Understanding and Managing Frozen Shoulder

Understanding and Managing Frozen Shoulder

Introduction

Frozen shoulder, medically known as adhesive capsulitis, is a condition characterized by pain and stiffness in the shoulder joint. It affects about 2-5% of the population, with a higher incidence in women and those between the ages of 40 and 60. In this blog, we'll explore what frozen shoulder is, its symptoms, causes, diagnosis, treatment options, and some preventive measures.

What is Frozen Shoulder?

Frozen shoulder occurs when the capsule surrounding the shoulder joint becomes inflamed and thickened, leading to the formation of scar tissue. This scar tissue, or adhesions, cause the shoulder joint to become tight and hard to move. The condition typically progresses through three stages:

1. Freezing Stage - Gradual onset of pain with increasing stiffness, lasting 6-9 months.

2. Frozen Stage - The shoulder becomes very stiff, but the pain might lessen, lasting 4-12 months.

3. Thawing Stage - Gradual return of motion, which can take from 6 months to several years.

Symptoms

• Pain in one shoulder, often worse at night.

• Stiffness and difficulty moving the shoulder, particularly with overhead activities.

• Decreased range of motion.

Causes

The exact cause of frozen shoulder is not fully understood, but several factors are commonly associated:

• Inactivity or Immobility - After shoulder surgery, injury, or a period of disuse like after a stroke.

• Systemic Diseases - Conditions like diabetes, thyroid disorders, or cardiovascular disease.

• Age and Gender - More common in women over 40.

Diagnosis

Diagnosis typically involves:

• Clinical Examination - Your doctor will assess your shoulder's range of motion and pain levels.

• Imaging - X-rays or MRI might be used to rule out other conditions like arthritis or tears.

Treatment Options

Non-Surgical Treatments:

• Physical Therapy - Key to improving motion and strength. Techniques include stretching and range-of-motion exercises.

• Medication - NSAIDs for pain and inflammation, corticosteroid injections for severe pain.

• Heat/Cold Packs - To manage pain and stiffness.

Surgical Treatments:

• Manipulation Under Anesthesia - Where the doctor moves the shoulder through a full range of motion to break up adhesions.

• Shoulder Arthroscopy - To remove scar tissue or adhesions directly.

Prevention and Management

While not all cases of frozen shoulder can be prevented, here are some strategies:

• Keep Active - Regular, gentle shoulder exercises can help maintain mobility.

• Manage Health Conditions - Good control of diabetes or thyroid issues might reduce risk.

• Post-Injury Care - Proper rehabilitation after shoulder injuries.

Living with Frozen Shoulder

Living with frozen shoulder can be challenging due to its impact on daily activities. Here are some tips:

• Adapt Activities - Modify how you perform tasks to avoid pain, like using your unaffected arm more.

• Support - Use ergonomic aids or braces if needed to support your shoulder.

• Patience - Recovery can be slow; patience is crucial.

Conclusion

Frozen shoulder is a condition that requires understanding, patience, and consistent management. If you suspect you might have frozen shoulder, consulting with a healthcare provider for an accurate diagnosis and tailored treatment plan is crucial. Remember, each person's experience with frozen shoulder can vary, so what works for one might not work for another. Keep active, stay informed, and seek support when necessary to navigate through this condition effectively.

Managing frozen shoulder

Managing frozen shoulder involves a series of exercises aimed at improving range of motion, reducing pain, and preventing further stiffness. Here's a list of exercises commonly recommended for frozen shoulder:

Stretching Exercises

1. Pendulum Stretch

• Lean forward, supporting yourself with your good arm on a table or chair.

• Let the arm on the affected side hang down.

• Gently swing the arm back and forth, side to side, and in small circles.

2. Towel Stretch

• Hold a towel behind your back with one hand from the top and the other from the bottom.

• Gently pull the towel upward with your good arm to stretch the affected arm.

3. Cross-Body Reach

• Use your good arm to lift the affected arm at the elbow, pulling it across your body.

4. Finger Walk

• Stand facing a wall just under arm's reach away.

• Walk your fingers up the wall, leading with your shoulder, keeping your elbow slightly bent.

5. Armpit Stretch

• Lift the arm on the affected side and place it on a shelf or high surface that is just above shoulder height.

• Gently bend your knees to stretch the armpit area.

6. Wall Crawl

• Similar to the finger walk but using the whole hand, crawl up the wall as high as comfortable.

Strength and Mobility Exercises

7. External Rotation

• Hold a light weight or resistance band.

• With your elbow bent at 90 degrees and tucked into your side, rotate your forearm outward.

8. Internal Rotation

• Hold the weight or band with the affected arm behind your back, elbow bent, and rotate your forearm inward.

9. Shoulder Blade Squeezes

• Sit or stand with arms at your sides.

• Squeeze shoulder blades together, hold for a few seconds, then release.

10. Seated Row

• Using a resistance band or light weights, sit with legs extended, pull the band/weights towards your waist, squeezing the shoulder blades.

11. Isometric Exercises

• Press your fist into a wall or against your other hand without moving your shoulder to engage muscles without movement.

12. Scapular Retraction

• Lie on your back with arms at your sides, palms up, and slowly move your shoulder blades together.

General Tips:

• Warm-Up: Start with a warm-up like a hot shower or using a heat pack to relax muscles.

• Frequency: Perform these exercises several times a day if possible, especially in the morning and evening.

• Pain Management: Stop if you feel sharp pain, but some discomfort during stretching is normal.

• Gradual Progression: Increase the range and intensity slowly to avoid re-injury or worsening the condition.

• Consistency: Consistent practice is key to regaining mobility.

Always consult with a physiotherapist or healthcare provider before starting these exercises to ensure they are appropriate for your specific condition and to get personalized guidance. They can also adapt these exercises or add more based on your progress and pain levels.