WHAT IS IT? FROZEN SHOULDER

Frozen shoulder, also called adhesive capsulitis, is a painful condition in which the movement of the shoulder becomes limited. Frozen shoulder occurs when the strong connective tissue surrounding the shoulder joint (capsule) become thick, stiff, and inflamed.

Degenerative changes also affect the bursa and rotator cuff tendons

It is a stiff and painful condition which occurs in three stages:

  • Stage 1 – (Freezing) - pain and spasm which prevents movement.

  • Stage 2 – (Frozen)   -  pain with loss of shoulder movement

  • Stage 3 – (Thawing) -  predominantly stiffness rather than pain.  Poor scapular and shoulder movement pattern.

The condition is called "frozen" shoulder because the more pain that is felt, the less likely the shoulder will be used. Lack of use causes the shoulder capsule to thicken and becomes tight, making the shoulder even more difficult to move -- it is "frozen" in its position.

Signs & Symptoms

  • Gradual onset of pain

  • Loss of range of movement (especially outward rotation of a bent arm)

  • Increasing difficulty with carrying out everyday activities (e.g. brushing hair, doing up bra, playing golf or overhead racquet sports).

What Causes It?

  • Can occur for no reason

  • Can be triggered by: trauma, surgery, immobilisation, shoulder injuries

  • More common in 40-60 year olds

  • Increased risk if diabetic, or have thyroid dysfunction

How to Self Manage

  • Anti-inflammatory medication

  • R.I.C.E protocol

  • Home exercise program

  • Seeking the advice of a physiotherapist is recommended

Prognosis

  • Following trauma or surgery recovery can take 1-2 years to resolve.

  • If the onset is unrelated to trauma or surgery, then it can be more than 2 years.

  • If not treated, and the frozen shoulder does not resolve on its own, then the condition can last years.

  • Corticosteroid injections can offer short term pain relief.

  • Manipulation under anaesthetic and arthroscopy are surgical interventions which may provide relief.

How Physio Helps

  • Assess your shoulder presentation to confirm that frozen shoulder is the issue

  • Address factors which are impairing normal shoulder and shoulder blade function

  • Provide manual treatment to provide pain relief (massage, acupuncture)

  • Recommend a range of movement, and stabilising program

  • Mobilise of the shoulder joint, scapula and thoracic spine

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