Frozen Shoulder

Description

Also called adhesive capsulitis.

Frozen shoulder is the inflammation of the shoulder capsule. It is a extremely painful condition where the shoulder capsule becomes thickened, develops adhesions as well as severe restrictions to movement.

Whilst there is no definite cause for frozen shoulder to develop, your risk of frozen shoulder increases dramatically if you are:

  • Recovering from another shoulder condition such as a rotator cuff tear.
  • Post surgery for example after a acromioplasty or a mastectomy.
  • It may also develop following a stroke that limits movement of an arm or after a condition which causes you to restrict the movement of your arm, especially if you have to use a sling. This is the reason many surgeons, doctors, physios or other health professionals insist on you getting your shoulder moving as soon as possible after injury, even if it involve just taking your arm out of the sling for a couple of times each day to regain the movement.
  • It has been known to develop for no apparent reason or after a minor strain or period of heavier work.
  • Once you have had it in one shoulder while is is uncommon to develop it again in the same shoulder there is a 30% chance of the other shoulder developing it as well.
  • Frozen shoulder typically effects people between the ages of 40 and 60 and occurs sightly more often in women than men.
  • Once you have had it in one shoulder while it is uncommon to develop it again in the same shoulder there is a 30% chance of the other shoulder developing it as well.
  • The length of conditions differs between patients but it has been known to last over 3 years without appropriate treatment.

Symptoms

There are 3 phases of frozen shoulder:

  1. The first phase is the freezing phase. This can come on quite suddenly and is characterised by severe pain on movement, this encompasses movement in all directions. This phase can last from 6 to 12 weeks.
  2. The next phase is the frozen phase. This phase is where your shoulder becomes very stiff and becomes restricted with all movements. This makes it difficult to do many things including reaching up, doing your hair, putting on a bra or reaching accross to wash your opposite armpit. This phase can last 4 – 6 months.
  3. The last phase is the thawing phase this is where the shoulder movement gradually returns to normal. This phase can last for over a year.

Treatment

Physiotherapy treatment consists of:

  1. Modalities to treat pain heat, ice.
  2. Massage to the surrounding muscles will prevent them from tightening and causing pain. This happens often as these muscles become tight compensating for the lack of movement.
  3. Mobilisations to the joints such as the neck and upper back will help maintain the scapulo-thoracic movement, again these areas will become stiff from the increased compensatory movements.
  4. Care has to be taken in the freezing stage to prevent aggravation, because of this aggressive stretching of the shoulder will be saved for the frozen and thawing stages.