Frozen Shoulder: Causes, Symptoms, and Effective Physiotherapy Management
Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by pain, stiffness, and limited range of motion in the shoulder joint. It can significantly affect daily activities and quality of life, making it important to understand its causes, symptoms, and management strategies.
In this blog, we will explore the essential aspects of frozen shoulder and highlight the role of physiotherapy, with a particular focus on pendulum exercises and other effective techniques.
Image by Victoria from Pixabay
What Is Frozen Shoulder?
Frozen shoulder occurs when the connective tissue surrounding the shoulder joint (the capsule) becomes thickened and inflamed, restricting movement. The condition typically develops in three stages:
- Freezing Stage: Pain gradually increases, and the shoulder’s range of motion becomes limited. This stage may last for 6-9 months.
- Frozen Stage: Pain begins to diminish, but stiffness and restricted movement persist. This stage often lasts 4-12 months.
- Thawing Stage: Gradual improvement in range of motion occurs as the shoulder starts to recover. This stage can last anywhere from 6 months to 2 years.
Causes and Risk Factors
The exact cause of frozen shoulder remains unclear, but several factors may increase the risk:
- Injury or Surgery: Shoulder immobility following trauma or surgery can trigger frozen shoulder.
- Medical Conditions: Diabetes, thyroid disorders, and cardiovascular disease are commonly associated with frozen shoulder.
- Age and Gender: It is more common in individuals aged 40-60, with a higher prevalence in women.
- Prolonged Immobilization: Conditions like rotator cuff injuries or fractures that limit shoulder movement can contribute.
Symptoms of Frozen Shoulder
- Persistent pain in the shoulder, often worsening at night.
- Stiffness and difficulty in moving the arm.
- Limited range of motion, making simple tasks like dressing or reaching overhead challenging.
Diagnosis
Diagnosis typically involves a thorough physical examination, medical history review, and imaging tests like X-rays or MRI to rule out other conditions such as arthritis or rotator cuff tears.
Physiotherapy Management of Frozen Shoulder
Physiotherapy plays a pivotal role in managing frozen shoulder. The goal is to reduce pain, improve range of motion, and restore shoulder function. A customized program combining manual therapy, exercises, and pain-relief techniques is essential.
Key Components of Physiotherapy:
Pain Management:
Modalities such as heat packs, ultrasound, or electrical stimulation may be used to alleviate pain and improve tissue flexibility.
Stretching Exercises:
Gentle stretches help maintain and improve the range of motion.
Examples include:
Cross-body Stretch: Pull the affected arm across your chest using the opposite hand.
External Rotation Stretch: Hold a stick or towel and gently rotate the affected arm outward.
Strengthening Exercises:
Strengthening the shoulder’s supporting muscles can improve joint stability and function. Resistance bands or light weights may be used progressively.
Manual Therapy:
Techniques like joint mobilization and soft tissue release can help reduce stiffness and improve mobility.
Home Exercise Program:
Regularly practicing prescribed exercises at home is crucial for recovery.
The Role of Pendulum Exercises
Pendulum exercises are a cornerstone of frozen shoulder rehabilitation. These gentle movements use gravity to reduce pain, improve joint lubrication, and increase range of motion.
How to Perform Pendulum Exercises:
Starting Position:
- Stand beside a table or chair, using your unaffected arm to support yourself.
- Lean slightly forward, allowing the affected arm to hang freely.
Performing the Exercise:
- Begin by moving your arm in small circular motions, both clockwise and counterclockwise.
- Gradually increase the size of the circles as tolerated.
- Perform for 2-3 minutes, 2-3 times daily.
- Keep the movements gentle and avoid using your shoulder muscles to create motion.
- Focus on relaxation and let gravity assist the movement.
Pendulum exercises are often recommended during the early stages of frozen shoulder when pain and stiffness are prominent.
Other Effective Exercises for Frozen Shoulder
In addition to pendulum exercises, the following exercises are beneficial:
Wall Climbing:
Stand facing a wall and walk your fingers up the wall as far as you can.
Hold for a few seconds and then walk back down.
Towel Stretch:
Hold a towel behind your back with one hand and pull it upward with the other hand.
Reverse the roles to stretch in the opposite direction.
Shoulder Rolls:
Roll your shoulders forward and backward in a circular motion to reduce stiffness.
Lifestyle Tips for Managing Frozen Shoulder
Stay Active:
Avoid prolonged immobilization and incorporate gentle movements into your daily routine.
Pain Management:
Use over-the-counter pain relievers or prescribed medications as needed.
Ergonomic Adjustments:
Modify workspaces or daily activities to minimize strain on the shoulder.
Seek Professional Guidance:
Regular follow-ups with your physiotherapist can ensure optimal progress.
When to Seek Medical Attention
If symptoms persist despite conservative management or worsen over time, consult a healthcare provider. In severe cases, interventions like corticosteroid injections or surgical procedures (e.g., shoulder manipulation or arthroscopic release) may be necessary.
Conclusion
Frozen shoulder can be a frustrating and debilitating condition, but with timely physiotherapy and a commitment to exercises like pendulum movements, recovery is achievable. Consistency, patience, and professional guidance are key to regaining shoulder mobility and function.
Remember, every individual’s journey with frozen shoulder is unique. Work closely with your physiotherapist to develop a tailored plan that meets your specific needs. With the right approach, you can overcome frozen shoulder and return to your daily activities with ease.
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