FROZEN SHOULDER
Frozen shoulder, also known as adhesive capsulitis, is a condition characterised by pain and stiffness in the shoulder joint. It typically develops gradually over time and progresses through three stages: freezing, frozen and thawing. The exact cause of frozen shoulder is not fully understood, but it is believed to involve inflammation, thickening and tightening of the capsule surrounding the shoulder joint, leading to restricted movement and pain.
Understanding Frozen Shoulder:
Stages of Frozen Shoulder:
Freezing Stage: Gradual onset of shoulder pain and progressive stiffness, typically lasting 2-9 months. Pain worsens with movement.
Frozen Stage: Pain may decrease but stiffness persists, limiting shoulder movement. This stage can last 4-12 months.
Thawing Stage: Gradual improvement in shoulder mobility and reduction in stiffness, often taking 6 months to 2 years to resolve completely.
Symptoms:
Dull, aching pain in the shoulder joint.
Difficulty or inability to move the shoulder, especially when reaching overhead or behind the back.
Stiffness that worsens over time and limits daily activities and sleep.
Risk Factors:
Age (40-60 years old).
Gender (more common in women).
Diabetes, thyroid disorders or other medical conditions.
Previous shoulder injury or surgery.
Prolonged immobilisation of the shoulder (e.g., after surgery or injury).
How Physiotherapy Can Help with Frozen Shoulder:
Physiotherapy plays a crucial role in the management of frozen shoulder by focusing on reducing pain, improving shoulder mobility and restoring function. Here's how physiotherapy can help:
Pain Management: Physiotherapists use various techniques such as gentle mobilisations, manual therapy and modalities like heat or cold therapy to alleviate pain and reduce inflammation in the shoulder joint.
Range of Motion Exercises: Specific stretching and range of motion exercises are prescribed to gradually increase shoulder flexibility and mobility. These exercises are tailored to the stage of frozen shoulder and the individual's tolerance.
Joint Mobilisations: Manual therapy techniques, including joint mobilisations and soft tissue massage, help restore normal joint mechanics and reduce stiffness in the shoulder capsule.
Progressive Strengthening: Once pain and stiffness begin to improve, physiotherapists prescribe strengthening exercises to regain muscle strength and endurance in the shoulder and surrounding muscles.
Patient Education: Physiotherapists educate patients about the stages of frozen shoulder, self-management techniques and ergonomic principles to prevent exacerbation of symptoms. This includes guidance on posture, daily activities modification and home exercise programs.
Modalities: Therapeutic modalities such as ultrasound, electrical stimulation or laser therapy may be used to complement exercises and manual therapy, providing additional pain relief and promoting tissue healing.
Functional Rehabilitation: Emphasis is placed on restoring functional activities such as reaching, lifting and daily tasks to improve quality of life and independence.
Benefits of Physiotherapy for Frozen Shoulder:
Non-Invasive Approach: Physiotherapy offers conservative management without the need for surgery in most cases.
Improved Shoulder Function: Restores range of motion and strength, allowing patients to perform daily activities and tasks with less pain and stiffness.
Prevents Recurrence: Physiotherapy helps prevent recurrence by addressing underlying joint stiffness and muscle imbalances through targeted exercises and education.
In summary, physiotherapy is essential for the management of frozen shoulder, providing personalised treatments to reduce pain, improve shoulder mobility and restore function. Early intervention with a comprehensive physiotherapy plan can significantly shorten the duration of symptoms and optimise long-term outcomes for individuals affected by this challenging condition.Â