What is a Frozen Shoulder?
Adhesive capsulitis is more commonly known as Frozen Shoulder and is characterised as chronic inflammation of the glenohumeral joint and its connective tissues. It is not fully understood what triggers the condition, but it causes pain and stiffness that limits the shoulders normal range of movement. Frozen shoulder symptoms tend to develop progressively over a few months and can last more than two years. It initially restricts movement at the end of normal active range, full flexion and abduction, but can develop to restrict all shoulder movement.
Above: Our physiotherpists will advise you on a number of technques to treat frozen shoulder.Adhesive capsulitis is one of the most common musculoskeletal conditions after back pain and neck pain. Frozen shoulder can affect anyone but is more commonly reported amongst individuals over 50, with a slightly higher number of women affected compared to men.
Frozen Shoulder can be briefly described as having three distinct phases. The initial freezing phase is characterised by the gradual onset of ache, then pain, when the shoulder joint is moved. The subsequent frozen phase describes the increasingly severe stiffness that can eventually limit all shoulder mobility. Pain begin to lessen during this stage. Finally, the thawing phase sees the pain slowly fade leaving the stiffness to decrease slowly until full functional ability is regained. The entire course of the condition may take more than two years.
It is typically the early painful stages of frozen shoulder where people seek help, then living for protracted periods with reduced range of movement in their shoulders. Whatever stage of adhesive capsulitis you suffer from, our experienced physiotherapists at Liverpool Physio can comprehensively assess you and tailor targeted treatments to address your symptoms. Early treatment can help reduce pain, regain mobility and quicken a return to full normal functionality.
What causes a frozen shoulder?
Adhesive capsulitis or Frozen Shoulder can affect anyone and is sometimes developed following injury to the shoulder, but often there is no apparent trigger for the condition. Rather than straight forward chronic inflammation, there appears to be complex genetic and neurological element to how the condition develops. Although the exact cause is unknown the following factors are thought to increase your risk of developing Frozen Shoulder;
- Age – People over 50 are at higher risk.
- Gender – Marginally more cases reported amongst women.
- Endocrine Disorders – More common if you have Thyroid problems and diabetes.
- Parkinson’s disease – higher incidence amongst people with this condition.
- Shoulder Injury – Single traumatic event or overuse injuries can increase risk.
- Shoulder Surgery – particularly when followed by protracted periods of rest.
Above: A patient effectively regaining range of motion following a frozen shoulder.
What are the symptoms of a frozen shoulder?
The principle symptom of adhesive capsulitis is the gradual onset of pain when moving the joint, particularly towards its end of range. This is followed by stiffness, which combined with the pain, leads to very restricted mobility of the shoulder. If you have a frozen shoulder you may experience the following symptoms;
- Pain – intense in the early stage of development, increases towards end of movement range, during the night or when pressure applied, such as lying on affected shoulder. Pain eases off, in the latter stages of the condition.
- Reduced range of movement – initially only marginally restricted but progressively stiffens until sometimes there is barely any active movement available. Shoulder stiffness results from joint capsule contractures.
- Affected Capsular pattern – Changes to the normal shoulder mobility. This includes reduced mobility when abducting and externally rotating the shoulder, and to a lesser degree if you extend and internally rotate the shoulder.
- Onset and duration – Unlike other shoulder injuries the gradual onset of adhesive capsulitis can takes months. It can then be more than two years before you regain pain free normal movement in the shoulder. In young people this entire process can start and finish in the space of 10 – 12 weeks.
Diagnosis of a frozen shoulder
A frozen shoulder can be diagnosed on examination by a physiotherapist or a doctor. An X-Ray is occasionally taken to confirm that there are no other problems or possible causes for the shoulder pain.
For more information about how Physiotherapy can help treat shoulder problems, or to book yourself an appointment, please email us at office@liverpoolphysio.co.uk or ring us on 0151 558 0077
What would a physiotherapy assessment for frozen shoulder involve?
If you book in for an appointment, the first session would be spent doing a comprehensive assessment before deciding on an appropriate treatment plan. Our physiotherapists at Liverpool Physio will divide this into two parts:
Subjective
A discussion between you and our physiotherapist to find out where in your shoulder the pain is, how long it has been there, what activities aggravate and ease your symptoms and how your injury is affecting you and your lifestyle.
Objective
An assessment of your pain, range of movement, muscle strength and a series of special tests to rule out other possible conditions.
What does Physiotherapy Treatment for a frozen shoulder involve?
Our experienced physiotherapists at Liverpool Physio can perform details assessments of your adhesive capsulitis and develop treatments to target your specific symptoms. Physiotherapy treatment can significantly reduce your recovery time, especially if you receive intervention early. Our aim throughout will be the quickest possible return to pain free, independent, normal functional activity. Treatment for frozen shoulder may include;
- Stretches – passive and active mobilisations exercises to maintain and improve available range of movement in the joint.
- Strengthening exercises - to maintain and improve muscle strength after long periods of stiffness and reduced joint mobility.
- Heat treatment – for pain relief and preparation of joint tissues for stretches and exercise.
- Ultrasound – Stimulate deep tissue healing response.
- Cortisone steroid injections – administered directly into the joint can bring a lot of pain relief but are only truly effective if followed by mobilisations and exercises.
Your doctor may also prescribe anti-inflammatory drugs and in extreme cases surgery is an option to stretch contracted tissue and remove any inhibiting scar tissue. Physiotherapy treatment at Liverpool Physio will keep your shoulder joint mobile with regular exercise tailored to you that will improve pain symptoms, stiffness and functional ability.
How can I arrange a physiotherapy assessment for frozen shoulder?
If you are experiencing pain, aching, swelling or stiffness around your shoulder, and feel unable to continue with your normal daily activities, you would benefit from an assessment with one of our experienced physiotherapists at Liverpool Physio.
You can contact us directly to arrange an assessment and we can advise you if further treatment is recommended, or give you details on self-management for minor cases. To arrange an appointment please email office@liverpoolphysio.co.uk or call 0151 558 007I .
Summary
Adhesive Capsulitis or Frozen Shoulder can cause severe pain in the shoulder joint that can inhibit you from engaging in normal activity. It can lead to chronic stiffness that effectively immobilises the shoulder limiting all functional use and ruling out sports participation. The condition of Frozen Shoulder can last for over two years, but with early intervention and consistent treatment this can be greatly reduced.
At Liverpool Physio we want to ensure you get the best treatment for your condition and we will use pain relief techniques, mobilisations, strengthening exercises and functional activity exercises to help you achieve the best possible recovery.
For more information about how Physiotherapy can help treat shoulder problems, or to book yourself an appointment, please email us at office@liverpoolphysio.co.uk or ring us on 0151 558 0077 .
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