What is frozen shoulder?
Frozen shoulder, also called adhesive capsulitis, is the gradual and painful restriction of movement in your shoulder joint. Normally, this occurs in three phases: an initial painful phase, followed by a stiffening phase, and finally, a gradual recovery. This seems to be caused by a reaction in the shoulder capsule, a structure involved in attaching your arm bone to your scapula. The capsule becomes stiffened due to fibrotic changes over the course of this problem. Proper care and management will be key to reducing your pain and help you to return to the things you want to do.
Why does it happen?
The exact cause of many cases of frozen shoulder is unknown, and have no obvious predisposing factors. This is called primary frozen shoulder. Secondary frozen shoulder is when the issue is caused by:
- Diabetes, Stroke, Thyroid disorders, Cancer, Parkinson’s Syndrome
- Previous shoulder injury
Frozen shoulder occurs in up to 5% of the population, with women four times more likely than men to have it, and it also occurs more often in the non-dominant arm.
The role of Physiotherapy
It is important to remember that pain and injuries often have many contributing factors. Your Physiotherapist will perform a thorough assessment and work with you to find the most effective treatment strategy. Some approaches for treating frozen shoulder may include:
- Education for self-management
- Stretching and strengthening exercises
- Manual therapy such as joint mobilization
- Therapeutic device modalities
There is strong evidence that a cortico-steroid injection combined with shoulder exercises is more effective than mobility and stretching exercises. Often a combination of techniques will be performed to improve shoulder function and to reduce your symptoms. As a frozen shoulder can take months or even years to resolve, your physiotherapist can give you advice to help improve and manage your symptoms.
Mezian K, Coffey R, Chang KV. Frozen Shoulder. [Updated 2020 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482162/
Kelley, M. J., Shaffer, M. A., Kuhn, J. E., Michener, L. A., Seitz, A. L., Uhl, T. L., Godges, J. J., & McClure, P. (2013). Shoulder Pain and Mobility Deficits: Adhesive Capsulitis. Journal of Orthopaedic & Sports Physical Therapy, 43(5), A1–A31. https://doi.org/10.2519/jospt.2013.0302