What is frozen shoulder and how does physiotherapy help?
Frozen shoulder, or adhesive capsulitis, is a condition where your shoulder becomes stiff and painful. It happens when the tissues around your shoulder joint get thicker and tighter, making it hard to move your shoulder. Here we discuss the condition in more detail, and explain how we can help!
What causes a frozen shoulder?
The exact cause of frozen shoulder is not fully understood, but several factors might play a role. It is thought to be caused by irritation of the shoulder joint and the tissue around it, known as the capsule. This irritation leads to inflammation, called capsulitis, and results in small scars, or adhesions, forming between the layers of the joint capsule.
Frozen shoulder can develop with no clear cause, but often it develops after the shoulder has been kept still for a long time, such as after surgery or an injury. Certain health conditions like diabetes, thyroid problems, and heart disease can also increase the risk. It is more common in people between the ages of 40 and 60 and tends to affect women more than men.
What are the stages of frozen shoulder?
Frozen shoulder develops in three stages:
The first stage, called the "freezing stage," lasts from about 6 weeks to 9 months, where pain and stiffness slowly start and get worse, especially with movement and at night.
Next is the "frozen stage," which can last 4 to 12 months. During this time, the pain may lessen, but the shoulder remains very stiff, making it hard to move.
Finally, the "thawing stage" can last from 6 months to 2 years, where the stiffness gradually eases, and the range of motion slowly improves.
What are the symptoms?
Gradual onset of shoulder pain, often worsening over time
Pain that is typically worse at night and can disturb sleep
Stiffness in the shoulder joint, leading to restricted range of motion
Difficulty performing everyday activities, such as reaching overhead, behind the back, or out to the side
Sharp pain during shoulder movement, particularly in the early stages.
If you think you have a frozen shoulder or suspect you might, it's important not to ignore it. Delaying treatment could lead to worsening pain and increased stiffness, making it harder to recover and lengthening the time it takes to heal.
How can physiotherapy help a frozen shoulder?
Physiotherapy is key to managing frozen shoulder and aiding recovery. It includes pain management techniques along with stretching exercises to improve flexibility and mobility.
Strengthening exercises target the rotator cuff and surrounding muscles for shoulder stability. These can be helpful when the shoulder has weakened through a lack of use.
Manual therapy techniques can reduce stiffness, improve pain and enhance joint function. Education about the condition helps you to modify activities, manage the pain and maintain progress through a tailored home exercise programme.
Functional training focuses on restoring your ability to perform daily activities. Together, these components help you regain normal shoulder function.
Physiotherapy should ideally start right after a frozen shoulder is diagnosed. Early treatment can help control symptoms and stop the shoulder from becoming even stiffer. The timing and intensity of the therapy might change depending on the stage of the condition.
How can we at First Line Physio help with treatment?
At our clinic, our physiotherapists are committed to helping you recover from frozen shoulder with a personalised approach. We begin with a thorough assessment to create a tailored treatment plan, focusing on pain management through techniques like electrical stimulation, acupuncture, and heat therapy.
We adjust activities that may cause discomfort and design a custom exercise programme to strengthen your shoulder. Hands-on therapies, such as soft tissue treatment and joint mobilisation can improve movement and reduce pain.
We guide you through your rehabilitation, monitoring your progress and making adjustments as needed, to ensure a full recovery and lasting results.
What exercises can you do for frozen shoulder?
1. Pendulum stretch
Start with this exercise. Relax your shoulders, then stand and lean forward slightly, letting your affected arm hang down freely.
Gently swing your arm in a small circle, about a foot wide.
Repeat 10 circles in each direction, 2-3 times a day.
As your shoulder improves, you can make the circles bigger, but keep it gentle.
2. Towel stretch
Hold one end of a long towel behind your back and grab the opposite end with your other hand.
Hold the towel in a horizontal position. Use your good arm to pull the affected arm upward to stretch it.
Hold the bottom of the towel with the affected arm and pull it toward the lower back with the unaffected arm.
Complete 10 repetitions, 2-3 times a day.
3. Finger Crawl
Stand facing a wall about three-quarters of an arm's length away.
Touch the wall at waist level with the fingertips of your affected arm.
With your elbow slightly bent, slowly walk your fingers up the wall like a spider, raising your arm as high as you comfortably can. Let your fingers do the work, not your shoulder muscles.
Slowly lower your arm (using your good arm if needed) and repeat.
Repeat 10 times, 2-3 times a day.
This is absolutely not written to substitute medical advice and it is always important to see a qualified healthcare professional for a formal diagnosis. If any of the exercises cause pain during or after the exercise, discontinue and consult a physiotherapist.