Frozen Shoulder (Adhesive Capsulitis)
Editor: Dr. Amy Spencer, PT, DPT, OCS, MTC, CSCS, CKTP - A Board Certified Clinical Specialist in Orthopedic Physical Therapy and Certified Manual Therapist. Owner and Physical Therapist, Specialized Physical Therapy in North Reading, MA.
Frozen shoulder is an inflammatory thickening of the joint capsule. Certain shoulder movements will be difficult and painful if the tissue around the joint stiffens or if scar tissue forms around the joint. The severe pain will prevent you from moving your arm, which will lead to increased stiffness and immobility. This condition usually comes on slowly and gradually slows back down over the course of several months or years.
There are three distinct stages of frozen shoulder:
- Freezing: In the “freezing” stage, the pain will start to gradually appear and increase. The increased pain is accompanied by a reduced range of motion. Freezing typically lasts from 6 weeks to 9 months.
- Frozen: Painful symptoms may actually improve during this stage, but the stiffness remains. Daily activities can be very challenging during the frozen stage, which lasts anywhere from 4 to 6 months.
- Thawing: Shoulder mobility will slowly improve during the “thawing” stage. A complete return to normal condition will typically take anywhere from 6 months to 2 years. Physical therapy involving stretching, strengthening exercises, range of motion therapy, and targeted soft-tissue work will usually speed up the thawing process.
Symptoms of Frozen Shoulder:
Frozen shoulder is a gradual onset of stiffness and pain. As it progresses, it will become increasingly difficult to move your shoulder through normal ranges of movement, even with the help of a physical therapist or physician. Frozen shoulder will make it impossible to reach over your head or behind your back without experiencing immense pain.
Treatment of Frozen Shoulder:
Physical therapy is the most recommended treatment for frozen shoulder. A trained physical therapist will help stretch the joint using safe and controlled movements. Moving the joint is essential to your recovery. Manual therapies like joint and soft tissue mobilization will break up any scar tissue that is contributing to the stiffness and immobility. You can also use heat, ice or ultrasound to reduce the pain and swelling. Manual physical therapy is usually combines with a personalized exercise program. It is crucial that you gradually increase your stretching and exercising. Progressing too quickly can cause irritation or soreness. Make sure to only perform stretches and exercises that have been prescribed by your physician or physical therapist.
Causes of Frozen Shoulder:
In most case, the onset of frozen shoulder is unknown. It occurs in approximately 2% of the population and it most often affects individuals between the ages of 40 and 60. Women are also more susceptible to frozen shoulder than men.
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