Fastening a bra clasp, brushing your hair and reaching for a seat belt, are daily activities that are difficult with a frozen shoulder. Characterized by stiffness and pain in the shoulder joint, frozen shoulder, also known as adhesive capsulitis, is due to scar tissue forming in the shoulder capsule which thickens and becomes tight. With the shoulder capsule inflamed, shoulder movements become reduced, causing pain and the shoulder can become completely “frozen.”
Frozen shoulder can develop following an injury, a chronic health condition, such as diabetes or recovering from a medical condition that prevents using the joint normally; such as a mastectomy or a stroke. However, there are patients who present with onset of shoulder stiffness and the cause is unknown. Signs and symptoms typically begin gradually, worsen over time and then resolve.
Signs and symptoms include:
Dull or aching pain
Loss of both active and passive range of motion (internal rotation is often affected)
Difficulty performing tasks: personal hygiene, dressing etc.
Night pain and sometimes disrupted sleep
Physiotherapy for frozen shoulder involves managing shoulder pain and increasing range of motion. Modalities for pain may include electrotherapy, ultrasound and heat therapy. Restoring range of motion and strength in the shoulder is important for rehabilitation. Manual therapy techniques such as passive range of motion, joint mobilization, and an exercise routine involving stretching, will help rehabilitate shoulder flexibility and ROM. A strengthening exercise program is introduced when active range of motion is achieved.
Correct diagnosis = Effective treatment plan. Frozen shoulder can often be diagnosed from signs and symptoms alone but imaging such as X-ray and MRI may be requested.