ARTHROSCOPIC CAPSULAR RELEASE
This leaflet provides general information to help you understand arthroscopic capsular release (arthrolysis) for a stiff or frozen shoulder.
This keyhole procedure releases the tight capsule to restore movement, and is usually a day case.
At the heart of my practice is Shared Decision-Making. Whether we pursue conservative management (Plan A) or surgical intervention (Plan B), the goal is to create a tailored treatment plan that aligns with your lifestyle, values, and functional goals.
This leaflet provides general information and does not replace individual medical advice.
The Anatomy of the Shoulder Joint
The shoulder is one of the most complex joints in the body, relying on several structures working together:
How the Shoulder Works
Three main bones form the joint:
- Humerus (upper arm bone)
- Clavicle (collarbone)
- Scapula (shoulder blade)
The Four Key Joints
- Glenohumeral Joint – the main ball-and-socket joint
- Acromioclavicular (AC) Joint – collarbone meets shoulder blade
- Subacromial Space – tunnel above the rotator cuff
- Scapulothoracic Joint – shoulder blade glides over rib cage
The Labrum (Stabilising Ring)
- A rim of rubbery tissue that deepens the shallow shoulder socket — like a "bumper" or suction cup that keeps the joint stable and prevents dislocation.
The Rotator Cuff
Four deep muscles keep the ball centred in the socket and let you lift and rotate your arm:
- Supraspinatus
- Infraspinatus
- Subscapularis
- Teres Minor
About the Operation
Arthroscopic capsular release is a keyhole procedure for shoulder pain and stiffness, most often from frozen shoulder (adhesive capsulitis). The tight, thickened capsule around the ball-and-socket joint is released with fine instruments so the shoulder can move freely again. It is often combined with subacromial decompression, and can also treat stiffness after previous surgery or injury.
Benefits & Logic
The operation aims to:
- Relieve pain from the inflamed, tight capsule
- Restore a fuller, smoother range of movement
- Allow other problems (e.g. cuff, impingement) to be treated at the same time
The Procedure, Step by Step
The operation, step by step:
- Assessment: a camera examines the joint and subacromial space
- Release: the tight capsule is released with fine instruments
- Decompression: bone or inflamed tissue removed if needed
- Closure: dissolvable stitches, strips and a sling for comfort
Before, During & After Surgery
Before Surgery
- Fasting: no food for 6 hours, no drinks for 2 hours before
- Smoking: avoid for at least 12 hours before, to aid healing
- Medications: continue as advised by the pre-op team
- Please read 'Preparing for Surgery'
On the Day
- Admission: check in at main reception, then to your room
- Consultation: meet your surgeon and anaesthetist
- Preparation: timing and instructions are reviewed
Anaesthesia
- General anaesthetic with a nerve block that numbs the arm
- Nerve block alone (awake) if general anaesthetic is unsuitable
Recovery & Results
Recovery is a partnership. The timeline below is a guide — your physiotherapist and I will adapt it to you — this shared decision-making process ensures you are fully informed and involved in your care.
Recovery Milestones
- Sling: for comfort only, briefly
- Gentle exercises: begin immediately — movement is vital
- Recovery: most do well by 3–4 months
- Full recovery: may take up to 12 months
Results
About 90% of patients achieve good or excellent outcomes. Early, regular movement after surgery is the single most important factor.
After Surgery — In the First Weeks
- Sling: for comfort only — remove early to move the shoulder
- Pain Relief: start at home; take regularly for the first few days
- Wound Care: dressings changed at 24–48 hours; showering after 3–5 days
- Physiotherapy: frequent gentle movement from day one is essential
- Follow Up: 2–6 weeks post op to monitor progress
Watch the Surgery Videos
For more information you can watch procedure videos at: www.youtube.com/c/ProfBijayendraSingh
Watch on YouTubeRisks & Complications
Uncommon, but possible:
- Anaesthetic: complications are rare
- Infection: fewer than 1 in 1000; treated with antibiotics
- Pain: common early, usually improves over weeks; an injection helps if it persists
- Stiffness: can recur — physiotherapy reduces the risk (slower with diabetes)
- Nerve: minor, temporary irritation in about 5%
- Failure to Improve: 90% patients report good to excellent outcomes, a small percentage may have ongoing pain and may require further injection or surgery
Return to Activities
This can be extremely variable and discuss with the surgeon. These are just guidelines.
Desk work 1–2 weeks; driving once safe and out of the sling; sport is staged — your physiotherapist will guide the timeline. A member of the team will discuss your specific plan. Driving: 2–4 weeks when safe. A member of the team will discuss your specific plan.
Recovery Timeline & Sleeping
⚠ Red Flags — When to Seek Urgent Help
Fever, spreading redness or discharge from the wound, worsening pain, or numbness and a cold hand — seek urgent assessment.
If you experience any of the above, contact the practice, your GP, NHS 111, or attend your nearest Emergency Department.
Key Points to Remember
- Releases the tight capsule of a frozen shoulder
- Early movement after surgery is essential
- Most people improve markedly
- Stiffness can recur — keep up the exercises
Questions You May Wish to Ask
- When can I take the sling off?
- When can I drive and return to work?
- How much improvement can I expect?
- What happens if I don't have surgery?
Book or Enquire Directly at Each Site
| LIPS Healthcare London | 0203 870 9996 | singh.admin@lips.org.uk |
| Spire Alexandra Chatham | 01634 662866 | alexandraselfpaypsc@spirehealthcare.com |
| Practice Plus Gillingham | 01634 969045 | Private.gillingham@practiceplusgroup.com |