01/12/2021
Frozen shoulder is a condition that affects shoulder joint. It usually involves pain and stiffness that typically begin gradually, worsen over time and then resolve, usually within one to three years.
It is also called Adhesive Capsulitis of Shoulder Joint.
Developing frozen shoulder depending upon condition that limit or restrict shoulder joint movement eg. post fracture shoulder stabilize and not allowed to do movement and may lead to joint stiffness, paralysis or pain around shoulder joint may also contributing factor in developing stiffness of joint.
In frozen shoulder, the capsule becomes so thick and tight that it’s hard to move. Bands of scar tissue form and there’s less of a liquid called synovial fluid to keep the joint lubricated. These things limit motion even more.
Treatment for frozen shoulder involves shoulder joint range-of-motion mobilization exercises and medications that relieve pain also Called NSAIDS /injected pain reliever medicine into the joint capsule. In a small percentage of cases, arthroscopic surgery may be indicated to loosen the joint capsule so that it can move more freely.
It’s unusual for frozen shoulder to recur in the same shoulder, but some people can develop it in the opposite shoulder.
Frozen Shoulder Anatomy
Anatomy Of Shoulder Joint :
To Understand Frozen shoulder, we must have basic understanding of shoulder joint anatomy and function of joint. Shoulder joint is made up of three bones that form a ball-and-socket joint. They are your upper arm (humerus), shoulder blade (scapula), and collarbone (clavicle). There’s also tissue surrounding your shoulder joint that holds everything together. This is called the shoulder capsule.
Cause – Frozen Shoulder
It is not exact reason why some people develop it, but some groups are more at risk.
It happens more often in women than men, more likely to be between the ages of 40 and 60. People which are risk might also go up if in the process of recovering from a medical condition like a stroke, or surgery like a mastectomy that keeps you from moving your arm.
Certain medical conditions can increase risk too. People may also be more likely to get frozen shoulder if you have diabetes. About 10% to 20% of people with diabetes get frozen shoulder. Other medical problems like heart disease, thyroid disease, or Parkinson’s disease are linked to frozen shoulder, too.
Which Symptoms are common in Frozen Shoulder ?
The common symptoms are pain and stiffness that restrict shoulder joint to movement and may lead to difficult to use shoulder joint in day to day activity.
If anyone have frozen shoulder, you’ll likely feel a dull or achy pain in one side of shoulder. You might also feel the pain in the shoulder muscles that wrap around the top of your arm. You might feel the same sensation in your upper arm. Your pain could get worse at night, which can make it hard to sleep.
There are typically go through three phases with a frozen shoulder. Each has its own unique symptoms and timeline.
Stage 1 : Freezing stage :
Shoulder joint pain (sometimes severe)
It slowly gets worse over time and may hurt more at night.
This can last anywhere from 6 to 9 months.
Stiffness of Shoulder Joint / Restriction of Shoulder Joint Movement
Stage 2 : Frozen stage :
Shoulder pain Fluctuating but Joint stiffness gets worse.
Moving shoulder joint becomes more difficult and it becomes harder to get through daily activities.
This stage can last 4-12 months.
Stage 3 : Thawing stage :
Shoulder Joint range of motion starts to go back to normal.
This can take anywhere from 6 months to 2 years.
How Diagnosis is done?
Physiotherapist or Doctor will Examine shoulder Joint, physical examination Mainly type of pain, Other Medical History of patient, Range of Motion Examination.
A physical examination is usually enough to diagnose frozen shoulder, but sometimes doctor may also order imaging tests such as X-rays, ultrasound, or MRI to rule out other problems like arthritis or a torn rotator cuff that can also cause pain and limit how far it moves.
Treatment of Frozen Shoulder :
To reduce pain non-steroidal anti-inflammatory drugs (NSAIDs) can help relieve the pain and inflammation in your shoulder. If they don’t help, doctor might prescribe a stronger medication.
If symptoms are intense or don’t improve over time, doctor might recommend other kinds of treatments, including:
A corticosteroid injection in shoulder joint to reduce pain and improve range of motion.
