This 1975 prospective cohort study by Reeves established the true natural history of idiopathic frozen shoulder in 41 patients followed for 5-10 years. It defined three consecutive stages (pain, stiffness, recovery) and measured outcomes against the contralateral shoulder. The study directly challenged the prevailing assumption that frozen shoulder resolves fully within 18 months.
When a patient with frozen shoulder asks "how long will this take," the honest answer based on Reeves' data is over 2.5 years on average — not the 18 months that had been taught for decades. This paper is why we counsel patients that incomplete recovery is common: only 39% regained full motion, though fewer than 10% had functionally limiting stiffness at 5-10 years.
When counseling patients in the painful phase, communicate that a prolonged early course predicts a prolonged overall course. The 3 patients with functional limitation all had protracted painful stages — this is your early warning sign.
The arthrographic finding of fewer rotator cuff tears in frozen shoulders than in contralateral shoulders is a useful board fact: the fibrotic process appears to seal small and medium cuff defects, which explains why these two conditions are not simply coexisting pathology.
This 1975 prospective cohort study by Reeves established the true natural history of idiopathic frozen shoulder in 41 patients followed for 5-10 years. It defined three consecutive stages (pain, stiffness, recovery) and measured outcomes against the contralateral shoulder. The study directly challenged the prevailing assumption that frozen shoulder resolves fully within 18 months.
When a patient with frozen shoulder asks "how long will this take," the honest answer based on Reeves' data is over 2.5 years on average — not the 18 months that had been taught for decades. This paper is why we counsel patients that incomplete recovery is common: only 39% regained full motion, though fewer than 10% had functionally limiting stiffness at 5-10 years.
When counseling patients in the painful phase, communicate that a prolonged early course predicts a prolonged overall course. The 3 patients with functional limitation all had protracted painful stages — this is your early warning sign.
The arthrographic finding of fewer rotator cuff tears in frozen shoulders than in contralateral shoulders is a useful board fact: the fibrotic process appears to seal small and medium cuff defects, which explains why these two conditions are not simply coexisting pathology.