What is Frozen Shoulder?
At some point in time, you have more than likely heard of a family member or friend, that experienced what is
commonly called Frozen Shoulder. This term affects roughly 4% of people worldwide every year for a variety
of different reasons. There are two types of Frozen Shoulder,
- Primary Frozen Shoulder: This occurs for reasons that even medical research still cannot understand. It
is understood that lifestyle factors and genetic predisposition factors, such as diabetics, who are 2-4x
more likely to develop a Frozen Shoulder. - Secondary Frozen Shoulder: This is as a result of recent shoulder trauma/injury, or recent shoulder,
neck, spinal or cardiac surgery that lead to long periods of shoulder immobilization and bedrest. As a
result, these factors cause inflammation, contracture and synovitis to the Glenohumeral Joint Capsule
(The fluid filled sac that surrounds your shoulder joint) and surrounding soft tissue structures.
For today’s topic, we will be focusing on Secondary Frozen Shoulder.
Frozen Shoulder, or in medical terms Adhesive Capsulitis, is the diagnosis given to someone’s shoulder when
they are unable to move their shoulder in different directions from the body, the most common being unable
to lift your shoulder above your head. Your shoulder “feeling stiff” or “feeling stuck” are commonly used with
those who are experiencing Frozen Shoulder.
A true diagnosis of Frozen Shoulder is given by your doctor or physiotherapist when the range of motion is
restricted in both active shoulder flexion and external rotation. As well as passive range of motion. This is
when someone or something moves your shoulder for you.
MRI’s can be used to diagnosis Frozen Shoulder if all other diagnoses can be ruled out, or the Glenohumeral
Joint Capsule and surrounding soft tissue structures show signs of inflammation, contracture or Synovitis.
The most up to date research says the following people are 2-4x more likely to develop Secondary Frozen
Shoulder after shoulder trauma, shoulder injury, or surgery.
- Individuals who have been diagnosed with Diabetes. Both Type 1 and Type 2.
- If you have a Thyroid disorder, you are more likely to develop a Frozen Shoulder
- Females are more likely than men to develop Frozen Shoulder between the ages of 40-70years old.
- If you have had recent shoulder, neck, spinal or cardiac surgery, there is a higher chance of developing
a Frozen Shoulder due to prolonged shoulder immobilization and bedrest.
How and why does Secondary Frozen Shoulder occur?
As mentioned previously, the diagnosis of Secondary Frozen Shoulder occurs when your shoulder has
undergone a recent Trauma or injury that causes the capsule and surrounding soft tissue structures around
your shoulder joint to thicken and inflame. The other cause being that of a recent shoulder surgery such as a
Arthroscopic Rotator Cuff Repair, in which your shoulder joint is immobilized in a sling for an extended period
of time after surgery. Secondary Frozen Shoulder is not just limited to shoulder surgery, but neck and cardiac
surgery can cause extended periods of bedrest, which can also immobilize your shoulder as a result.
Both Primary and Secondary Frozen shoulder is divided into 3 different phases:
- The Freezing Stage
- The Frozen Stage
- The Thawing Stage
The Freezing Stage
The first stage of Frozen shoulder is indicated if your shoulder is experiencing an increase in pain with
movement, particularly in raising your shoulder above your head or rotating your shoulder joint side to side.
You will also notice your shoulder becomes much stiffer and harder to move in these directions. This stage will
last anywhere from 2-9 months.
The Frozen Stage
The middle stage of a Frozen shoulder is indicated if your shoulder has a reduction pain but becomes
extremely stiff. It may not even be possible to lift your shoulder above your head in this stage, not because of
pain, but because it feels “stuck”. Day to day tasks such as reaching up into a cupboard or putting clothes on a
clothesline become extremely difficult due to the limitations of your shoulder range of motion. This stage will
last anywhere from 4-12 months.
The Thawing Stage
The last stage of Frozen Shoulder is indicated if your shoulder pain is reducing significantly, alongside your
shoulder being able to move easier without pain. You may notice that reaching into a cupboard or putting
clothes on the clothesline becomes much easier and less painful. This is a positive sign that you have moved
from the Frozen Stage to the Thawing Stage. This phase can last anywhere from 6 months to 2 years.
It is important to note that Frozen Shoulder symptoms remain for a long while. The typical recovery from a
true diagnosis of Frozen Shoulder is estimated between 1-2 years.
How can physiotherapy help with Frozen Shoulder and why is it important?
Physiotherapy can help reduce pain and improve function with Secondary Frozen Shoulder in many different
ways.
Physiotherapy can:
- Reduce pain with targeted manual therapy techniques, such as soft tissue massage to your shoulder
muscles. - Mobilization techniques of the shoulder to improve movement of the shoulder.
- Provide you with Shoulder stretches to assist in movement of the affected shoulder.
- Provide you with Specific shoulder exercises to tailored to you to improve overall strength of your
shoulder while your range is still limited. - Provide you with a combination of Ice and heat therapy to reduce inflammation and restore
movement of the shoulder
Physiotherapy is a vital step in addressing your Secondary Frozen Shoulder. Studies show that 80% of patients
suffering with Secondary Frozen Shoulder that have commenced early intervention programs such as
physiotherapy treatment, will regain near-normal or normal shoulder function and movement within 1-2
years.
It is important that if you, a loved one or friend is suffering with symptoms of a Frozen Shoulder, seek out a
physiotherapy to better understand how we can assist with reducing your pain, and improving your shoulder
function.
Book in today at Sports Focus via our website or call us on (02) 9601 8411.
