The shoulder is a complex joint with a great amount of mobility. The shoulder joint can move through 180 degrees of motion as we raise our hands overhead. However, a variety of conditions may limit our ability to move our shoulder through this great deal of mobility.
One medical diagnosis may be Adhesive Capsulitis, or Frozen Shoulder. Adhesive capsulitis is the thickening of the capsule around a joint, most commonly seen in the shoulder. The surrounding capsule of the joint becomes scarred and forms adhesive fibrotic tissue, which restricts movement at the joint, hence the name frozen shoulder.
Subsequently, other soft tissues, including bursa and muscles of the shoulder girdle, such as rotator cuff, become restricted as well. Often times these muscles tend to atrophy, or weaken, because the pain becomes intense and we tend to use the opposite arm more as compensation. The shoulder may appear weak, painful, and “stuck” within a limited range of motion as a person attempts to lift his/her arm against the restriction of multiple soft tissue.
The condition typically occurs in individuals between ages 40-60 years of age and more commonly in females. Frozen shoulder generally has a gradual, insidious onset worsening over time (although sometimes surgery, trauma or other injury to the shoulder, such as rotator cuff tear, may spark an inflammatory process leading to more scarring in joint).
In addition, people with diabetes have a higher incidence of frozen shoulder.
There are three phases of frozen shoulder, often referred to as “freezing,” “frozen” and “thawing.” The phases vary in intensity of pain and restricted range of motion. The symptoms may vary from six months up to two years.
Physical therapy can help! Physical therapy is one of the conservative ways to treat frozen shoulder.
First, a physical therapist will perform an examination. During the examination, they will perform special tests for the shoulder to confirm the diagnosis of possible frozen shoulder and use differential diagnosis skills to rule out other shoulder injuries that may appear very similar to frozen shoulder.
A physical therapist will help guide you through a program to help safely increase your range of motion in the shoulder and strengthen the shoulder when appropriate. During your physical therapy sessions, you will learn to avoid compensations and reduce your pain.
A physical therapist understands how to stretch a frozen shoulder and how to avoid overstretching the shoulder in order to minimize any inflammation in the joint.
The physical therapist will incorporate patient education about the diagnosis and pain management techniques and provide the patient with a home exercise program to perform daily.
Call us at the Center for Physical Therapy to schedule an appointment to further discuss your shoulder injury.
Article by Victoria Luddy
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