Frozen Shoulder is a condition which is characterized by pain and a pattern of stiffness in the shoulder in specific proportions. Most often it occurs after a period of immobilization. Indeed, people with an injury to the tendon (end of the muscle) or the bursa (a pad-like sac) are susceptible to developing frozen shoulder, particularly if they are 40 years or older. Because of the pain in the shoulder patients don’t move the arm enough and subsequently stiffness ensues.
In the frozen shoulder, the capsule (the tissue that holds joints together) becomes thickened and very tight with adhesions. Clinically patients go through 3 phases. The first phase involves pain: pain at rest, pain disturbing sleep, and pain with movement which is also limited with rotation and elevation. Treatment focuses on trying to maintain active mobility within pain free range and pain relief through medication and modalities. Sometimes a cortisone shot into the joint is given to settle the pain and inflammation. This stage can last 10 to 36 weeks. The second phase involves stiffness and can last up to 1 year. Physiotherapy focuses on trying to improve mobility through gentle mobilization and home exercises. Usually there is less pain at rest during this phase. The final phase is the recovery phase which can last up to 2 years to regain full mobility with no discomfort. In some cases patients are left with slight limited mobility.
With painful shoulder conditions it is important to maintain mobility without aggravating the problem. A physical therapist can provide patients with appropriate exercises to help prevent a frozen shoulder from developing.
By Sue Reive, owner Kilborn Physiotherapy Clinic