Frozen shoulder or adhesive capsulitis is a condition characterised by both pain and decreased range of motion or stiffness. It is common in women between the ages of 40-60 but can also occur in men. The cause is still unknown despite much research but is often related to auto-immune or thyroid disease, cardiac disease and diabetes but researchers are unsure why there is an increased incidence of it in these patient groups. Frozen shoulder can also occur post-surgically and may be as a result of being protective of the arm and avoiding movement, which is why post-surgically it is so important to be guided by your physio regarding the safe time frames for doing exercise and which exercises to perform.
Frozen shoulder has a distinct symptom pattern of pain, loss of function and eventually stiffness. The pain can affect sleep at night and cause difficulty with activities of daily living like dressing, doing up your bra, washing hair, hanging washing or reaching into cupboards. Diagnosis is usually made after a thorough clinical assessment but imaging can be performed to confirm it. There is often a lot that physiotherapy can do to help a frozen shoulder but each case is treated individually.
There are three stages of frozen shoulder although they are not always as distinct as it sounds.
Stage one is the freezing stage which is characterised by pain and increasing loss of function. During this phase treatment should not be aggressive and generally includes pharmacological medications and possibly corticosteroid injections, if advised by a specialist. Very gentle shoulder mobilisations, muscle releases, dry needling and taping techniques to unload the shoulder may prove helpful.
During stage two- the frozen stage – the stiffness is the dominant feature. During the early part of this stage, aggressive mobilisation and exercise is avoided but at the appropriate time gentle mobilisation techniques, stretching, muscle releases and exercises to increase strength and range of motion are helpful.
In the final stage, stage three of thawing, you will notice improvement in range of motion and you can definitely benefit from physiotherapy.
At Janet Brandt-Sarif Physiotherapy, we will help you with specific mobilisation techniques, exercises for strength and range of motion and we will help you return to function as soon as possible. Once the shoulder starts to “thaw” it is important to perform a specific exercise program to help increase range and improve any muscle strength that has been lost.