How Physiotherapy Can Help You Manage Frozen Shoulder
We recently worked with a patient who came to us after struggling with shoulder pain for several months. While she hoped it would go away on its own, it only got worse over time. When she visited us, she was also struggling to lift her shoulder overhead or reach behind her back.
This patient had developed adhesive capsulitis, more commonly known as frozen shoulder. It gets that name from the fact that the condition causes the shoulder to “freeze up” after a period of intense pain.
A frozen shoulder will eventually “unfreeze,” but that process can take anywhere from 1-3 years. Fortunately, the team at Montrose Physiotherapy and Massage can help you manage your symptoms and facilitate a more efficient recovery.
What Causes Frozen Shoulder?
The condition develops when the capsule of connective tissue that wraps around your shoulder thickens and tightens, restricting the joint. However, researchers aren’t entirely clear why this happens. Certain factors can increase your risk:
- Having certain diseases, including diabetes, thyroid conditions, or cardiovascular disease.
- Immobilizing your shoulder after an injury or surgery
- Being a woman between the age of 40 and 60 years old
Understanding the Three Phases Of Frozen Shoulder
One reason frozen shoulder recovery can take so long is that the condition progresses through three distinct phases, each with its own set of symptoms and concerns. Here’s what you need to know about each one:
1. Freezing Phase
This initial stage is marked by increasing pain and stiffness in the shoulder. During this phase, we focus on maintaining your shoulder’s range of motion to help reduce stiffness and improve comfort.
Duration
Anywhere from six weeks to nine months
Symptoms
- A gradual onset of pain that worsens with movement
- Increased stiffness in the shoulder
- Pain is often worse at night, disrupting sleep
2. Frozen Phase
The frozen stage involves less pain but greater stiffness, significantly restricting your shoulder’s movement. We’ll focus on improving your shoulder’s mobility using stretching or manual therapy techniques.
Duration
Anywhere from four to six months
Symptoms
- Decreased pain compared to the freezing stage
- Significant stiffness and difficulty moving the shoulder
- Everyday movements like reaching overhead or behind the back become challenging
3. Thawing Phase
In the final stage, your pain decreases, and your shoulder’s range of motion gradually returns. However, it’s important to continue physiotherapy to ensure you make a full recovery.
Duration
Anywhere from six months to two years
Symptoms
- Pain continues to decrease
- Gradual improvement in mobility as scar tissue around the shoulder capsule begins to loosen and break down
Physiotherapy and Frozen Shoulder: What You Need to Know
Physiotherapy plays an essential role in helping you manage frozen shoulder symptoms at all three stages. Our team will work with you to develop a comprehensive treatment program, pulling from a range of different techniques based on your current symptoms:
Acute Pain Management
We’ll help you manage shoulder pain (especially in the freezing phase) with techniques such as dry needling, Kinesio taping, hot and cold therapy, and more.
Manual Therapy
Various hands-on techniques can gently mobilize the shoulder joint, improve joint capsule movement, and reduce pain.
Mobility Exercises
Targeted exercises and techniques help improve your shoulder’s range of motion in all directions, gradually restoring your ability to reach, lift, and rotate your arm.
Strengthening Exercises
Strengthening the muscles surrounding the shoulder joint enhances stability and supports improved function.
Management Strategies
Understanding frozen shoulder is an integral part of managing it. We’ll help you navigate the difficulties of the condition, including identifying which stage you’re in and providing you with home exercises to help alleviate your symptoms.
Exercise of the Month
Shoulder Internal Rotation Stretch
(Shoulders, Rotator Cuff)
Start by standing up straight, holding a towel behind your back with one end over your shoulder and the other by your lower back. Grab the bottom end of the towel with your hand on the side you want to stretch and gently pull up on the towel with your other hand.
Hold for 30 seconds – 2 Sets, 1 Rep
(Materials needed: towel)
The Complexity of the Shoulder Joint
Did you know the shoulder is the most mobile joint in the human body? This unique ball-and-socket joint allows for an impressive range of motion so you can reach overhead, throw a baseball, or go for a swim.
