Everyday tasks can become incredibly challenging when a frozen shoulder strikes. But what exactly is a frozen shoulder?
Frozen shoulder, also known as adhesive capsulitis, is a common ailment that brings pain, stiffness, and a restricted range of motion to the shoulder. Left untreated, it can lead to significant disability, and its symptoms tend to worsen over time. Typically, frozen shoulder affects people between the ages of 40 and 60, with women more often affected than men.
Recognizing Frozen Shoulder Symptoms
When afflicted with a frozen shoulder, the shoulder becomes stiff, painful, and loses mobility in all directions. Symptoms of a frozen shoulder include:
- Initial stiffness that gradually improves over time.
- Persistent, aching pain that intensifies as the condition progresses, especially during arm movement.
Developing a frozen shoulder can take anywhere from two to nine months. While the pain may slowly alleviate, stiffness persists, and your range of motion remains limited.
Understanding the Anatomy of a Frozen Shoulder
The shoulder boasts a remarkable range of motion compared to other parts of the body, primarily due to its ball-and-socket configuration, known as the glenohumeral joint. This joint connects the upper arm bone (humerus) to a scooped-out portion of the shoulder blade (scapula) called the glenoid cavity.
The glenohumeral joint facilitates forward and backward shoulder movements and allows the arm to rotate and extend outward. It is enveloped by a flexible capsule filled with synovial fluid, which lubricates the joint, ensuring smooth motion. Ligaments connect bone to bone, tendons attach muscles to bones, and fluid-filled sacs called bursae cushion tendons and bones during movement.
The rotator cuff, a group of muscles and tendons, stabilizes the shoulder and governs its movements. This intricate network of soft tissues accounts for the shoulder's exceptional flexibility but also renders it susceptible to trauma and chronic wear and tear.
Possible Causes of Frozen Shoulder
The precise cause of frozen shoulder remains elusive, but inflammation likely plays a pivotal role. Sometimes, immobilization of the shoulder due to prolonged injury, surgery, or illness can lead to freezing. In many instances, the cause remains unclear. Fortunately, a frozen shoulder can often be treated, though complete recovery takes time and dedication to self-care.
The process usually begins with an injury or inflammation of the soft tissues, commonly due to overuse injuries like bursitis or rotator cuff tendinitis. Inflammation results in pain that intensifies with movement, restricting the shoulder's range of motion.
When the shoulder becomes immobilized due to pain, the connective tissue surrounding the glenohumeral joint, known as the joint capsule, thickens and contracts, losing its normal elasticity. Attempting to avoid pain by avoiding shoulder movement only exacerbates the capsule's contraction. This leads to reduced space for the humerus to move and a potential loss of synovial fluid in the joint. In advanced cases, scar tissue (adhesions) can form between the joint capsule and the humerus.
Who Is at Risk for Frozen Shoulder?
Several factors can increase the risk of developing a frozen shoulder:
- Neglecting exercise therapy after experiencing tendinitis or an injury.
- Wearing a sling for an extended period without intermittent stretching.
- Having rotator cuff disorders (approximately 10% of people with these disorders develop frozen shoulders).
- Experiencing enforced immobility due to conditions such as stroke, heart conditions, or surgery.
- Having other underlying conditions like thyroid disorders or Parkinson's disease.
Treating a Frozen Shoulder
If you suspect you have a frozen shoulder or are in the early stages of developing one, seek the guidance of a healthcare professional or a shoulder specialist for a thorough examination. To assess your shoulder's range of motion, they will have you perform various arm movements, such as reaching across your chest to touch the opposite shoulder or reaching down your back to touch the opposite shoulder blade (known as the Apley scratch test).
X-rays may be ordered to rule out any underlying issues like arthritis or dislocation, while an MRI can identify a rotator cuff tear.
Treatment for a frozen shoulder focuses on alleviating pain and restoring the shoulder's natural range of motion. Your clinician will devise a personalized treatment plan. Common treatments for frozen shoulder include:
- Anti-inflammatory medications like aspirin, ibuprofen (Motrin, Advil), or Naproxen (Aleeve, Naprosyn, Anaprox).
- Application of an ice pack or a bag of frozen vegetables to the shoulder for 10 to 15 minutes several times a day to reduce pain.
- Corticosteroid injections into the shoulder joint or soft tissues.
- PHYSIOTHERAPY at VanCity Physio, which is the cornerstone of treatment, with a focus on exercises that stretch the joint capsule initially and later on strengthening exercises. A physical therapist will guide you on the appropriate exercises and help you understand your limitations, allowing you to practice most exercises at home.
While working to stretch the shoulder capsule, avoid activities that involve overhead reaching or lifting, as they may exacerbate pain. Diligent adherence to your frozen shoulder exercise regimen is key, with more than 90% of people experiencing improvement through these non-surgical measures.
However, a full recovery from a frozen shoulder takes time, ranging from several months to two or three years. If improvement is not steady or you reach a plateau, consult your clinician or a shoulder specialist. In rare cases, stubborn frozen shoulders may require surgery.
5 Essential Frozen Shoulder Exercises
Always remember to warm up your shoulder before beginning your exercises. You can achieve this by taking a warm shower or bath for 10 to 15 minutes. Alternatively, use a moist heating pad or a damp towel heated in the microwave, although this may not be as effective.
During these exercises, stretch until you feel tension but not pain. Here are five effective stretches to help release a frozen shoulder:
VanCity Physio, a trusted resource for comprehensive physical therapy, can provide expert guidance and support on your journey to release a frozen shoulder and regain full shoulder function. Don't let a frozen shoulder hold you back—take the first step towards recovery today. Call us at 604-398-5584 or click here to book online by visiting us at www.vancityphysio.com.