Frozen Shoulder
What is Frozen Shoulder?
Frozen shoulder, also known as adhesive capsulitis, is a condition in which the shoulder becomes stiff, painful, and difficult to move. It is characterized by a gradual loss of range of motion in the shoulder.
What causes Frozen Shoulder?
The exact cause of frozen shoulder is unknown, but it is believed to be related to inflammation and scarring of the shoulder capsule, a fibrous structure that surrounds the shoulder joint and helps to hold it in place.
Frozen shoulder is more common in certain groups of people, such as those with diabetes, people who have recently had shoulder surgery or sustained shoulder trauma, and people over the age of 40.
Stages of Frozen Shoulder
1. Freezing Stage
Typically lasts from 6 to 9 months.
As the inflammation of the joint capsule progresses, it is typical to experience more pain and stiffness in the shoulder joint. The pain can be sharp and worsen at night.
2. Frozen Stage
Typically lasts from 4 to 12 months.
It is characterized by a more severe reduction in shoulder mobility. There is typically less pain, but the shoulder joint remains stiff and has limited range of motion.
3. Thawing Stage
Typically lasts from 6 to 24 months.
The shoulder joint slowly regains its mobility and range of motion begins to improve. Pain begins to decrease and the function of the shoulder joint is slowly restored.
What are the symptoms of frozen shoulder?
1. Pain in and around the shoulder
This pain can be located around shoulder, upper arm, and/or upper back. It may feel dull or ache, and can radiate down the arm.
2. Movement Restrictions at Shoulder Joint
Inflammation and scarring in the joint capsule can restrict movement, causing pain and difficulty with moving the shoulder into certain positions.
3. Gradual Reduction of mobility
The onset of frozen shoulder varies by individual, but usually progresses slowly over 1-2 months. Over this period of time, the range of motion of the shoulder will decrease.
4. Compensatory Shoulder Blade Movements
Stiffness in the shoulder joint can cause the shoulder blade to move in an abnormal pattern. This can lead to strain on the trapezius and neck muscles.
How does physiotherapy Treat Frozen Shoulder
improve shoulder function
During the assessment, your therapist will determine what stage of frozen shoulder you are in and rule out any other possible conditions. Your therapist will then provide treatments, prescribe exercises, and educate you on how to manage, maintain, and improve your shoulder’s mobility and function.
Management Strategies
1. Manual Therapy
Myofascial release: to alleviate pain, stiffness, and inflammation of the muscles, joints, nerves, and fascia around the shoulder.
Joint mobilization: to promote smooth joint movement and mobility of the shoulder joint and shoulder blade.
2. Biomechanical Optimization
Shoulder blade conditioning: to improve the stability of the shoulder blade stabilizers, posture, overall function of the shoulder joint, and reduce compensations,
Trapezius conditioning: to reduce the compensatory styles of movement in the trapezius during shoulder use.
3. Exercise Therapy
Stretching: to prevent stiffening of muscles around the shoulder.
Range of motion: to maintain and improve joint mobility of the shoulder.
Strengthening: to improve the strength and stability of the shoulder as well as prevent muscle atrophy.
Home exercise program: individualized exercise prescription to restore optimal and balanced movement.
4. Modalities
Taping: to support the shoulder and shoulder blade.
Acupuncture: use of thin needles to improve local and systemic function, regulate the nervous system, and promote the body’s natural healing processes.
Heat and cold therapy: to manage reduce pain and tension or control inflammation.
Electrostimulation: use of electrical currents to stimulate muscles and reduce pain.
Ultrasound: use of high-frequency sound waves to produce deep tissue heating to reduce muscle tension and inflammation.
Laser therapy: to improve blood flow, reduce pain and inflammation, and promote tissue healing.
5. Education
Advice on posture, activity modification, and self-management strategies to reduce the risk of recurrence and further injury.