Frozen Shoulder

Adhesive Capsulitis/Frozen Shoulder: Are you at risk?

Have you ever heard the term Frozen Shoulder? The clinical term for it is Adhesive Capsulitis, and it lives up to both of its names.

Symptoms of Adhesive Capsulitis can include:

– A significant and progressive decrease in range of motion (specifically external rotation)
– Pain at the end ranges of motion
– Pain in the upper shoulder/neck
-An inability to move the arm through normal ranges of motion even with assistance.

The changes in range of motion and pain are due to the capsule (think of it like a water balloon) around the joint tightening up and compressing on the joint. The capsule is normally loose and spacious. The capsule tightens and compresses the joint there is no longer any space for the arm to move within the shoulder joint. There are two types of frozen shoulder, Primary and Secondary. Primary is caused by a direct injury to the shoulder. Alternatively, secondary is related to metabolic diseases such as diabetes and thyroid disease

There are four stages to the progression of frozen shoulder

Stage 1: Can Last up to 3 months – Defined by sharp pain at the end ranges of motion, achy pain when at rest and pain that disturbs your sleep. There is no adhesions or contracture at this time. It is not easily diagnosed in this stage and can be misdiagnosed as subacromial shoulder impingement.

Stage 2: Painful or freezing stage. Defined by a gradual loss of motion in all directions. Pain happens with movement at the end range of motion for all movements. The freezing stage can last anywhere from 3-9 months.

Stage 3: Frozen stage. Defined by a loss of motion that can typically last 9-15 months. The pain is typically decreased by this stage as the range of motion has been limited and while ‘frozen’ the pain typically only occurs during movement.

Stage 4: Thawing stage. In this stage the pain begins to resolve, but an overall stiffness can persist from the 15-24 month mark after onset of symptoms. While the joint may ‘thaw’ and range of motion becomes greater while the pain becomes less, some range of motion restrictions may persist after the shoulder has fully thawed and is pain free.

About the recovery:

Adhesive Capsulitis can be a challenging injury to manage due to the limited range of motion and the long drawn out nature of the injury. Early intervention can be a key factor in decreasing the lifespan of the injury and helping improve range of motion. Through a variety of interventions such as soft tissue therapy, stretching, rehab exercises and activity modification we can help to improve range of motion and decrease pain.

Like many injuries passive interventions (i.e. soft tissue therapy) can significantly help improve your symptoms but active interventions play a large role in long term success. Having support in determining which exercises are helpful, and which aren’t is key. Focusing your energy on consistency with exercises and treatment and avoiding triggering exercises can lead to long term success.

Does this sound like shoulder pain you are experiencing? Reach out today to schedule an assessment to help lead you to recovery!

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