Unfortunately, this incredible mobility comes at a cost: instability and a high likelihood of injury. But if you understand the complexity of your shoulder joint, you’ll be well on your way to protecting it from damage.
How the Shoulder Joint Works
The shoulder joins three bones together in two different joints. The head of your upper arm bone fits in the shallow socket of your shoulder blade, forming the main joint of your shoulder. Your collarbone then connects the shoulder blade to your rib cage, forming the second joint.
However, several soft tissues also play a role in shoulder function, helping to provide additional support and stability:
Rotator Cuff
A group of muscles and their tendons that surround the shoulder joint, providing stability and controlling movement.
Labrum
A ring of cartilage that protects the shoulder socket.
Ligaments
Bands of connective tissue that connect bones and provide support.
Additional Muscles
In addition to your rotator cuff, numerous chest and upper back muscles contribute to shoulder movement and stability. Physiotherapy has been shown to help alleviate pain and mobility losses.
Understanding Shoulder Injuries
With all these moving parts, it’s no surprise that the shoulder is so vulnerable to injury! There are two main types of shoulder injuries you need to be aware of:
Acute Injuries
These injuries happen suddenly, often due to a fall or direct blow to the shoulder. Examples include fractures, dislocations, or labral tears.
Overuse Injuries
Overuse injuries develop due to repetitive overhead motions that strain the tissues in the shoulder, particularly the rotator cuff. They’re particularly common in sports like swimming, baseball, or weightlifting.
That said, not all shoulder injuries develop due to injuries. Degenerative changes in the shoulder joint, including age-related wear and tear or underlying conditions like arthritis, can cause the protective cartilage to break down, leading to pain and restricted mobility.
Dealing with Shoulder Pain? We Can Help
Regardless of the reason for your shoulder discomfort, the team at Montrose Physiotherapy and Massage can help you find lasting relief. Our physiotherapists have the knowledge and expertise to treat a range of shoulder injuries, help you rehabilitate after shoulder surgery, or teach you how to effectively manage degenerative conditions.
Schedule an appointment with us today to get started!
Healthy Recipe: Quick Summer Rolls & Peanut Sauce
Ingredients
- Rolls: 8 rice paper wrappers, 1 cup cooked shrimp (halved), 1 cup cooked vermicelli noodles, 2 cups mixed veggies (shredded carrots, julienned cucumber, lettuce), 1/2 cup mixed herbs (mint/cilantro).
- Sauce: 1/4 cup peanut butter, 1 tbsp soy sauce, 1 tbsp lime juice, 1 tsp honey, 1-2 tbsp warm water.
Directions
- Sauce: Whisk all sauce ingredients together in a small bowl until smooth.
- Soften: Dip one rice paper wrapper in a shallow bowl of warm water for 10 seconds until pliable. Lay flat on a damp surface.
- Assemble: Layer a small amount of lettuce, noodles, veggies, herbs, and shrimp on the lower third of the wrapper.
- Roll: Fold the bottom edge over the filling, fold the left and right sides in, and roll up tightly. Repeat with the remaining ingredients and serve with the peanut sauce.
Ready to Break Free From the Icy Grip of Frozen Shoulder?
If you suspect you have frozen shoulder, schedule an appointment at Montrose Physiotherapy and Massage. Physiotherapy is essential for managing the condition in all three phases, and the earlier you can begin treatment, the better your outcomes will be. Our team is here to help you manage pain, restore mobility, and understand your shoulder’s movement patterns.
Don’t let frozen shoulder hold you back. Call us today to schedule your initial evaluation!
Sources:
https://www.koreascience.or.kr/article/JAKO202032265179017.page, https://www.banglajol.info/index.php/BJMS/article/view/51550, https://ijcrr.com/uploads/2754_pdf.pdf
