Physical therapy at a

Frozen shoulder.

The fast facts:
  • Women are more likely to have frozen shoulder than men

  • In the 40-59 age group, frozen shoulder is most common

  • People with an autoimmune disease or diabetes are more likely to develop a frozen shoulder

  • Sometimes a frozen shoulder occurs as a result of a fall or surgery

  • A frozen shoulder is a self-limiting disease, meaning that symptoms will eventually disappear without intervention really being necessary

  • The condition can last from 4 months to 3 years

Trochantor major syndrome
What is a frozen shoulder

Frozen shoulder, also called frozen shoulder or adhesive capsulitis, is a condition of the shoulder that involves pain along with limited range of motion of the shoulder. This may limit you in your daily life. For example, the reduced mobility in the shoulder can make it difficult to comb your hair, grab something from your back pocket or grab anything above shoulder height. The pain can also cause difficulty sleeping.

The cause of a frozen shoulder is often not clear. What we do know is that the risk of developing a frozen shoulder is greater if surgery or a moment of trauma (i.e. a fall or collision) has preceded it. Also, people with diabetes or people with an autoimmune disorder have a greater chance of developing a frozen shoulder. It is more common in women than in men and in people between the ages of 40 and 59.

A frozen shoulder is a "self-limiting disease. This means that the disease process may go away on its own. Depending on factors impeding recovery, the total duration of the condition can vary from 4 months to 3 years or sometimes more. The course of a frozen shoulder always runs in 3 characteristic phases

Phase 1: also called freezing phase or painful phase. In this phase, there is mainly pain in the shoulder.

Phase 2: also called frozen phase or stiff phase. In this phase, there is less pain, but the mobility of the shoulder is greatly reduced.

Phase 3: also called thawning phase. In this phase, the shoulder ''thaws out.'' The pain continues to decrease and mobility will gradually increase again.

    Anatomy and function of the shoulder

    The shoulder joint consists of the humerus(upper arm bone), scapula(shoulder blade) and clavicle(collarbone). The joint between the upper arm and shoulder blade is called the glenohumeral joint. The clavicle with the shoulder blade is the acromioclavicular joint. Another joint of the shoulder area is the scapulothoracic joint. This is the joint between the shoulder blade and the ribs. These joints allow the shoulder to move in many different directions. The shoulder contains many different muscles and tendons. The function of these muscles is to move and stabilize the shoulder during various daily movements. There are smaller muscles that are closer to the joint as well as larger muscles that have a more powerful function. Anatomically, a distinction is made between a local muscle system and a global muscle system. Functionally, however, they largely have the same function. In a non-restricted shoulder, the glenohumeral capsule, the capsule around the glenohumeral joint is extensible, long and does not restrict the normal range of motion of the shoulder. The function of this capsule is to provide strength in the shoulder. In frozen shoulder, the capsule of the glenohumeral joint tightens due to an inflammatory reaction. This limits the mobility of the shoulder. There may also be a decrease in synovial fluid in the joint. This synovial fluid, also known as joint fluid, allows joint surfaces to move smoothly in relation to each other by minimizing friction.


    Physical examination for a frozen shoulder

    If we recognize with during the history a recognizable pattern as in frozen shoulder we are going to do some tests. There is no specific test to diagnose frozen shoulder. In practice we test the active and passive movement in the shoulder. Together with the recognizable symptoms and course of the complaint we can then make a suspicion about the diagnosis of frozen shoulder.


    Common symptoms in frozen shoulder pain when lying on the shoulder
    • pain when lifting the arm
    • pain when turning the arm outward with the elbow in the side
    • Sometimes there is radiation in the upper arm
    • Quick and unexpected movements cause pain
    The treatment for a frozen shoulder

    The treatment of a frozen shoulder consists of several aspects. Initially, we choose pain relief through massage. Then we look at the range of motion in the shoulder and address it specifically through mobilizing exercises in the room and exercise room. During treatment, we take into account the reactivity of the shoulder along with the stage the shoulder is in. At the beginning of the treatment period, the emphasis is on relatively pain-free exercises to increase or maintain mobility. At a later stage, it is necessary to optimize the entire chain of motion of the shoulder girdle, and more active exercise is done toward all end positions. Sometimes a corticosteroid injection may be chosen. Especially in the early stages, this can provide relief of symptoms. In later stages, it has little to no added value. Other pain relief may possibly provide some relief and provide some rest between treatments.

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