Do you have a Frozen Shoulder?
What is a Frozen Shoulder?
Frozen shoulder technically known as adhesive capsulitis, is when the shoulder becomes stiffer and more painful, eventually getting to the point that it is difficult or painful to move the arm much at all. The shoulder joint, like most other joints, is enveloped by a very thin capsule. This is a tissue similar to nylon in that it is strong but with some stretch to allow us to move our arms with lots of freedom.
What Are The Stages Of Frozen Shoulder?
Frozen shoulder follows 3 distinct stages – freezing, frozen, and thawing.
- Freezing: In this stage, the shoulder gets very painful and becomes progressively stiffer. Movements such as reaching out or putting your hand behind your back are typically very stiff and sore.
- Frozen: As the condition moves into the frozen stage the pain begins to subside but the stiffness remains. Although inconvenient due to lack of mobility, this stage is much more comfortable as there is much less pain.
- Thawing: Eventually the shoulder progresses into the thawing stage where the range of motion steadily improves and in most cases returns to normal.
Why do people get frozen shoulders?
The exact cause of frozen shoulder is unknown. Sometimes you can develop the condition following a fall, a stroke, or after a shoulder operation. However, most of the time it develops for no apparent reason.
How do you diagnose frozen shoulder?
Frozen shoulder is a “clinical diagnosis” which means that your physiotherapist can diagnose it during your initial assessment.
The term ‘frozen shoulder’ means that the joint is restricted in specific directions. This is known as the ‘capsular pattern’.
A capsular pattern is when your joint is restricted into lateral rotation (when your elbow is tucked into your side and you move your hand away from you), abduction (moving your arm out to the side), and medial rotation (putting your hand behind your back). Most patients suffering from frozen shoulders have difficulty putting on a bra, washing and combing their hair, and reaching up to cupboards.
The recommended treatment for a frozen shoulder depends on the stage of the condition. To progress through the stages of the frozen shoulder as quickly as possible, a combination of treatments is most effective:
- hands-on mobilization is key to start to get the shoulder moving
- stretching the capsule and surrounding muscles to improve flexibility
- soft tissue release of the muscles around the shoulder. The muscles around the shoulder blade are usually very tight which adds to the pressure on the joint so these muscles need to be released early too.
- Gunn IMS and acupuncture will help with the muscle release and also desensitize irritated nerves
- heat therapy is helpful to reduce pain and increase fresh blood flow to the healing shoulder
What will a Physio do?
A physiotherapist will immediately get to work with some hands-on treatment to release the muscles around the shoulder and stretch the joint capsule. Treatments to reduce the pain such as acupuncture and heat will help to relax the shoulder. You will also be guided through a specific exercise program that you can do at home and this will be progressed according to the stage your frozen shoulder is at.
PCA clinicians have experience with orthopedics, sports medicine, neurology, pediatrics, and geriatrics. We work closely with each patient to design an individualized treatment plan that is specifically tailored to fit each patient’s needs as well as their personality and schedule. Treatments vary and may include, but are not limited to: therapeutic exercises, neuromuscular re-education, and balance training, gait training, functional training, manual treatments such as joint and soft tissue mobilizations, massage therapy, therapeutic modalities such as electric stimulation or ultrasound, traction or taping. We can assist in accessing occupational and speech therapists to support post-stroke treatment.
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