One of the most difficult shoulder problems to improve is a frozen shoulder. So what is it?
Also called adhesive capsulitis it is characterised by a stiff shoulder, pain and a loss of range of movement. It involves the capsule of the shoulder thickening and becoming inflammed, often associated with other shoulder injuries like rotator cuff tears and bursitis as well as surgery or when immobilised for long periods.
The true reason for this developing isnt fully known.
Frozen shoulder will proceed in 3 stages
1. Freezing (painful) stage. This is at the beginning and is characterised by the shoulder getting more and more stiffer as well as high levels of pain in the shoulder joint.
2. Frozen stage. Where the shoulder is stiff and limited in movement but usually no longer painful unless stretched.
3. Resolution (or thawing) stage. In this stage the shoulder is able to gradually regain its movement.
The timeframe for frozen shoulder can be difficult to predict. It can often last for 1-2 years and in many cases resolving on it's own.
Treatment for frozen shoulder in each phase is focusing on managing pain and inflammation as well as improving or maintaining range of movement.
Physiotherapy techniques, like capsule releases, dry needling and stretches may improve movement and pain and in some cases a cortisone injection may help.
In the early phase of a shoulder injury if there isn't improvement in movement then it may br progressing to a frozen shoulder in which case progression to movement maintenance is important as a fast recovery may not be realistic.
Below some of our senior physiotherapists show us exercises to improve movement in the early phase of frozen shoulder. The first is from our physio Paul at our Clemton Park clinic demonstrating the pulley range of movement exercise.
Paul's second exercise is the wall crawl. Again a good exercise to use in the early phase when the shoulder is stiff and sore.
The third exercise from Paul is our laying down shoulder flexion exercise.
and our third is from Steve, our head physio at Sans Souci demonstrating the external rotation movement exercise for the shoulder.
These exercises are all useful to do in each phase of frozen shoulder even the early phases. It is likely to be more painful and difficult early on so it is important to check with your therapist how many repetitions is appropriate and how far you should take the movements.
One you reach the resolution or thawing phase of frozen shoulder it is important to include strengthening and stability exercises to rebuild the shoulder strength and function as the movement returns.
In most cases there are minimal lasting effects once the recovery from frozen shoulder is complete but it can be a challenging condition to live and work with while you have it.
To reduce the risk of getting frozen shoulder make sure that you manage any shoulder injury promptly and correctly and ensure that recovery after surgery is done as the specialist recommends (even if it is a relatively mild one),
If you feel like you are getting a sore shoulder and movement is very limited see a physiotherapist or a doctor and get it diagnosed in a lot of cases it may not be frozen shoulder and a quick recovery with treatment is very much possible.
Leave a comment if this has been helpful and thanks for reading!
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