Frozen shoulder, also known as adhesive capsulitis, is a common shoulder condition that limits your range of motion. Frozen shoulder develops when the capsule of connective tissue where bones, ligaments and tendons are located in) thickens and tightens around your shoulder joint, hence restricting movements. It is more likely to occur in people aged between 40 and 60 years old. Some factors can predispose individuals to be more prone to developing frozen shoulder, which includes: hormonal imbalance, diabetes or a period of limited activity following an injury or surgery.
Common symptoms are:
- Shoulder stiffness, severe pain at night, loss of active and passive movement of shoulder (particularly external rotation of the shoulder: when you rotate your arm out)
3 stages for this condition:
Freezing (painful)
- Usually lasts for 2 – 9 moths
- Started with a gradual increase in severe shoulder pain especially worsen at night
- Pain is usually most severe during this stage
- Main focus is pain relieve with ice/heat pack and gentle shoulder mobilisation exercise and stretches
Frozen (Adhesive)
- Usually lasts for 4 – 12 months
- Pain is less, but noticing more loss in the range of motion (particularly external rotation of the shoulder: when rotating arm out)
- The main focus is stretching exercises + introduction of early strengthening exercises to maintain muscle strength
Thawing
- Usually lasts for 5-26 months
- Have a gradual return of range motion
- Main focus is mobility exercises, stretches as well as strengthening exercises for shoulder, back and chest
What can physiotherapy help you with frozen shoulder?
- Physiotherapy is the first line treatment for frozen shoulder as it is shown as effective in pain reduction and improving range of motion, as a result, can reduce limitation in activities and improve quality of life.
- Your physiotherapist at Refine will conduct a thorough assessment to help diagnose frozen shoulder, the stage of frozen shoulder and identify your restriction in range of motion and movements
- Your physiotherapist will develop your treatment plan base on your assessment findings. Treatment usually includes advice regarding activity modification, coping strategies and posture, manual therapy, and hand on muscular releases, as well as stretching and strengthening exercise program that is suitable for your case.
What can I do at home while waiting for my appointment with physiotherapist?
- Try applying heat/ice pack to help with pain relief
- Consider seeking medical advice regarding medication or other treatment options if the pain level is intolerable
- Gentle stretch exercises to help reduce some tightness/stiffness in the shoulder
- Gentle mobilisation exercise
1. Pendulum exercise
- Have your hand on your good arm side supported on the table/chair, relax your arm on the painful side, letting it straight down on your side, slowly begin to swing the painful arm in a small circle, then reverse the direction
- Spend 3 minutes doing this circular movement, 3 times a day
2. Assisted shoulder forward elevation
- You can either lie on your back or sit in a chair to do this exercise
- Use your hand on the good arm side to grasp the hand on the painful side
- The starting position is to have hands close to your stomach, then slowly lift the arm overhead while keeping your elbow straight
- Maintain the elevation for about 10 – 15 seconds then slowly lower them down
- Repeat for 10 – 20 times, 3 times a day
3. Assisted shoulder external rotation
- Use a stick and hold it as shown in the picture above
- Slowly and gently push the stick towards the painful arm side of your body, which will assist an external rotation movement at your shoulder joint (right photo: finishing position)
- Stop at where your pain and range allows, hold at the finishing position for 10 seconds, then slowly return to midline (left photo: starting position)
- Repeat 10 – 20 times, 3 times a day
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