Joint distension. This means doctor will inject sterile water into shoulder capsule to stretch it. This will may improve shoulder joint movement.
Physiotherapy Management :
Shoulder Exercise to improve Range Of Motion
Physiotherapy Exercise are mostly preferable option nowdays, Natural Treatment and No Side Effects that’s why mostly choosen option of all other way of Treatment.
Shoulder joint stiffness and pain are common in Frozen shoulder, so Symptomatic Physiotherapy Treatment is designed according. First Physiotherapist take Range of Motion of Each Movement , Type and area of pain identified, according to which treatment plan are decided.
To Control Pain :
Pain Relieving Modalities Like Short Wave Diathermy (SWD), Ultrasound Therapy, Interferential Therapy, TENS, LASER are used to improve pain and relieve muscle spasm and other co-related other symptoms.
Why Do Exercise for Frozen Shoulder ?
Benefits Of Exercise
To Improve Range Of Motion Exercise :
After Examination of Range Of Motion Of Movement, Checking End feel, Physiotherapist Suggest Few Exercise at Home and Few Exercise in clinic with the Help of Equipment in clinic and mobilization technique are used to improve R.O.M.
Home Exercise Guideline :
Here we Update few Simple Exercise anyone can do exercise at home on convenient Time :
(1) Passive Range of Motion Exercise of Shoulder Joint :
Few Best Exercise IN Frozen shoulder
To Do Passive Movement we should use opposite hand and do shoulder flexion and try to uplift the hands towards heads try to improve R.O.M, This exercise will improve shoulder flexion and gradually increase Repetation and Early morning and evening session – two time a day are more Helpfull.
(2) Active Movement of Shoulder Joints :
Active Movement are useful to maintain R.O.M off All Movement and also improve muscle tone also this can be done two times a day and Gradually increase repetition day by day.
(3) Wall Sliding with Help of Finger :
Wall Sliding Exercise
Wall sliding with Help of Finger is improve shoulder flexion and Abduction movement and are easily done at home and recommended two times a day and simple home exercise.
(4) Shoulder Towel Stretches :
Shoulder Stretching Exercise
This Exercise will improve Rotation movement of shoulder joint and Gradually stretching is Recommended and two times a day and Gradually improve Repetition also.
(5) Rope and Pully Exercise :
Rope and Pully are commonly used By Physiotherapist , Mostly Ready made pully available in market , this is used widely , Easily available and This will improve Flexion and Abduction Range.
(6) Shoulder Pendular Exercise :
Shoulder Pendular Exercise
Shoulder Pendular Exercise is Helpful for Early Warm up and Reduce Pain sometimes. Easy Exercise and Do at Home anytime.
(7) Use Of Affected Shoulder in Day To Day Activity :
Pain in shoulder may limit the movement and we reducing use of this shoulder and adversely affect shoulder and become more stiff. so use of shoulder in day to day activity is best way of Treatment.
(8) Use Of Stick :
Stick are used to improve mainly flexion movement and Abduction Movement, These are the common Exercise, Anyone can do 2 times a day and Gradually increase Repetation are Recommended.
Surgery : This is very rarely necessary to treat frozen shoulder. But if other treatments haven’t helped, your doctor may suggest surgery. It likely would be an arthroscopic procedure. That means it’s done with lighted, pencil-sized tools that are inserted through tiny cuts in your shoulder.
Shoulder manipulation under anesthesia can help loosen up your shoulder tissue, but is very rarely done anymore because Surgeons would forcefully move the shoulder under general anesthesia. With this method, there was an increased risk of complications including fractures and Tissue injury.
Preventive Measure and care During Frozen Shoulder :
Gentle, progressive range-of-motion exercises, stretching, and using your shoulder in day to day activity more may help prevent frozen shoulder after surgery or an injury. Diabetes under control, Pain Free Regular Exercise and Use Of Hot and Cold Pack are also Natural Way Of control pain and stiffness.
Other Shoulder Joint Related Post :
Shoulder Hand Syndrome
Next Read: Frontalis Muscle - Details and Exercise »
