Frozen shoulder, also known as adhesive capsulitis, is a condition that causes pain, stiffness, and limited motion in the shoulder joint. It can develop gradually over time and make even small and simple movements painful or challenging. While the exact cause is often obscure, physiotherapy can help restore movement and function to the shoulder.
What is a Frozen Shoulder?
Frozen shoulder is a condition where the shoulder joint becomes stiff and painful, leading to restricted movement. It typically progresses through three stages: the freezing stage (where pain increases and movement becomes restricted), the frozen stage (where stiffness is the primary issue), and the thawing stage (where motion begins to improve). The condition can last from several months to up to two or three years. While it often resolves on its own, treatment with physiotherapy can significantly improve outcomes.
Anatomy of the Shoulder
The shoulder is one of the most flexible joints in the human body. It’s a ball-and-socket joint where the head of the upper arm bone (humerus) fits into the shallow socket of the shoulder blade (glenoid cavity). The joint is surrounded by a capsule made of connective tissue that allows the arm to move freely.
In a healthy shoulder, this capsule is lubricated by synovial fluid, allowing smooth movement. When someone develops a frozen shoulder, the capsule thickens and tightens, restricting movement. This tightening can also lead to the formation of scar tissue or adhesion, which further reduce the shoulder's range of motion.
Symptoms of Frozen Shoulder
The main symptoms of frozen shoulder are pain, stiffness, and a reduced range of motion. These symptoms tend to develop gradually, starting with mild discomfort that worsens over time. Pain is often described as a dull ache, which may intensify during movement or at night, making sleep difficult.
As the shoulder becomes "frozen," stiffness limits the ability to perform everyday tasks like reaching overhead, putting on clothes, or even lifting objects. In severe cases, individuals may struggle to move the shoulder at all.
Causes of Frozen Shoulder
The exact cause of frozen shoulder is not always clear, but certain risk factors increase the likelihood of developing the condition. These include:
- Injury or Surgery: Shoulder immobilisation due to an injury, surgery, or a long period of inactivity can lead to frozen shoulder. For instance, wearing a sling without performing any stretching exercises may cause the capsule to contract.
- Inflammation and Overuse Injuries: Conditions such as tendinitis or bursitis can lead to inflammation, which restricts shoulder movement and can trigger frozen shoulder.
- Other Health Conditions: People with diabetes, thyroid disorders, or Parkinson’s disease have a higher risk of developing frozen shoulder.
- Age and Gender: Frozen shoulder typically affects people aged 40 to 60 and is more common in women.
Treatment of Frozen Shoulder
While frozen shoulder can resolve over time, physical therapy plays a crucial role in managing pain, improving range of motion, and preventing the condition from worsening. Below are some of the most effective physical therapy treatments for frozen shoulder:
- Stretching Exercises: Physical therapists often recommend gentle stretching exercises to help improve mobility. Some common exercises include:
- Pendulum Stretch: This exercise involves leaning forward and letting the affected arm hang down, then gently swinging it in small circles. It helps loosen up the shoulder without causing too much strain.
- Towel Stretch: Holding a towel behind your back, you use your good arm to gently stretch the affected shoulder upwards.
- Cross-Body Reach: Using your unaffected arm to bring the painful shoulder across your body helps stretch the capsule and improves flexibility.
- Strengthening Exercises: Once mobility begins to improve, strengthening the rotator cuff and surrounding muscles is important to stabilise the shoulder joint. Rubber exercise bands can be used for outward and inward rotation exercises to build strength.
- Manual Therapy: Physiotherapy may use hands-on techniques, such as joint mobilisation, to stretch the joint capsule and improve range of motion. These manual techniques are designed to reduce stiffness and break up scar tissue or adhesions.
- Heat and Cold Therapy: Applying heat before exercises can help loosen the muscles and reduce pain, while cold therapy afterward can reduce inflammation and swelling.
- Home Exercise Program: Consistency is key to recovery, so therapists often develop a personalised home exercise program. Performing these exercises daily can accelerate the recovery process and help maintain progress made during in-clinic therapy.
Conclusion
Frozen shoulder can be a painful and limiting condition, but with the right treatment, particularly physical therapy, most people can regain full use of their shoulder. Early intervention, a combination of stretching and strengthening exercises, and consistent at-home care can shorten recovery time and restore mobility. If you’re experiencing symptoms of frozen shoulder, consulting a physiotherapist can help guide you through a personalised treatment plan for optimal recovery.
At Ground Up Physio, our experienced physiotherapists can help you develop a recovery plan to get your shoulder back to 100% as soon as possible. Book an appointment now
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