Technically called “Adhesive Capsulitis,” this painful condition occurs in roughly 2% to 5% of the general population. Women tend to be more affected than men, and the age of onset is typically 45 years and older. For those individuals unfortunate enough to experience this debilitating condition, 20% to 30% will tend to get it in the other shoulder.
WHAT IS FROZEN SHOULDER (ADHESIVE CAPSULITIS)?
Frozen Shoulder is the stiffening of the shoulder due to scar tissue, resulting in painful movement and loss of motion. The actual cause of Frozen Shoulder is debatable. Some believe it is caused by inflammation of the lining of the joint, while others believe it is a result of autoimmune reactions, where the body launches an “attack” against its own tissues. Other possibilities include:
- Immobilization of your arm, such as in a sling, after fracture or surgery
- Reactions after trauma or surgery
- Pain from other conditions, such as arthritis, bursitis, tendinitis, or rotator cuff tear, that has caused limited mobility of the shoulder due to pain
HOW DOES FROZEN SHOULDER PROGRESS?
Frozen Shoulder is generally broken down into 4 stages (some theories condense Stages 1 and 2 into 1 Stage). Most individuals start with worsening pain followed by a loss of range of motion.
The overall goal is to restore motion and decrease pain to allow the individual to resume their normal daily activities and life roles. During Stages 1 and 2, treatment focuses on maintaining as much range of motion as possible, as well as keeping pain manageable. This typically includes a combination of manual therapy techniques and gentle stretching to increase mobility of the shoulder. A home exercise program is essential to maintain the gains in range of motion attained during one’s Physical Therapy session. In Stage 3, the focus of treatment will also be on improving shoulder mobility, and manual therapy techniques and stretching tend to get more aggressive. Strengthening exercises will also typically be added in the clinic and to one’s home exercise program as well. In Stage 4, the final stage, focus will be on the return to “normal” shoulder mechanics with an emphasis on the return to one’s normal panfry activities. Manual therapy, stretching, and strengthening will continue to be progressed during this time.
CAN FROZEN SHOULDER BE PREVENTED?
Since the cause of Frozen Shoulder is debatable with no known definitive cause, there is no known method of prevention. The onset is generally gradual, with the disease process needing to “run its course.” Physical Therapy can, however, assist in regaining mobility and decreasing pain during the course of the 4 Stages.