Frozen Shoulder (adhesive capsulitis) is a condition in which moving the Shoulder becomes painful, and the range of motion becomes limited. Some functional activities that can be affected by a frozen shoulder are brushing your hair or teeth, reaching behind your back, lifting something off a high shelf, or raising your arm into the shirt sleeve to get dressed.
3 Stages of Frozen Shoulder:
A frozen shoulder typically occurs when the patient limits movement or is required to limit shoulder movement following an injury or surgery, such as breaking the arm or Rotator Cuff Repair.
Stage 1: The first stage of a frozen shoulder is the freezing stage, which can last 2-9 months. Pain is felt with any shoulder movement, so the patient limits movement, encouraging stage 2, the frozen stage. Pain can often be felt at night, especially if you sleep on the frozen shoulder side, which restricts sleep.
Stage 2: Pain resolves or lessens in the frozen stage, but the shoulder joint and arm movement dramatically decreases. Some symptoms of the frozen stage may also include weakness in the Shoulder, elbow, or hand and sometimes numbness or tingling down the arm. This stage can last 4 to 12 months.
Stage 3: Thawing Stage occurs when mobility returns to the Shoulder and lasts five to 24 months.
Causes of Frozen Shoulder:
As discussed earlier in this article. Frozen Shoulder typically occurs over a more extended period and can result from not moving the shoulder joint after trauma, injury, or surgery. People over 40, particularly women over 40, are at higher risk of developing a frozen shoulder. Some other risk factors include:
- Family history
- Recovering from a stroke
- Recovery from mastectomy
- Obesity
- Smoking
- Chronic Illnesses such as autoimmune diseases and diabetes
- Parkinson’s Disease
- Cardiovascular Disease
- Overactive or Hyperthyroidism
Diagnosis of Frozen Shoulder:
Patient history, symptoms, and a simple physical exam are used to diagnose Frozen Shoulder. The MD will press on your arm and Shoulder in different locations to assess the location of the pain, the mechanism of symptoms, and how strength is affected. To rule out other conditions, the MD might request imaging such as X-ray, ultrasound, or Magnetic Resonance Imaging (MRI).
Treatment for Frozen Shoulder:
The goal for treating a Frozen Shoulder is to return to a full and pain-free range of motion and mobility to be restored. Your physical therapist will instruct you on improving your range of motion through a combination of anti-gravity and gravity exercises, progressing as you can tolerate. Some other options available to physical therapists include modalities such as iontophoresis, dry needling, ultrasound, and electrical stimulation.
Some cases may require over-the-counter medication such as Ibuprofen or Tylenol to relieve pain and reduce inflammation. In some cases, the physician may recommend corticosteroid shots and hydrodilation by injecting saline into the joint, manipulation under anesthesia, or surgery may be needed to return to full function.
Examples of Exercises to Improve Frozen Shoulder:
Pendulum Arm Swings
- Lean your unaffected side against a counter or chair for stability as you bend at the waist and allow your affected side to hand toward the ground.
- As if your arm were a wet spaghetti noodle, rock it in circles to the front, back, side, and side by moving your trunk in those directions without using your shoulder or arm muscles.
Stick or Cane Stretch
- When lying on your back, use a cane or a broom or stick and lift the stick above your head with both hands as far as possible.
- Try to get your arms to reach your ears.
- Do not go into painful movement.
- Repeat this five times, trying to get deeper with each stretch.
Wall Crawls
- Place your hands on an open-surfaced wall
- Use your fingers to crawl up as high as you can
- Slowly crawl back down the wall
Towel Table Range
- Use a clean, dry hand towel on a clean, open table.
- Lean your body towards the table with your affected arm resting on the towel.
- Relax your affected arm, and with your non-affected hand, assist the movement of your arm on the towel in all directions.
How Do I Prevent a Frozen Shoulder From Occurring?
- Discuss with your medical provider how to maintain shoulder joint mobility following an injury or stroke.
- Keep the joint moving.
- Monitor and adjust your posture to be ergonomic.
Conclusion
In conclusion, Frozen Shoulder, or adhesive capsulitis, poses significant challenges by dramatically limiting shoulder movement and causing pain. It progresses through three stages: freezing, frozen, and thawing, each with distinct timelines and symptoms. Diagnosis involves patient history and physical examination, often supplemented by imaging to rule out other conditions. Treatment aims to restore a full, pain-free range of motion through physical therapy, medication, or, in severe cases, surgical intervention. Preventive measures include maintaining shoulder mobility and ergonomic posture. Understanding the condition’s risk factors, symptoms, and treatment options is crucial for effective management and recovery.
Frozen Shoulder References:
- 1. Frozen Shoulder: Menopause Increases The Risk And Here’s Why (shouldersavvy.com)
- 2. Frozen Shoulder: Causes, symptoms, and treatments (medicalnewstoday.com)
- 3. Frozen Shoulder: Causes, Symptoms, and Treatment (patient.info)
- 4. Frozen Shoulder: Causes | Stanford Health Care
