Frozen Shoulder/Adhesive Capsulitis

By Carla Cranbury, PT

What is it?

Frozen shoulder, also called adhesive capsulitis, is a gradual onset shoulder condition characterized by pain and limited range of motion. This is caused by inflammation and tightening of the shoulder capsule. Typical initial symptoms are pain midway between the shoulder and the elbow and difficulty reaching behind the back. Most women will report that they have difficulty doing up their bra and men difficulty putting on their belt.

Why does it happen?

Limited research has been able to discern one certain cause of frozen shoulder – in short, we don’t know. We do know that it is most common in middle aged women (aged 40-65) and people with diabetes. It also is more likely to occur after a virus, a lingering shoulder injury or after shoulder or upper limb surgery.

How long does it take?

Frozen shoulder goes through three main stages, each of which can take weeks to months:

  • Freezing – pain is noticed and range of motion becomes progressively limited
  • Frozen – pain is reduced, but range of motion is further restricted
  • Thawing – pain is reduced and range of motion gradually returns

Can physio help?

Physiotherapy cannot speed up the course of the condition – everyone has to go through each of the three stages in order to recover. The total process of frozen shoulder can take one to two years to resolve.

What physio can do is help you retain function while going through frozen shoulder, decrease some pain, and ensure a full recovery. Maintaining mobility through the process is important and is where physiotherapy can help the most. Physio will also help prevent other injuries that can be caused by compensating for the frozen shoulder – this is especially significant as it is common for the other shoulder to get the same condition.

Your physiotherapist will give you exercises to maintain as much movement as possible and instruct you on how to perform them properly to ensure you are not compensating for the limited range of motion. Hands on manual therapy will help stretch out the capsule to make the exercises easier to perform. Modalities such as ice, heat, TENS, and acupuncture can also be used to decrease pain.

Though frozen shoulder can be a lengthy and frustrating process, the right care can make it more manageable and prevent any further complications.

BodyTech Physiotherapy

 

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Pal B, Anderson J, Dick WC, Griffiths ID. Limitation of joint mobility and shoulder capsulitis in insulin- and non-insulin dependent diabetes mellitus. Br J Rheumatol. 1986;25:147–51. doi: 10.1093/rheumatology/25.2.147. [PubMed] [Cross Ref]
Bridgman JF. Periarthrits of the shoulder in diabetes mellitus. Ann Rheum Dis. 1972;74:738–46.
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