Have you noticed difficulty putting a shirt on? Unable to reach behind your back? Maybe you are experiencing frozen shoulder.
Frozen shoulder (adhesive capsulitis) is a condition that can cause pain, stiffness and loss of flexibility at the shoulder. Whilst the reasons are not fully understood, it is caused by excessive inflammation of the shoulder joint and capsule.
It is thought to occur in people between 35 – 50 years of age with females more commonly affected. A number of risk factors can increase the likelihood of frozen shoulder including trauma, surgery, diabetes, inflammatory conditions or autoimmune conditions.
Symptoms of frozen shoulder
There are three stages of frozen shoulder, each with different symptoms. If left untreated, each phase may take six to eight months to resolve.
Stage 1 – Freezing
Freezing is the initial phase. It is commonly characterised by local pain around the shoulder followed by progressive loss of movement. Movements that may cause pain and reduce in mobility include reaching overhead or reaching behind your back to do a bra up or tuck your shirt in.
Stage 2 – Frozen
During the frozen phase, there is minimal pain around the shoulder. It is commonly associated with reduced movement and significant stiffness of the shoulder.
Stage 3 – Thawing
Thawing results in a gradual increase in shoulder flexibility and movement. If strength has deteriorated due to disuse, weakness with movements may become evident.
Physiotherapy for frozen shoulder
Your physiotherapist can diagnose frozen shoulder following a clinical examination. Frozen shoulder can be misdiagnosed as rotator cuff injury but your physiotherapist is able to provide an accurate diagnosis. X-rays are unable to provide a definitive diagnosis but can rule out other causes if necessary.
As treatment is dependent and tailored to the phase of frozen shoulder, it is important to diagnose the stage depending on signs and symptoms.
During the freezing phase, treatment focuses on reducing inflammation and limiting pain. It is important not to aggravate the shoulder during the freezing phase
When the shoulder is frozen your physiotherapist will focus on maintaining strength and gradually improving range of motion. Exercises will be provided to maintain strength and safely improve mobility.
Shoulder mobilisations and stretches are utilised during the thawing phase. Functional exercises will also be provided to mimic daily tasks.
Whilst the spontaneous causes of frozen shoulder are unknown, it is possible to prevent frozen shoulder associated with disuse of the shoulder following trauma or surgery around the region. Timely and accurate diagnosis of your shoulder or arm injury can reduce the likelihood of secondary frozen shoulder developing.