How physical therapy can help a frozen shoulder
Frozen shoulder, or Adhesive Capsulitis, refers to an inflammatory condition that causes fibrosis of the shoulder joint capsule and is accompanied by a gradual progression of stiffness and loss of range of motion at predictable time frames.
It is most common in women between the ages of 40 and 65 and patients with a history of diabetes and/or thyroid disorders. It is often misdiagnosed in the early phases, as the clinical presentation is identical to a rotator cuff strain. However, as time goes on, range of motion restrictions worsen which could limit sleep (due to pain), grooming, dressing and reaching activities. Range of motion is limited in all directions with both active and passive movements. Active movement is defined as movement the patient performs independently. Passive range of motion is defined as someone else (such as your physical therapist) attempting to move your arm with you fully relaxed.
Frozen shoulder has different stages that occur at predictable time frame. The natural course of frozen shoulder is about 18 months, though impairments may still be present at up to four years. This means that even with no treatment, you should feel mostly better by the 18-month mark. However, it is a good idea to have treatment during the course of frozen shoulder to minimize range of motion and strength loss to allow you to fully participate in activities you need to do and enjoy. Strength loss with frozen shoulder is common due to disuse.
Frozen shoulder treatments include shoulder joint mobilizations, strengthening and stretching exercises, soft tissue work, dry needling to lessen pain and muscle tension, modalities to reduce pain/discomfort and activity modification strategies to allow you to work with your limitations and still participate in activities you enjoy. Some patients utilize a combination of corticosteroid injections and physical therapy.
- Kelley, Martin J. et al. “Shoulder Pain And Mobility Deficits: Adhesive Capsulitis.”. Journal Of Orthopaedic & Sports Physical Therapy, Vvol. 43, Nno. 5, 2013, pp. A1-A31. Journal Of Orthopaedic & Sports Physical Therapy (JOSPT), https://doi.org/10.2519/jospt.2013.0302.
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