Adhesive Capsulitis, aka Frozen Shoulder

If you suffer from frozen shoulder, physiotherapy might be your answer. Frozen shoulder, also known as adhesive cap­sulitis, affects the shoulder joint and can
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Adhesive Capsulitis, aka Frozen Shoulder

If you suffer from frozen shoulder, physiotherapy might be your answer. Frozen shoulder, also known as adhesive cap­sulitis, affects the shoulder joint and can result in excruciating pain and extreme difficulty when moving the affected limb.

Physiotherapy is an effective way to treat frozen shoulder and can help to alleviate pain and restore movement to the joint over time.

Physiotherapists specialise in helping people move better. When someone is injured, ill, or disabled, physiotherapy can help restore movement and function.

Physiotherapy treatment for frozen shoulder may include massage techniques, prescriptive exercises and heat therapy.

 

What is frozen shoulder?

The shoulder capsular ligaments thicken and become stiff and tight in frozen shoulder. Adhesions or thickened bandages form, and less synovial fluid may be present.

This condition causes severe pain and makes it difficult for you to use your arm, even with assistance.

It is common to mistake frozen shoulder for a rotator cuff injury. Shoulder aches, arm weakness, and limited range of motion characterise rotator cuff injuries. Frozen shoulder is characterised by severe shoulder pains, lost shoulder function and stiffness.

It usually happens insidiously but can occur after a shoulder injury. 

 

There is a higher incidence in:

  • People older than 40 years old
  • Women
  • People with diabetes or thyroid issues

There are three stages of frozen shoulder

There are three different stages of frozen shoulder: freezing, frozen and thawing.

Stage 1: Freezing phase

Your shoulder will start to feel stiff and painful in this early stage of a frozen shoulder. It’s similar to when an icy cold water bottle freezes up and becomes rigid.

If you’re experiencing the first stage of frozen shoulder, be aware that it may take up to nine months for the condition to improve. You might experience severe discomfort during this time, but there are ways to relieve the pain. Anti-inflammatory medications are one option.

 

Stage 2: Frozen phase

During the frozen stage, your shoulders will feel stiffer than normal. However, the most noticeable symptom of stage two is the lack of shoulder movement until the pain subsides much later, nearing the end of stage two.

After the first nine to fifteen months, you may need some physiotherapy assistance to regain full movement. Pain relief treatments for frozen shoulder can usually be discontinued after this time.

 

Stage 3: Thawing phase

Stage three is when your frozen arm starts to feel better. Your range of motion returns, and your frozen shoulder begins to “thaw”.

In treating frozen shoulder, physiotherapy is most effective during the thawing period, lasting anywhere from 15 to 24 months.

Physiotherapy treatment can help speed up the recovery process for frozen shoulder, which can take about 30 months on average to recover.

Adhesive Capsulitis, aka Frozen Shoulder

Common symptoms of frozen shoulder

  • Pain and stiffness are the two most common symptoms of frozen shoulder. Night pain makes sleeping difficult for people who suffer from it.
  • There is also a decrease in both the passive (resting) and active ranges of movement, particularly in external rotation, which causes limitations in activities and performance.
  • As time passes, reaching out and placing your hands behind your neck or back becomes increasingly difficult.
  • Stiffness/loss of shoulder movement may result in difficulties combing hair, putting things in the back pocket, reaching overhead etc.
  • X-ray images look normal but are often taken to rule out more severe injuries like fractures, avascular necro­sis, locked dislocations, arthritic conditions, or bone tumours.

 

Physiotherapy treatment for frozen shoulder

Frozen shoulder treatment varies depending on the stage.

At this point, your main concern will be dealing with pain. If necessary, you should also take steps to prevent further injury.

During the frozen phase, gentle and specific periarticular shoulder exercises are the best way to treat your frozen shoulder. Overdoing them can cause further injury, so it’s vital that you work closely with a physiotherapist during this time.

Some types of massages performed by your physiotherapist might help relieve pain associated with frozen shoulder.

During the thawing phase, your best treatment option is to perform shoulder mobilisation and strengthen­ing exercises. Working closely with a physiotherapist is essential to ensure that you’re progressi­ng safely towards recovery.

Physiotherapy treatments for frozen shoulder have been proven effective and increase recovery rates.

Shoulder surgeries are another treatment option for frozen shoulder that cannot be dealt with by physiotherapy alone. Physiotherapy is often needed during the recovery period after shoulder capsule surgeries.

Adhesive Capsulitis, aka Frozen Shoulder

Final thoughts on Adhesive Capsulitis aka Frozen Shoulder

If you cannot move your shoulders normally after an accident, broken arm, or stroke, you increase your chances of developing frozen shoulder.

If you’ve had any injury that has made it hard for you to use your shoulder correctly, feel free to ask one of our physiotherapists for exercises to help keep your shoulder joint healthy.

 

Book an appointment with us today! Our team of experts will lead you down the best treatment path for your frozen shoulder.

 

Author

  • David Kho

    David completed his Bachelor of Physiotherapy at The University of Queensland. He started his career overseas working in major public hospitals in both the inpatient and outpatient setting assisting clients of all ages with musculoskeletal injuries, elective or traumatic post-operative rehabilitation and neurological complications. Apart from work, David enjoys spending time with his family at the beach or the mountains.

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