n<li>Structures ant\u00e9rieures touch\u00e9es entra\u00eenant une perte de la rotation lat\u00e9rale<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Diagnostic<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Absence de gold standard<\/li>\n\n\n\n<li>Histoire du patient, exclusion d&rsquo;autres pathologies<\/li>\n\n\n\n<li>Radio normale : exclusion de luxation, arthrose, fracture, n\u00e9crose avasculaire, etc<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Examen clinique<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Interrogatoire : d\u00e9but lent et insidieux<\/li>\n\n\n\n<li>Douleur : pr\u00e8s de l&rsquo;insertion du delto\u00efde<\/li>\n\n\n\n<li>Origine : douleurs sous-acromiales<\/li>\n\n\n\n<li>Diminution des amplitudes actives et passives avec douleur en fin d&rsquo;amplitude (restriction de plus de 50% par rapport au c\u00f4t\u00e9 sain)<\/li>\n\n\n\n<li>Perte de la RL en R1<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<h3 class=\"wp-block-heading\">Test du processus coraco\u00efde positif <\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Sensitivit\u00e9 : 96%, sp\u00e9cificit\u00e9 : 87%<\/li>\n\n\n\n<li>Permet de diff\u00e9rencier une vraie \u00e9paule gel\u00e9e d&rsquo;une pseudo \u00e9paule gel\u00e9e (provoqu\u00e9e par une protection musculaire)<\/li>\n<\/ul>\n\n\n\n<ul id=\"block-1ae03c8e-ca5c-4415-b3a1-05bff4a235d5\" class=\"wp-block-list\">\n<li>Palpation de l&rsquo;acromio-claviculaire<\/li>\n\n\n\n<li>Palpation de la partie ant\u00e9ro-lat\u00e9rale de la zone sub-acromiale<\/li>\n\n\n\n<li>Palpation de l&rsquo;apophyse coraco\u00efde<\/li>\n\n\n\n<li>=> Le test est consid\u00e9r\u00e9 positif pour une vraie \u00e9paule gel\u00e9e quand la douleur est sup\u00e9rieur \u00e0 3\/10 (l&rsquo;\u00e9paississement du ligament coraco-hum\u00e9ral, l&rsquo;intervalle entre les muscles de la CR et le triangle coraco\u00efde sont sensibles \u00e0 la pression)<\/li>\n<\/ul>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Coracoid Pain Test | Adhesive Capsulitis Diagnosis\" width=\"925\" height=\"520\" src=\"https:\/\/www.youtube.com\/embed\/rqCBa2zqASo?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n<\/div>\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading\">R\u00e9\u00e9ducation<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Evolution clinique<\/h3>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"652\" height=\"354\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/12\/image-39.png\" alt=\"\" class=\"wp-image-7195\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/12\/image-39.png 652w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/12\/image-39-300x163.png 300w\" sizes=\"auto, (max-width: 652px) 100vw, 652px\" \/><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Phases et principes de r\u00e9\u00e9ducation<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">Phase I : douleur > raideur<\/h3>\n\n\n\n<p>Phase inflammatoire : inutile de venir modifier les sympt\u00f4mes. Seules les infiltrations ont des effets b\u00e9n\u00e9fiques pour pouvoir passer rapidement \u00e0 la phase II<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Rassurer le patient<\/li>\n\n\n\n<li>Gestion de la douleur : physioth\u00e9rapie (chaud\/froid, cryoth\u00e9rapie, \u00e9lectroth\u00e9rapie-TENS), AINS\/corticost\u00e9ro\u00efdes, IC<\/li>\n\n\n\n<li>Gestion de la mobilit\u00e9 articulaire et posture : \u00e9tirements et mobilisations douces (GH, scapulo-thoracique, rachis cervical)<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Phase II : raideur > douleur<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Gestion de la douleur (- importante)<\/li>\n\n\n\n<li>D\u00e9buter la r\u00e9cup\u00e9ration douce des amplitudes : \u00e9tirements, d\u00e9buter renfo musculaire<\/li>\n\n\n\n<li>R\u00e9adresser au chirurgien si besoin<\/li>\n\n\n\n<li>Strat\u00e9gie \u00ab Wait and see \u00bb<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Phase III <\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>R\u00e9cup\u00e9ration + intense des amplitudes<\/li>\n\n\n\n<li>Restaurer les sch\u00e9mas de mouvements<\/li>\n\n\n\n<li>\u00c9duquer le patient<\/li>\n\n\n\n<li>Retour aux activit\u00e9s<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Th\u00e9rapie manuelle : pouss\u00e9e ant\u00e9ro-post\u00e9rieure de la GH<\/li>\n\n\n\n<li>\u00c9tirements<\/li>\n\n\n\n<li>Am\u00e9lioration des amplitudes articulaires<\/li>\n\n\n\n<li>Prendre en compte l\u2019irritabilit\u00e9<\/li>\n\n\n\n<li>Mobilisations + \u00c9tirements = + b\u00e9n\u00e9fique<\/li>\n\n\n\n<li>Maitland \/ Mulligan (mobilisation avec mouvement)<\/li>\n<\/ul>\n\n\n\n<p><strong>Renforcement musculaire<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Renfo de la CDR<\/li>\n\n\n\n<li>Renfo m.scapulo-thoracique : dentel\u00e9-ant, grand dorsal, trap\u00e8ze moy et inf<\/li>\n\n\n\n<li>Am\u00e9lioration de la fonction<\/li>\n\n\n\n<li>R\u00e9duit la douleur<\/li>\n\n\n\n<li>Augmente les amplitudes<\/li>\n\n\n\n<li>Pas de consensus concernant les modalit\u00e9s d\u2019applications<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Autres d\u00e9nominations : capsulopathie enraidissante, \u00e9paule raide, \u00e9paule gel\u00e9e, frozen shoulder, adhesive capsulitis Introduction D\u00e9finition Restriction fonctionnelle des mouvements actifs et passifs de l\u2019\u00e9paule, pour laquelle les imageries de la GH sont\u00ab normales \u00bb \u00e0&hellip;<\/p>\n<p class=\"more-link-wrapper\"><a href=\"https:\/\/kineaphp.fr\/?p=7185\" class=\"more-link\">Continue Reading<span class=\"screen-reader-text\"> \u00ab\u00a0Capsulite r\u00e9tractile\u00a0\u00bb<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[359],"tags":[],"class_list":["post-7185","post","type-post","status-publish","format-standard","hentry","category-pathologie-epaule"],"_links":{"self":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/7185","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=7185"}],"version-history":[{"count":14,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/7185\/revisions"}],"predecessor-version":[{"id":7202,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/7185\/revisions\/7202"}],"wp:attachment":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=7185"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=7185"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=7185"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}