Frozen Shoulder
Frozen Shoulder, often referred to as Adhesive capsulitis (AC), is a condition characterized by stiffness and pain in the shoulder joint. It occurs when the shoulder capsule becomes thickened and tight, restricting movement. It is characterized by initially painful over the shoulder joint and later progressively restricted shoulder movements with spontaneous complete or nearly-complete recovery over a varied period of time. Frozen Shoulder is more prevalent in women.
Signs and Symptoms:
- Frozen shoulder progresses through three stages :
- Freezing stage : Gradual onset of shoulder pain at rest with sharp pain at extremes of motion, and pain at night with sleep interruption which may last anywhere from 2-9 months.
- Frozen stage : Pain starts to subside, stiffness and limitation of movements become more significant. This phase may occur at around 4 months and last till about 12 months.
- Thawing phase: Spontaneous, progressive improvement in functional range of motion which can last anywhere from 5 to 24 months.
Physiotherapy Managements:
- Freezing stages:
- Pain management such as ice therapy, ultrasound therapy or electrotherapy to reduce swelling and manage pain and inflammation.
- Gentle active range of motion exercises to maintain some mobility without exacerbating pain.
- Manual therapy such as gentle shoulder joint mobilization and muscle release to reduce muscles tension and pain.
- Activity modification to avoid activities that cause significant pain but encourage light, daily movements to prevent stiffness.
- Frozen stages:
- Continued Pain Management such as ice therapy, heat therapy, ultrasound or electrotherapy to reduce the pain.
- Manual therapy such as joint mobilization to help improve the shoulder flexibility and reduce the stiffness.
- Stretching exercises to reduce the muscle tightness
- Begin strengthening exercises as pain allows, focusing on the rotator cuff and shoulder stabilizers.
- Thawing stages:
- Continue stretching and strengthening exercises by increasing intensity and duration as range of motion improves.
- Return to normal activity of daily living by progressing to functional exercises that mimic daily activities
- Regular Exercise is encouraged to prevent re-adhesion.
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