While all joints in the body can become stiff, involving a reduced range of movement, the shoulder has the potential to stiffen more than any other. There's even a name given to it, frozen shoulder. The medical terminology for this is adhesive capsulitis.
After a period of worsening symptoms, frozen shoulder tends to get better, although full recovery may take up to 3 years. Physiotherapy, with a focus on shoulder flexibility, is the primary treatment recommendation for frozen shoulder. Because the shoulder is not moved very much with a frozen shoulder, the muscles can also become weak and may need to be strengthened.
Frozen shoulder most commonly affects people between the ages of 40 and 60, and occurs in women more often than men. In addition, people with diabetes are at an increased risk for developing frozen shoulder.
Frozen shoulder can develop after a shoulder, injury, or surgery. sometimes frozen shoulder can develop for no apparent reason. It can be a very disabling condition where patients can't lift their arm up or rotate their arm. This has a big impact on people as they can't reach up for items off the shelf, or might have difficulty getting dressed.
In frozen shoulder, the shoulder capsule thickens and becomes stiff and tight. Thick bands of tissue — called adhesions — develop. In many cases, there is less synovial fluid in the joint.
The hallmark signs of this condition are severe pain and being unable to move your shoulder -- either on your own or with the help of someone else. It develops in three stages:
- "Freezing" In the "freezing" stage, you slowly have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.
- "Frozen" Painful symptoms may actually improve during this stage, but the stiffness remains. During the 4 to 6 months of the "frozen" stage, daily activities may be very difficult.
- "Thawing" Shoulder motion slowly improves during the "thawing" stage. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.
Occasionally, some people might benefit from an injection of saline fluid into the shoulder, joint to stretch out the capsule. this is sometimes effective. In other severe cases there are surgical procedures that can be done to increase the range of movement.
The causes of frozen shoulder are not fully understood. There is no clear connection to arm dominance or occupation. A few factors may put you more at risk for developing frozen shoulder.
Diabetes. Frozen shoulder occurs much more often in people with diabetes. The reason for this is not known. In addition, diabetic patients with frozen shoulder tend to have a greater degree of stiffness that continues for a longer time before "thawing."
Other diseases. Some additional medical problems associated with frozen shoulder include hypothyroidism, hyperthyroidism, Parkinson's disease, and cardiac disease.
Immobilization. Frozen shoulder can develop after a shoulder has been immobilized for a period of time due to surgery, a fracture, or other injury. Having patients move their shoulders soon after injury or surgery is one measure prescribed to prevent frozen shoulder.
At Melbourne Shoulder Physiotherapy, you will receive a detailed home program of exercises to mobilise and strengthen your shoulder. You will be educated on this condition and supported until you regain full range and function.
We have had excellent success dealing with this challenging condition and its lengthy journey.