Frozen Shoulder

Not Just a cold shoulder… A frozen shoulder:

If you look at these pictures and are wishing that  you could raise you arm above your head, you may very well have a frozen shoulder.

What is frozen Shoulder?

Frozen shoulder, or adhesive capsulitis, as the medical profession know it, is a condition that causes pain and restriction of motion in the shoulder joint. The cause of a frozen shoulder is not well understood, but it often occurs for no known reason.  Frozen shoulder causes the capsule surrounding the shoulder joint to contract and form scar tissue.  The joint capsule is vital to the function of  joints like the shoulder. It seals the joint space, provides passive stability by limiting movements, and provides active stability via its special nerve endings.  It is a dense fibrous connective tissue that is attached to the bones via attachment zones and forms a sleeve around the joint.

When the capsule becomes restricted, as in frozen shoulder, it typically follows three phases.  In the freezing stage, pain occurs with any movement of your shoulder and your shoulder’s range of motion starts to become limited. In the frozen stage pain may begin to diminish but your shoulder becomes stiffer and your range of motion decreases significantly.  During the thawing stage, the range of motion in your shoulder begins to improve.  Without treatment each stage can last up to 6 months.   We advocate for early diagnosis and aggressive physiotherapy treatment to reduce the total time of disability to less than 6 months…

How Do I know If I have Frozen Shoulder?

• It is essential to have a qualified physician or physical therapist assess your shoulder problem in order to determine if you have a frozen shoulder.  There are many conditions that can cause pain and limitation in the shoulder and the treatment and recommendations are different depending on the diagnosis. 
• You may have a frozen shoulder if:  you have pain and limitation in your shoulder movement – especially when trying to lift your arm to your side or put your hand behind your back and this motion is still limited even when you use your other arm to help achieve the motion.
• It may or may not wake you at night depending on the stage that it is in  

What should I do?

Call us today!  The natural history of frozen shoulder is 18 months; that is, if you just wait, it may go away in a year and a half.  Frozen shoulder is a problem that is best dealt with immediately.  Aggressive mobilization in the form of myofascial release and other physiotherapy techniques help to get the joint capsule more mobile and alleviate pain arising from the reduced movement within the joint capsule and rotator cuff muscles.  Modalities such as heat and ultrasound can assist with increasing tissue elasticity, circulation and reducing pain arising from inflammation.  Electrical modalities can further assist to reduce the inflammation and pain.  Ultimately, a comprehensive home stretching and mobilization routine is essential to get the shoulder moving.  It needs to emphasize gross movement initially and strengthening and stability in the final stages.  Additionally, some simple exercises can be provided buy a physician or physiotherapist should help to guide you through a safe and specific exercise regime based on your individual limitations and tolerances.