Frozen shoulder, clinically known as Adhesive Capsulitis, presents a perplexing challenge for many individuals. It manifests as pain, stiffness, and a gradual loss of motion in the shoulder joint, often hindering everyday activities and causing considerable discomfort, as well as frustration as a result of not being able to partake in activities like sport.
To comprehend frozen shoulder as an injury, it’s essential to grasp the complexity of the shoulder capsule. This fibrous sheath envelops the glenohumeral joint (ball and socket joint) , providing stability while allowing for a wide range of motion. Reinforced by ligaments and supported by the rotator cuff tendons, the capsule is crucial for shoulder function.
Although the precise cause of frozen shoulder remains unclear , various factors can contribute to its development. Injury, inflammation, surgery, stroke, and systemic conditions such as diabetes and rheumatic disorders are among the known predisposing factors. The resulting scarring and thickening of the capsule lead to the hallmark symptoms of decreased range of motion and persistent discomfort.
Frozen shoulder progresses through three specific phases, each presenting its unique challenges:
- Painful or Freezing Phase: The initial phase is characterised by escalating shoulder pain, particularly exacerbated at night, this phase limits movement and sets the stage for decreased range of motion.
- Adhesive or Frozen Phase: Secondly , as the capsule contracts and thickens, stiffness becomes more pronounced, significantly impacting the ability to perform everyday tasks, sports and training . The reduction in range of motion follows a predictable pattern, with external rotation, abduction, and internal rotation affected in succession.
- Resolution or Thawing Phase: Gradually, the shoulder begins to regain mobility, at a varied pace for different individuals. While some may experience full recovery, others may contend with lingering stiffness or limited range of motion.
Diagnosing frozen shoulder relies on a comprehensive assessment, considering factors such as patient history, pain severity, range of motion, and musculoskeletal integrity. While imaging tests like X-rays and MRI scans may aid in ruling out alternative diagnoses ( e.g scapular/humeral fractures , rotator cuff injuries), clinical evaluation remains paramount.
Effective management of frozen shoulder encompasses a multifaceted treatment plan:
– Pain Management: During the freezing phase, alleviating pain and inflammation is paramount. Modalities such as heat, ice, TENS therapy, and targeted exercises offer relief while minimizing discomfort.
– Restoring Mobility: As the condition progresses, emphasis shifts to restoring range of motion and enhancing muscle strength. Physiotherapy interventions, including joint mobilizations, stretches, and muscle retraining exercises, play a pivotal role in facilitating functional recovery.
– Surgical Intervention: In cases where conservative measures prove inadequate, interventions such as injections, arthroscopic release, or manipulation under anesthesia may be considered to alleviate symptoms and restore shoulder function.
While the journey through frozen shoulder may be frustrating , it’s essential to remain diligent and proactive in seeking treatment. By collaborating closely with healthcare professionals and adhering to personalized treatment plans, individuals can navigate the challenges posed by frozen shoulder and embark on the path to recovery.
At Pretto Physiotherapy , we’re committed to empowering our patients with knowledge and support throughout their healthcare journey. If you’re experiencing symptoms of frozen shoulder or seeking guidance on managing musculoskeletal conditions, our dedicated team is here to provide personalised care and comprehensive treatment options.
Frozen shoulder may present obstacles, but with the right approach, it can be overcome. By creating a collaborative partnership between patients and healthcare providers, we can unlock the mysteries of the frozen shoulder and pave the way for improved function and quality of life.
