The Stages of Frozen Shoulder
Frozen shoulder, also known as adhesive capsulitis, is an inflammatory condition that causes pain and stiffness in the shoulder joint. Three stages of adhesive capsulitis, have been described:
- Early Warning: Patients experience sharp pain at the end of range of motion, achy pain at rest and sleep disturbance due to pain. Restriction of external rotation is the hallmark sign of adhesive capsulitis. This may happen up to 3 months before the onset of the pathology
- Stage One - Freezing stage: Patients experience gradual loss of motion in all directions due to pain. It is the painful stage of the disease. This stage may last up to 6 months.
- Stage Two - Frozen stage: Patients experience less pain but greater loss of motion. This stage may last up to 6 months.
- Stage Three - Thawing stage: At this stage the pain begins to resolve, and the patients may gain back some of the lost range of motion. It lasts up to 9 months. Although the condition usually lasts up to 24 months in total, several patients experince pain for years to come, and disabling motion restriction.
Risk Factors of Frozen Shoulder
While the exact cause of frozen shoulder is unknown, research has shown certain risk factors that can increase likelihood of developing the condition:
- Age between 40 and 65
- Female gender
- Diabetes
- Thyroid disease
- Stroke or other neurological conditions
- Having had a shoulder injury or surgery
- Having a family history of frozen shoulder
How can Physical Therapy Help Frozen Shoulder?
Physical therapy can help alleviate the pain and stiffness associated with frozen shoulder and can improve range of motion. Physical Therapy is needed either as a conservating treatment , or after surgical or minimaly invasive treatment. Treatment may include:
- Stretching exercises to increase shoulder mobility
- Strengthening exercises to improve shoulder strength and stability
- Othropedic Manual Therapy to help reduce pain and improve mobility
- Modalities such as heat, ice, and ultrasound to reduce pain and inflammation
- TECAR Therapy heating deep tissues, alleviating pain and restoring range of motion
Differential Evaluation
The clinician must take into account the posibility of other conditions with same symptoms being present, such as:
- Osteoarthrits
- Shoulder dislocation
- Joint sprain and strain
- Trigger points
- Supraspinatus tendinopathy
- Shoulder impigment
- Bursitis
- Calcific tendonitis
Practical Advice
If you have frozen shoulder, making sure you continue to move your shoulder the proper amount is key to your recovery. There are a number of treatment options —joint mobilization or manipulation, exercise, and heat, among them—to help speed up your healing. Your physical therapist can help you better understand the condition and, after a thorough evaluation, customize a treatment program that will include exercises for you to perform at home to decrease the pain and improve the motion and function of your shoulder.
Did you have a surgery for Frozen Shoulder?
Physical Therapy can help you maximize the benefits of a surgery.Together with Physical Therapist Mr. Danalis you will customise your rehabilitaion, so that post-surgery pain is addressed quickly, and with exercise your hand will once again be strong and with full range of motion.
If you are experiencing a frozen shoulder Contact PhysioDanali today for expert consultation.
References:
- Kelley MJ, Shaffer MA, Kuhn JE, et al. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther. 2013;43(5):A1-A31. doi:10.2519/jospt.2013.0302