Pain Management

Frozen Shoulder: Symptoms and Physiotherapy Treatment

Frozen shoulder, or its medical name adhesive capsulitis, is a common condition that occurs in the general population. It happens when the connective tissue (ligaments, tendons, and muscles) in the shoulder joint gradually become stiffer over time. It is more common in women than men, and in the age group 40-70 years. Frozen shoulder can be debilitating, and can significantly reduce the movement of the shoulder. Most frozen shoulders resolve over time with physiotherapy. It can take approximately 2-3 years without the need for surgery. Physiotherapy can significantly reduce the pain, increase movement, and speed up the recovery process.  Today we go into more detail on physiotherapy for frozen shoulder in this blog post. For further information or to make an appointment book online or fill out our contact form.

What causes frozen shoulder?

There are two types of frozen shoulder primary and secondary. Primary frozen shoulder is where the pain develops gradually without any injury or cause. Secondary frozen shoulder also gradually develops over time. It can be more prone to happening if the person has diabetes, thyroid issues or after a humerus (shoulder) fracture.

What are the symptoms?

  1. Reduced movement of the shoulder in certain directions that gradually worsened over the past 6-12 months. For example, when putting a hand behind the back, putting a hand behind the head, or lifting an arm out sideways. If all three of these movements are restricted by pain and stiffness in the shoulder joint, then this is most likely a frozen shoulder
  2. Pain whilst lying on the affected shoulder or reaching upwards with the arm
  3. Struggling to undo a bra strap, putting the arm into a sleeve of a coat, or washing hair.

Best Physiotherapy exercises for frozen shoulder

  1. Lying on the back lock hands together, keep the elbows straight and move them back over the head aiming to touch the floor. Work into the stiffness but don’t force it. Do this for 30 seconds, 3 sets, twice daily.
Shoulder flexion stretch

2. Lying on your back aim to lock the hands behind the head. Move the elbow down to towards the floor. Repeat this 20 times, 3 times a day. Move in and out of the stiffness.

Shoulder external rotation stretch

3. Assist moving the affected arm up the back with the good arm. Move in and out of the stiffness 20 times, 3 daily.

Shoulder internal rotation stretch

4. With a walking stick, broom handle or golf club move the arm out to the side. Place the affected arm on top of the stick, with the good arm doing the work. Repeat this continuously up and down for 30 seconds, 3 sets, twice daily. Move in and out of the stiffness.

Active Assisted Shoulder Movements

 Top three treatments for frozen shoulder

  1. Chartered Physiotherapy, which could include: advice, education, manual therapy, mobility exercises, and shockwave therapy. These are all proven through evidence-based research to reduce pain and increase movement
  2. Steroid injection into the shoulder joint, combined with Physiotherapy
  3. As a last resort, and if all else fails and you are unwilling to wait, there are different surgical interventions that can be offered by an orthopaedic consultant.

What are the stages of frozen shoulder?

There are four main stages for frozen shoulder. These can last anywhere between 18-36 months approximately.

  1. Stage one – this can last anywhere from 3-9 months approximately. The pain is sharp and intense when the shoulder is moved in certain directions. For example, behind the back
  2. Freezing stage – this can last anywhere from 6-12 months. This is where the shoulder joint starts to become gradually stiffer and the amount the arm can move reduces. At this stage the pain will gradually reduce, and stiffness takes over
  3. Frozen stage – this can last anywhere from 9-15 months. This where the pain subsides, and the shoulder movement is stiff and considerably reduced. With little or no pain at the end of the shoulder movements
  4. Thawing stage – this can last anywhere from 15-36 months. The shoulder will gradually increase in movement reverting to its normal level of mobility.

Conclusion

Frozen shoulder is a complex, frustrating, and restrictive condition. It can be difficult to diagnose in the early stages and is often mis-diagnosed. The duration of symptoms can vary considerably, depending on whether physiotherapy is used. With physiotherapy interventions and exercises, the duration, level of pain and impact, can be significantly reduced. You can find out more information on frozen shoulder through Physiopedia or watch this YouTube video.

If you would like more information or want to book an appointment, get in touch with us by email, book online or feel free to give us a call on 0871849464. We are open six days a week, including evenings and Saturdays for your convenience.

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