Adhesive Capsulitis, more commonly known as Frozen Shoulder has many different ideologies. The most frequent cause of Frozen Shoulder is an injury to the shoulder that causes excessive inflammation and pain. If the pain is excessive, and the patient prevents movement of the shoulder, scar tissue can form in the shoulder capsule. The scar tissue or adhesion limit the elasticity of the joint, hence decrees the ability to lift the arm. This can happen very fast, sometimes two week of no movement can lead to a Frozen Shoulder.
According to the mayo clinic, a frozen shoulder is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years.
Some causes for frozen shoulder are:
- Thyroid problems
- Changes in your hormones, such as during menopause
- Shoulder injury
- Shoulder surgery
- Open heart surgery
- Cervical disk disease of the neck
Treatment requires a delineation of the cause, in other words you need understand how the issue came to be and treat accordingly. Using the same approach for every frozen shoulder would be a mistake. Therapists and specialists need to evaluate each patient as an individual and create a plan of care that is customized for the patient.
The treating therapist must be attune the level of inflammation and the pain to assure a successful treatment outcome.
Why should you see a physical therapist?
Your physical therapist will help you maintain as much range of motion as possible and will help reduce the pain. Your therapist may use a combination of stretching and manual therapy techniques to increase your range of motion. The therapist also may decide to use treatments such as heat and ice to help relax the muscles prior to other forms of treatment. The therapist will give you a home exercise program designed to help reduce the loss of motion. In the final stages, your therapist will focus on the return of “normal” shoulder body mechanics and your return to normal, everyday, pain-free activities.
Stages of a Frozen Shoulder:
Stage 1 – “Pre-Freezing”
Patient has shown symptoms for 1 to 3 months and is worsening. Movement increasingly creates more pain and range of motion lessens.
Stage 2 – “Freezing”
Patient has had symptoms for 3 to 9 months, most likely with a progressive loss of shoulder movement and an increase in pain (especially at night). The shoulder still has some range of movement, but this is limited by both pain and stiffness.
Stage 3 – “Frozen”
The patients symptoms have persisted for 9 to 14 months, and you have greatly decreased range of shoulder movement. During the early part of this stage, there is still a substantial amount of pain. Toward the end of this stage, however, pain decreases, with the pain usually occurring only when you move your shoulder as far you can move it.
Stage 4 – “Thawing”
Patient has had symptoms for 12 to 15 months and pain is slowly decreasing with limited range of motion but able to do more daily activities.