Frozen Shoulder

Nov 18

What is Frozen Shoulder?

Also known as adhesive capsulitis, it is an inflammatory and progressive condition of the glenohumeral joint.

It results in thickening/fibrosis and contraction of the joint capsule, leading to painful loss of active and passive range of motion. This more likely occurs following an injury to the shoulder or immobilization i.e. a rotator cuff tear, broken humerus or stroke.

How does this present?

The condition goes through a progression of stages/phases. These stages are freezing, frozen and thawing, respectively. In the early stage of freezing, high levels of pain is typical especially when trying to move the shoulder. People suffering from frozen shoulder will experience difficulty with external rotation of the arm, abducting the shoulder, and/or reaching toward touching your back. This will also disturb sleep, ache at rest and be very disabling. Pain and loss of range of motion are hallmark symptoms of frozen shoulder.

As the condition progresses to “frozen”, you may experience less pain, but stiffness in those ranges will be the main villain. The range of motion achieved will be the same between active and passive movements. In the thawing stage, range of motion starts to improve and return to the affected joint. A lot of cases do resolve completely or nearly-complete, but with any case, everyone’s road to recovery is different and varies in length from 12 to 24 months. This is a slow healing process, so be patient.

Who does this affect?

The typical population affected are between the ages of 40-65 years old and more commonly in women. There is also a greater risk in people with diabetes and thyroid conditions. People who have long periods of immobilization of the shoulder, from wearing a sling or cast, are also at a greater risk for developing frozen shoulder.

Why does this happen?

After prolonged immobilization and not maintaining shoulder range of motion, frozen shoulder is likely to arise and progress. The risk of this can be reduced or prevented by doing exercises prescribed by your physiotherapist. Some cases are also idiopathic, which means it is spontaneous or the cause is unknown. Regardless of cause, treatment will be progressed in the same way.

Treatment options and what to expect from therapy

It is natural to opt in for conservative treatment first. Pain management will be a main aim of therapy especially in the early stages. This can include use of modalities such as electrotherapy, acupuncture and soft tissue techniques. Therapy for the shoulder will include active, active assisted, passive range of motion exercises and mobilizations of the joint. Stretching is a fundamental part of rehab due to the shortening of structures. Resistance training will be added as tolerated in the later stages.

You will be given a home care program and if consistently followed, will help maintain and progress recovery. We will need to monitor the body’s response to the program. If conservative treatment fails, it is possible to have a manipulation of the shoulder under anesthetic, arthroscopic release/surgery and use of medications/corticosteroids.

How can we help?

Individuals seek therapy at different stages, so an initial assessment is necessary to cater the rehab program. As noted above, our physiotherapists will provide pain management and exercises to address your frozen shoulder.

Remember, this is a long process, and we will be there to guide you along the journey. To start receiving treatment by a Rehab Hero physiotherapist, click the button below:

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