Extra-articular adhesions or neurological deficits are seen as secondary, extrinsic causes [1]. According to the observations of Neviaser [2], patients may present with stiff shoulders that occur after trauma, who appear to not have any capsular contracture. These cases may be explained by the other extra-articular causes. Extra-articular adhesions might be caused due to soft tissue injury of the surrounding structures. For example, large burning injuries might result in excessive scarring of the skin, which then limits range of motion and therefore leads to a stiff shoulder joint. In these cases, the scarring of the skin layer directly causes the limitations. Hematomas located in the deltoid muscle or the subacromial space can cause direct adhesions and scarring within these structures and prevent proper function of the fascia, gliding of the soft tissue.

It is interesting to mention that if the glenohumeral joint is restricted for a longer period, deficits in motion might persist, even if the causing problem is solved (e.g., plastic surgery for restrictive burned skin). This is in contrast to the classic ideas of the “frozen shoulder,” which, as a self-limiting condition, resolves after a certain time and patients regain motion.