Frozen shoulder, also known as adhesive capsulitis, is a common condition that causes pain and limited mobility in the shoulder joint. Physiotherapy interventions, including exercises and manual therapy, have been shown to be effective in reducing pain and improving function in individuals with frozen shoulder.
As with all injuries, this information is simply a guide, and it is always best to check in with a Physiotherapist or Athletic Therapist to have a personalized assessment and hear recommendations for what you and your body may specifically need.
Frozen Shoulder or Adhesive Capsulitis is a frustrating condition that takes time to heal, but a committed effort can sometimes make a difference.
In many cases, the specific cause of a frozen shoulder is unknown. The freezing process usually begins following an injury (fracture) or inflammation of the soft tissues, such as bursitis or tendinitis of the rotator cuff. The risk of developing a frozen shoulder increases when there is a lack of exercise therapy following an episode of tendinitis, after an injury or, when the arm/shoulder has been in a sling for several days without periodic stretching. Frozen shoulder can also result from periods of immobilization following surgery, a heart condition, or a stroke. People with diabetes, Parkinson’s disease and thyroid disorders are at a higher risk of developing a frozen shoulder than those without. It is most common from the ages of 40 to 60 and in women more often than men.
When a joint, in this case the shoulder, has been immobilized, the connective tissue surrounding the joint capsule thickens and tightens affecting its usual ability to stretch. When we feel pain in a joint, we instinctively try to protect it by avoiding movement. Over time this causes additional tightening of the joint capsule and the joint loses some of its naturally occurring lubricating synovial fluid. Sometimes scar tissue adhesions will form between the head of the humerus bone and joint capsule. The result is a very stiff capsule of the shoulder that causes a reduction in range of motion and pain with movement.
This disorder causes pain, stiffness, and loss of normal range of motion in the shoulder.
Frozen shoulder is generally diagnosed via subjective history and physical exam. Your doctor or Physiotherapist will assess your range of motion, both actively and passively and note how the joint feels when it reaches the end of the passive range of motion.
Sometimes your doctor will order an x-ray, ultrasound or MRI to rule out other issues, such as tendon injuries or arthritis.
While sometimes Frozen Shoulder just takes time to resolve, there are many things that can be done through Physiotherapy or Athletic Therapy to make you more comfortable and your shoulder more functional. If treatment is increasing your range of motion, it is worth continuing.
Your Physiotherapist or Athletic Therapist will first assess your shoulders to ensure it is a true Frozen Shoulder and not a number of other conditions with similar symptoms in the shoulder.
They will then go about treating your shoulder with manual therapy focused on regaining range of motion through joint mobilization, soft tissue release and passive range of motion work.
They will also prescribe specific and safe exercises to stretch the seized joint capsule and restore range of motion. Once movement is reintroduced, you will start working on exercises to rebuild strength to the shoulder and arm.
Recovery from this disorder is a frustratingly slow process. It could take a few months to a couple of years for a full recovery. Patience is essential.
Use your normal arm to hold the side of a table or bed for balance.
Bend over at the waist and make sure your back is parallel to the floor.
Let the stiff arm dangle like a pendulum and gently swing it in a small circle that is parallel to the floor for 10-15 seconds (or as directed by your therapist).
Then, allow your arm to swing back and forth (as if you were bowling) for 10-15 seconds (or as directed by your therapist).
Start sitting or standing with the arm/hand supported on the counter top or table.
Slowly slide your arm in front until you feel a stretch.
Use a towel or similar to reduce friction.
Stand or sit under a pulley system. Hold each end of the pulley cord with each hand.
Pull the tip of your shoulder backward and pull down on the cord with the good arm moving the affected arm up and forward.
As the affected arm goes higher, slowly straighten the arm until it reaches the maximum height.
Maintain the position, return to the starting position and repeat.
The affected arm should not be doing any of the movement.
Sit next to a table with your forearm on the table, palm up, with your elbow straight.
Bend your trunk from the waist toward the table as you slide the arm to the side across the table.
Keep the back straight during the exercise.
Extend your shoulder behind you, reaching across your back as far as possible and applying extra pressure with your free hand.
Return to a neutral position and repeat the exercise.
Stand with the affected arm behind your back and each hand grabbing either end of the towel.
Pull the tip of your shoulder backwards and pull on the towel with your good hand to lift the affected arm as high as possible behind your back.
Slowly lower the arm and repeat.
The affected arm should not be doing any of the movement.
Lie on your back, tuck your arm in by your side and bend your elbow to 90 degrees.
Bring your wrist and forearm out to the side toward the ground as much as possible while keeping your elbow in contact with your side.
The best way to prevent a Frozen Shoulder is to keep your shoulder in good health and avoid tendon injuries by keeping your shoulders mobile and strong and focusing on posture and alignment in your daily life.
Unfortunately, there is no quick fix for Frozen Shoulder. The verdict is out on whether Physiotherapy or any form of treatment can have any impact on healing a frozen shoulder faster. The general thought is that frozen shoulders have their own time table and will only resolve when they are ready to, no matter what we do with them. If anything can heal them faster, it would be Physiotherapy, so it is definitely worth a try!
Inertia Physio+ offers Kanata and Stittsville exceptional Physiotherapy, Athletic Therapy and Registered Massage Therapy with private treatment rooms, one on one care, a maximum of two patients per hour and treatment focused on the evidence-based practices of manual and exercise therapy. Don’t suffer any longer. If you have pain or injury, our Kanata and Stittsville Physiotherapy, Athletic Therapy, and Registered Massage Therapy team is here to help you get back to living pain-free life and activities. Please reach out to us at (613) 672-2200 or info@inertiaphysio.ca for an appointment today! You are also welcome to book online. We also offer direct billing on Physiotherapy and Massage Therapy services whenever your plan allows.
