While all joints in the body can become stiff, involving a reduced range of movement, the shoulder has the potential to stiffen more than any other. There’s even a name given to it, frozen shoulder. The medical terminology for this is adhesive capsulitis.
The capsule is a soft tissue which envelopes the shoulder joint. It can become very stiff and tight. When this occurs, normal movements abnormally stretch out the capsule. This is very painful and leads to significant shoulder stiffness. People with frozen shoulder have a drastically reduced arm function, and many daily activities, from dressing to washing, become difficult or sometimes imposible.
After a period of worsening symptoms, frozen shoulders tend to get better, although full recovery may take up to 3 years, left without intervention. Frozen shoulder most commonly affects people between the ages of 40 and 60, and occurs in women more often than men. In addition, people with diabetes are at an increased risk for developing frozen shoulder.
Frozen shoulder can develop after a shoulder, injury, or surgery. However, sometimes frozen shoulder can develop for no apparent reason. A person might wake up in the morning with a frozen shoulder.
The hallmark signs of this condition are severe pain and being unable to move your shoulder, either on your own or with the help of someone else, and the limit of movement is painful. It develops in three stages:
- “Freezing” In the “freezing” stage, you slowly have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.
- “Frozen” Painful symptoms may actually improve during this stage, but the stiffnessremains. During the 4 to 6 months of the “frozen” stage, daily activities may be very difficult.
- “Thawing” Shoulder motion slowly improves during the “thawing” stage. Complete return to normal or close to normal strength, and motion typically takes from 6 months to 2 years.
Physiotherapy, with a focus on shoulder flexibility, is the primary treatment recommendation for frozen shoulder. Because the shoulder is not moving very much with a frozen shoulder, the muscles can also become weak and may need to be strengthened. A physiotherapist can manually mobilise your stiff shoulder, but their more important role is to assemble and supervise a progressive exercise programme, which can result in effective and frequent stretching of the shoulder capsule.
Occasionally, some people might benefit from an injection of saline fluid into the shoulder, joint to stretch out the capsule. this is sometimes effective. In other severe cases there are surgical procedures that can be done to increase the range of movement.
The causes of frozen shoulder are not fully understood. There is no clear connection to arm dominance or occupation. A few factors may put you more at risk for developing frozen shoulder.
Diabetes. Frozen shoulder occurs much more often in people with diabetes. The reason for this is not known. In addition, diabetic patients with frozen shoulder tend to have a greater degree of stiffness that continues for a longer time before “thawing.”
Other diseases. Some additional medical problems associated with frozen shoulder include hypothyroidism, hyperthyroidism, Parkinson’s disease, and cardiac disease.
Immobilization. Frozen shoulder can develop after a shoulder has been immobilized for a period of time due to surgery, a fracture, or other injury. Having patients move their shoulders soon after injury or surgery is one measure prescribed to prevent frozen shoulder.
At Melbourne Shoulder Therapy, you will receive a detailed home program of exercises to mobilise and strengthen your shoulder. You will be educated on this condition and supported until you regain full range and function.
We have had excellent success dealing with this challenging condition and its lengthy journey.