We discussed in our video how to identify if you have a frozen shoulder. In some cases a frozen shoulder could be confused with a rotator cuff tear, labral tear, shoulder impingement or cervical injury. A frozen shoulder also known as adhesive capsulitis is somewhat of an enigma in orthopedic physical therapy. We do know that some people are at greater risk of developing a frozen shoulder or a adhesive capsulitis, which include persons with diabetes, thyroid problems, typically women, persons between 40 and 60 years of age, and postsurgical shoulder cases. It is often of gradual onset, but can occur after a fall on your shoulder or significant trauma. Often the patient can experience significant night pain and difficulty raising your arm in multiple directions, but especially to the side.
When seen by a physician they will often to rule out whether there is not a contribution to the current stiffness by taking routine x-ray or pain. Most times. An MRI is not generally generally warranted, The diagnosis is made partially by the length of time the person is had the problem, x-rays an assessment of the patient’s range of motion. Generally it is a loss of motion in every plane specifically coming from the glenohumeral joint. This this joint and the surrounding capsule shrinks in size for unknown reasons , contributing to less motion at the shoulder. Often times since the motion is so restricted, you may develop problems at the cervical spine, sternolclavicular and acromioclavicular joints depending on length of time the patient has had this problem.
There are three phases that a patient will progress through who has a frozen shoulder. The first phase is 3 to 6 months and is termed the freezing phase. The second phase is the frozen phase where you have no change in range of motion for upwards of 12 to 18 months. Lastly, the thawing phase can last upwards of 12 to 24 months and sometimes longer upwards of three years. Typically, physical therapy will be started in the early freezing phase. We provided three of our top range of motion exercises in our video. . Is important in the early freezing phase, not to aggressively stretch the shoulder which can lead to gradually less motion. Often times patients during the course of treatment may also receive a cortisone injection. One of the last resorts is to get a mobilization under anesthesia.