What is frozen shoulder?

Frozen shoulder or adhesive capsulitis causes pain and stiffness in the shoulder and affects between 2-5% of the population. Frozen shoulder commonly presents in 40-to-60-year old’s and is more prevalent in women (70%).

The shoulder is made of three bones that form the ball-and-socket joint. These are the upper arm (humerus), shoulder blade (scapula), and collar bone (clavicle). The shoulder joint is surrounded by a capsule. In frozen shoulder, this capsule becomes inflamed resulting in pain and stiffness and reduced movement of the shoulder joint.

WHAT ARE THE SYMPTOMS OF FROZEN SHOULDER?

Frozen shoulder has three stages, each of which has a different set of symptoms

Phase 1: Freezing

The freezing phase is characterized by increased pain around the shoulder, followed by the onset of some stiffness. Like placing an ice cube tray full of water into the freezer, this is where your shoulder isn’t fully frozen but beginning to solidify, this phase can last anywhere from 6 to 9 months. Although this is a long time, aggressive treatment should be avoided during this phase.

Phase 2: Frozen

During this stage, stiffness will dominate. The transition from phase 1 to 2 can be painful, however, reduced movement of the shoulder and reduced pain occur at the end of stage 2. This stage can last between 9 and 15 months. Frozen shoulder physiotherapy during this phase is helpful in improving movement.

Stage 3: Thawing stage

Phase three is the final stage and involved a gradual return of range of movement. In the ice cube analogy, this stage refers to your stiffness and pain gradually melting away. The Range of motion of the shoulder will begin to increase. This stage can last 15 to 24 months with physiotherapy being the best form of treatment during this stage. On average, all three phases of frozen shoulder can last up to 30 months.

Causes of Frozen Shoulder

The exact cause of frozen shoulder is still unknown. However, some individuals are at more risk of developing frozen shoulder.

Frozen shoulder is more likely to occur in women than men, and you are more likely to get it if you're aged between 40 and 60. Health conditions such as diabetes, heart disease, and thyroid disease can increase the prevalence of frozen shoulder. A frozen shoulder can also occur if the shoulder is immobilized for an extended period, for example after surgery.

Diagnosis Of Frozen Shoulder

Frozen shoulder can be diagnosed by a physiotherapist from your clinical signs and symptoms. Your physiotherapist will ask about what activities you have the most difficulty performing.

Common issues found during a physiotherapy assessment include:

Unable to reach above shoulder height
Unable to throw a ball
Unable to reach for something quickly
Unable to reach out for your side and behind e.g reach for a seatbelt
Unable to reach behind your back e.g. tuck in your shirt
Unable to sleep on your side

Frozen shoulder is often misdiagnosed with rotator cuff injury. It’s important you see a physiotherapist to get an accurate diagnosis and the correct physio treatment for a frozen shoulder.

Treatment of Frozen Shoulder

Treatment for frozen shoulder is specific to what stage you are in and is tailored towards your specific needs.

Phase 1: Freezing

In this phase, physiotherapy treatment for frozen shoulder focuses on pain relief and completing very gentle and specific shoulder exercises. Pain relief may include pharmacological medications prescribed by your GP. It is incredibly important to see a physiotherapist for your frozen shoulder during this phase as overdoing it can make your frozen shoulder worse.

Cortisone injection: During this phase, an intracapsular corticosteroid injection may be considered on a case-by-case basis when the pain is unbearable. The corticosteroid injection is often ineffective after a few weeks in frozen shoulders.

Phase 2: Frozen

During this phase, gentle and specific shoulder joint mobilization and stretches, muscle release, dry needling, and exercise techniques to regain your range and strength are critical for return to function.

Hydrodilatation: This procedure may be considered a treatment option. It involved injecting saline along with cortisone and local anesthetic into the capsule to inflate and stretch the capsule. Research has shown that Hydrodilatation and physiotherapy are just as effective as receiving physiotherapy for frozen shoulder.

Phase 3: Thawing

During this phase, you will notice an improvement in your shoulder. Again, working with a physio during this phase will ensure you are safely progressing towards recovery.

Shoulder surgery

Frozen should usually resolve with non-surgical intervention in 60-80% of patients. Shoulder surgery may be considered during the last phase of the frozen shoulder if there is insufficient recovery after a specific physiotherapy program.

Can you prevent frozen shoulder?

As the frozen shoulder is of an unknown origin, you can’t prevent the spontaneous onset of frozen shoulders. However, you can prevent frozen shoulder caused by disuse e.g. post shoulder surgery.

Should I see a physio for a frozen shoulder?

Yes! Physio treatment for frozen shoulder is essential to return to normal function. Physiotherapy treatment for frozen shoulder can reduce pain, and stiffness and speed up the recovery process immensely.

How can we help you with Frozen Shoulder?

At Melbourne Sports Physiotherapy our goal is to get you moving pain-free as soon as possible.

But, we also want you to actually move better and live a healthier, more active, and fulfilling life!

If your sports, fitness training, or work has been wearing your body down, book in with one of our expert massage therapists so we can help you reduce your pain or stiffness.

If you are showing some signs of a frozen shoulder then book in with one of our highly experienced physiotherapists today!

Get in touch to speak with a physio for your frozen shoulder today. You can make an appointment by calling or booking online.