What is Frozen Shoulder?

Frozen shoulder, medically known as adhesive capsulitis, is a condition characterized by stiffness and pain in the shoulder joint. It typically develops gradually, worsening over time, and can severely limit the range of motion. The exact cause of frozen shoulder is often unknown, but it can occur after an injury or surgery or as a result of conditions like diabetes or a stroke.

Symptoms of Frozen Shoulder

Frozen shoulder progresses through three stages, each with distinct symptoms:

1. Freezing Stage (Early Stage):

• Pain: Gradual onset of pain, often worse at night.
• Stiffness: Increasing stiffness in the shoulder, making movements difficult
• Limited Range of Motion: Decrease in the ability to move the shoulder, especially with activities like reaching overhead or behind the back.

2. Frozen Stage (Mid Stage):

• Persistent Pain: Pain may start to diminish, but stiffness remains.

• Severe Stiffness: Significant reduction in shoulder movement.
• Difficulty with Daily Activities: Basic activities, such as dressing or lifting objects, become challenging.

3. Thawing Stage (Late Stage):

• Improvement in Range of Motion: Gradual return of shoulder movement

• Decreased Pain: Pain continues to subside.

• Slow Recovery: Recovery of motion can take months to years.

 

Causes of Frozen Shoulder

The exact cause of frozen shoulder is often unknown, but several factors may contribute:

• • Injury or Surgery: Shoulder injuries or surgeries can lead to immobility, triggering the condition.

• • Medical Conditions: Conditions like diabetes, thyroid disorders, cardiovascular disease, and Parkinson’s disease increase the risk.

• • Age and Gender: More common in people between 40-60 years old, particularly in women.

• • Immobility: Prolonged immobilization due to fractures or other arm injuries.

Physiotherapy Management of Frozen Shoulder

Physiotherapy is a cornerstone in managing frozen shoulder, focusing on pain relief, restoring movement, and strengthening the shoulder. The approach varies depending on the stage of the condition and the patient’s age and overall health.

Physiotherapy Techniques

Pain Relief:

• • Electrotherapy: It uses electrical currents to treat chronic pain, muscle spasms, muscle atrophy, reduce swelling, improving blood circulation and to repair damaged tissues and enabling wound healing.

• • Heat Therapy: Applying heat to the shoulder helps relax muscles and reduce pain, making exercises more effective.

• • Ice Therapy: Used to reduce inflammation and pain after exercises.

Stretching Exercises:

• • Pendulum Exercises: Gentle swinging of the arm to help increase range of motion.

• • Cross-Body Stretch: Stretching the affected arm across the body to improve shoulder flexibility.

• • Towel Stretch: Holding a towel behind the back with both hands and gently pulling to stretch the shoulder.

Strengthening Exercises:

• • Isometric Exercises: Strengthening shoulder muscles without joint movement, such as pressing the hand against a wall.

• • Resistance Band Exercises: Using resistance bands to perform shoulder rotations and abductions.

Manual Therapy:

• • Joint Mobilizations: Techniques performed by a physiotherapist to improve shoulder joint movement.

• • Soft Tissue Mobilization: Massage and myofascial release to reduce muscle tightness and pain.

Range of Motion Exercises:

• • Wall Climbing: Walking fingers up a wall to gradually increase shoulder elevation.

• • Table Slides: Sliding the arm forward on a table while sitting to improve forward flexion.

Postural Training:

• • Posture Correction: Exercises and techniques to improve posture, reducing strain on the shoulder.

Hydrotherapy:

• • Water Exercises: Performing exercises in a pool where buoyancy reduces stress on the shoulder.

General Management Tips:

• • Consistency: Regular physiotherapy sessions and adherence to home exercise programs are crucial for recovery.

• • Patience and Persistence: Recovery can be slow, requiring consistent effort in exercises and therapies.

• • Regular Monitoring: Regular check-ups with a health care provider to monitor progress and adjust treatment plans.

• • Education: Understanding the condition and the importance of exercises helps patients stay motivated.

Physiotherapy plays a vital role in managing frozen shoulder, offering a tailored approach that addresses pain, improves mobility, and enhances shoulder strength. With dedication and proper guidance, patients can achieve significant improvements and regain their quality of life.