Frozen Shoulder: How Physiotherapy Can Help Restore Your Movement

Adhesive Capsulitis, commonly known as frozen shoulder, is a regular condition seen at our Auckland physio clinic. It is a shoulder condition characterized by pain and a loss of both active and passive range of motion. It is estimated to affect between 2-5% of the population. This condition is more commonly seen in women aged 40-60 years old. The aeitology of frozen shoulder is idiopathic meaning that its exact cause is still unknown however risk factors include diabetes, stroke, autoimmune diseases, and obesity to name a few. Frozen shoulder is also linked to traumatic events such as an injury to the shoulder or following shoulder surgery.

Phases of Frozen Shoulder

Frozen shoulder is broken down into three phases:

• The painful (freezing) stage: this painful stage is marked by an increase in pain with a gradual loss of range of motion at the affected shoulder.
• The frozen or stiff stage: pain slowly begins to reduce at the shoulder, but it remains very stiff in all directions.
• The thawing stage: range of motion slowly begins to return to normal.

Stiffness and pain are believed to be caused by high levels of inflammation and adhesion at the joint capsule that surrounds the shoulder joint. There is also a reduction in the synovial fluid that helps to lubricate the ball and socket joint. Symptoms have been known to last anywhere from 1-5 years.

How is it Diagnosed?

Diagnosis is made primarily by patient history and physical exam. A global loss of passive range of motion is the primary diagnostic finding. The main movements that are lost are internal (hand behind back) and external (turning arm out) rotation. Imaging can be used to rule of the likes of arthritis and ultrasound, or MRI can confirm a frozen shoulder diagnosis.

What is the Treatment for Frozen Shoulder?

Physiotherapy plays an important role in all stages of the management pathway from education, soft tissue work, mobilizations, range of motion and strengthening exercises.

Regardless of the treatment, a frozen shoulder will still have to run through the three stages. Treatment is determined by what stage you are in. Treatment in the painful stage is aimed at reducing your pain and maintaining your range of motion. Management in the stiff stage is about assisting you getting your range back faster. Rehab in the final stage is about regaining your strength around your shoulder.

Management often requires a multi-disciplinary approach that includes a doctor and specialist. Other treatment options often used alongside physiotherapy include pain relief, steroid injections, hydrodilation and surgery. All these other options should be discussed with your physiotherapist who can refer on to a specialist for consideration.

Frozen shoulder can take many months to recover but with expert care from one of our highly trained physiotherapists, you will be on the right track to recovering. Our physiotherapists will tailor your treatment to your specific needs rather than relying on a recipe treatment. If you believe you have a frozen shoulder, contact us today to start on your path to recovery.