Frozen Shoulder
Frozen Shoulder
Frozen Shoulder
(adhesive capsulitis)
Definition
• Condition characterized by stiffness and pain of the
shoulder
• Signs and symptoms typically begin gradually, worsen
over time and then resolve, usually within one or two
years.
• The risk of developing frozen shoulder increases if
you're recovering from a medical condition or
procedure that affects the mobility of arm — such as a
stroke or a mastectomy.
Symptoms
Frozen shoulder typically develops slowly, and in three stages.
Each of these stages can last a number of months.
1. Painful stage (6-12 weeks). During this stage, pain occurs
with any movement of shoulder, and shoulder's range of
motion starts to become limited.
2. Frozen stage (4-6 months). Pain may begin to diminish during
this stage. However, shoulder becomes stiffer, and your range
of motion decreases notably.
3. Thawing stage (1 year). During the thawing stage, the range
of motion in shoulder begins to improve.
For some people, the pain worsens at night, sometimes
disrupting normal sleep patterns.
Causes
• The bones, ligaments and tendons of the shoulder joint are
encased in a capsule of connective tissue. Frozen shoulder
occurs when this capsule thickens and tightens around the
shoulder joint, restricting its movement.
• Exact cause is unknown
• It's more likely to occur in people who have recently
experienced prolonged immobilization of their shoulder,
such as after surgery or an arm fracture.
Risk factors
• Age : 40 and older
• Sex: women (double/triple risk than men)
• Immobility or reduced mobility: people who have experienced
prolonged immobility or reduced mobility of their shoulder are
at higher risk of developing frozen shoulder. Immobility may be
the result of many factors, including rotator cuff injury, broken
arm, stroke, recovery from surgery, systemic diseases with
altered fat metabolism, cardiovascular, Parkinson's disease,
high cholesterol, arthritis, autoimmune etc.
Treatments
• Treatment for frozen shoulder involves stretching exercises
and, sometimes, the injection of corticosteroids and
numbing medications into the joint capsule. In a small
percentage of cases, surgery may be needed to loosen the
joint capsule so that it can move more freely.
• Outcome: most frozen shoulders get better on their own
within 12 to 18 months
Precautions
• Avoid sudden movements and challenging as the heavy
lifting with the sore arm during the rehabilitation period.
• Avoid repetitive movements ( the washer glasses).
• Usually the “Freeze“ phase is the least sensitive to
treatments, so the persistence of pain and reduced
mobility at this stage should not demoralize the patient,
and is very important to continue physiotherapy for
improving shoulder range of motion.
Warning
• Always remember to perform a general warming before
beginning stretching movements to increase mobility of the
shoulder and improve the elasticity of the muscles and
tendons that make up the rotator cuff.
• Wear comfortable clothing that does not impede the
movements.
• Choose a relaxed and respected the proper breathing
technique.
• Avoid sudden movements and excessive elongation.
• If develop shoulder pain during movement, immediately
stop the exercises and consult a doctor if the pain is
particularly intense or does not go away after a few days of
rest.