Frozen Shoulder: How Physiotherapy Can Help
By Physiotherapy Student Georgia Isaacs
WHAT IS FROZEN SHOULDER?
“Frozen shoulder”, clinically known as adhesive capsulitis is an inflammatory condition that affects the main shoulder joint causing pain, significant stiffness and movement restrictions in all directions.
WHAT CAUSES FROZEN SHOULDER?
There is currently no definitive cause of frozen shoulder, however it is believed to begin as an immune response within the body, that causes inflammation in the shoulder joint. This inflammation leads to stiffening at the shoulder joint, which then creates large restrictions in movement – the shoulder is essentially “frozen”.
AM I AT RISK OF DEVELOPING FROZEN SHOULDER?
Risk factors for developing frozen shoulder include:
Diabetes: occurs in up to 20% of diagnosed population
High blood pressure
Rotator cuff injuries
Shoulder trauma including rotator cuff surgeries
3x more common in females than males
HOW LONG DOES FROZEN SHOULDER TAKE TO RECOVER?
There are 3 stages of progression in a frozen shoulder, however it is important to note these stages can overlap.
1. “Freezing Stage”
In the initial stage of a frozen shoulder, the main symptom experienced is considerable pain with movement. This may include muscle spasm and an achy feeling in the shoulder.
2. “Adhesive/Frozen Stage”
In the second stage of a frozen shoulder, pain is replaced with a large increase in stiffness, causing significant movement restriction at the shoulder joint.
3. “Recovery/Thawing Stage”
In the third and final stage of a frozen shoulder, pain will continue to decrease alongside a gradual increase in movement. The length of time for complete recovery without seeking treatment is variable, on average ranging between 1-3 years.
TREATMENT FOR FROZEN SHOULDER
Physiotherapists can provide a combination of manual therapy and exercise to aid in the management of frozen shoulder. The exercises are aimed at maintaining and preventing further movement restriction, as well as strengthening muscles around the shoulder & upper body.
Depending on the stage of the condition, it is likely the physiotherapist will work closely with other medical practitioners in the management of symptoms. This may include your GP or pharmacist to manage pain with medication as required.
WHAT CAN I DO FOR PAIN RELIEF?
The use of heat (e.g. wheat pack) is also a great option to manage pain experienced in various areas of the body, including the shoulder. Heat packs should never be placed directly on the skin but can be placed over clothing wrapped in a towel for 15 to 20 minutes at a time.
Depending on your preference, ice (e.g. ice-pack) can also help to relieve pain and inflammation. Alike a heat pack, ice should never be placed directly on the skin but can be placed on the skin while wrapped in a cloth/towel for 15 to 20 minutes at a time.
*Never place heat directly over an open wound, never sleep with a heat pack on and continue to monitor the skin while in use.
WILL I REQUIRE SURGERY?
In more severe cases of frozen shoulder where symptoms cannot be managed through conservative measures alone, surgical intervention may be required. Surgical management may include a procedure referred to as ‘Manipulation Under Anaesthesia’. This involves the shoulder joint getting manually forced into different directions of movement to break up stiffness in the joint, done while the patient is under a general anaesthetic.
There are also options for anti-inflammatory injections into the shoulder joint however these options can be discussed further with your GP or surgeon if required, as they are not procedures that can be completed by physiotherapists.
I THINK I HAVE FROZEN SHOULDER
WHAT DO I DO FROM HERE?
The first step would be to make an appointment with one of our physiotherapists for an assessment. The shoulder is a complex joint and there are many different structures that can affect its function.
If you’ve already been diagnosed, the physiotherapist can help to identify the current stage of the condition, and then discuss the best management approach for your specific goals.
Book An Appointment
Come and have a chat with one of our physiotherapists to see if we can help improve your health. Book online or call the clinic on (03) 5232 2400.