Frozen shoulder, or adhesive capsulitis, is a common shoulder issue that involves the first layer around the shoulder joint called the joint capsule. The capsule begins to thicken and tighten around the joint. It’s pretty typical to see a gradual loss of motion in the shoulder accompanied by pain in multiple motions.
Stages of a Frozen Shoulder:
Frozen shoulder involves three different stages. Each stage may take up to a few months:
Freezing: Pain starts to occur and the range of motion of the shoulder begins to decrease.
Frozen: The shoulder is really stiff and difficult to move.
Thawing: Movement of the shoulder begins to improve and pain subsides.
These stages have to occur before the shoulder returns back to a mobile state. An analogy I often use is an ice cube tray.
You take out a tray and fill it with water. You stick the tray of water into the freezer where the water begins to harden into ice. After some time the water becomes an ice cube and is completely frozen. You go into the freezer the next day to grab the tray of ice to use in a drink. As the glass stays out on the table the ice begins to melt.
Risk Factors
There are multiple risk factors that can increase your chance of developing frozen shoulder.
- Diabetes
- Auto-immune disorder
- Recent surgery of the shoulder with prolonged immobilization
- Mastectomy
- Peri or Post-Menopausal
- Parkinson’s Disease
- Over the age of 40, female more so than male
What can you do?
Like mentioned above, there is a time factor involved. This doesn’t mean you need to sit around and wait for time to pass without getting help. Physical therapy is a great conservative treatment for frozen shoulder.
During therapy:
- range of motion exercises will be given within a pain-free range
- A therapist will provide hands on care to decrease tightness of the muscles around the joint while gently stretching the shoulder only
- A physical therapist can spend the time educating you about the condition and give you a better idea which phase you are in which in turn will allow them to give you the appropriate exercises.
It is important to be able to maintain the available range of motion and provide pain management early on. As you progress through the stages and more so into thawing, exercises will be given to restore full range of motion and strength especially involving the muscles around the joint (rotator cuff).
By Devin Wurman, DPT
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