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Frozen Shoulder

FROZEN SHOULDER

(Adhesive Capsulitis)
 
What is Frozen Shoulder?
 
Frozen shoulder (adhesive capsulitis) is characterized by significant loss of range of motion (stiffness) and pain located at the shoulder joint.  It is the result of scarring, thickening and shrinkage of the shoulder joint capsule.  The capsule is the structure that encapsulates the shoulder joint, provides it with provides it with protection and lubrication.
 
Causes of Frozen Shoulder
 
The exact cause of frozen shoulder is still unknown. It usually occurs after an injury to shoulder or after a period of immobilization of the shoulder.
 
Frozen shoulder may also have an autoimmune component, which means, the body's immune system is attacking it own tissues. In this case, the shoulder joint capsule is attacked, and inflammation occurs. Autoimmunity is often genetically related. 
 
Who is at Greater Risk?
 
-People with arm fracture or surgery
-People who are aged beyond 40 years old
-People who have diabetes or systemic diseases such as hyperthyroidism and cardiovascular diseases.
 
Signs/ Symptoms of Frozen Shoulder
 
-Shoulder pain, especially at night
-Shoulder stiffness, decreased range of motion
-Difficulty using involved shoulder to carry out daily function
 
Signs/ symptoms can occur together or separately through the painful, frozen and thawing stage.  These stages can each last for months.
 
Diagnosis of Frozen Shoulder
 
Diagnosis of frozen shoulder is usually based on the physical signs and symptoms.  X-ray contrast can be used, if necessary, to confirm the shrinking of the shoulder joint capsule.
 
PT Treatment of Frozen Shoulder
 
Physical therapy treatment for frozen shoulder is often aggressive, since it can become a permanent condition if untreated.  It usually takes weeks to months for recovery.
 
Treatment aims to relieve pain, regain of motion and function.  It often includes electrical stimulation, ultrasound, ice, range of motion maneuvers/ exercises and later on strengthening exercises.
 
Home Care Suggestions
 
Heat -Apply heat pack to affected shoulder for 15 minutes helps to relieve pain.
 
Stretching Exercises
 
Goal: Regain range of motion
 
1. Pendulum stretching (can add weight)  
 
Description: Have the shoulder relaxed pointing vertically down to the ground. Swing the arm in small circle.  (You can hold a five pound weight in your hand.)
 
2. Wall climbing
 
Description: With yourself facing a wall, Slowly climb up the wall with fingers.  Shoulder shrugging should be avoided.
 
3. Hand behind back (town stretch)
Description: Grasp towel with both hands, use the upper (good) arm to pull the lower arm towards the back.
 
Stretches should be held for 30-40 seconds and seconds and repeated 5-10 times, avoid severe pain (overstretching)
 
Active Mobilization Exercises
 
Goal: maintain range of motion
 
1. Shoulder forward/ sideways raise (30 reps)
 
Strengthening Exercise (later stage) 
Goal: regain muscle strength
 
1. Inward/ outward rotation exercises
 
Description: Hold elbow at 90 degrees while lying on bed, upper arm supported.  Rotate forearms outward or inward.
 
For strengthening exercises, do 10 reps, 3-5 times per day, increase repetition to 20 when it feels easy.
 
Activity Limitation
 
Avoid overhead positioning, overhead reaching and lifting until stiffness is reduced.
 
If there are any questions, please contact our physical therapist.
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