Frozen shoulder

Training with knee pain

The fast facts:

  • Women are more likely to have a frozen shoulder than men
  • In the age group of 40-59, a 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, which means that symptoms will eventually disappear without any real need for intervention 
  • The condition can last from 4 months to 3 years 

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. As a result, you may be limited in your daily life. For example, the reduced mobility in the shoulder can make it difficult to comb your hair, reach for something from your back pocket, or grab something above shoulder height. Also, the pain can cause problems with sleeping.

The cause of a frozen shoulder is often not clear. What we do know is that the chance of developing a frozen shoulder is greater when there has been surgery or a trauma moment (i.e. a fall or a collision). Also, people with, for example, diabetes or people with an autoimmune disorder have a greater chance of developing a frozen shoulder. It occurs more often in women than in men and in people with an age between 40 and 59 years. 

A frozen shoulder is a "self-limiting disease. This means that the disease process can go away by itself. Depending on recovery factors, the total duration of the disease can vary from 4 months to 3 years or 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 rigid phase. In this phase, there are fewer pain symptoms, but the mobility of the shoulder has greatly deteriorated.

Phase 3, also called thawning phase. In this phase the shoulder "thaws". The pain will continue to decrease and the mobility will gradually increase again.

Cruciate ligament injury

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 the shoulder blade is called the glenohumeral joint. The clavicle with the scapula is the acromioclavicular joint. Another joint of the shoulder area is the scapulothoracic joint. This is the joint between the scapula 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 different daily movements. There are smaller muscles that are closer to the joint but also 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 have largely the same function. In an unimpaired shoulder, the glenohumeral capsule, the capsule around the glenohumeral joint is stretchy, 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 range of motion of the shoulder. There may also be a decrease in synovial fluid in the joint. This synovial fluid, also called 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 anamnesis a recognizable pattern as with frozen shoulder we will do some tests. There is no specific test to diagnose a frozen shoulder. In practice, we test the active and passive motion of the shoulder. Together with the recognizable symptoms and the course of the complaint, the diagnosis of a frozen shoulder can be suspected. 


    Common symptoms of a 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
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    The treatment for a frozen shoulder

    The treatment of a frozen shoulder consists of several aspects. In the first instance, we choose pain relief by means of massage. Then we look at the range of motion in the shoulder and we will tackle it specifically by mobilizing exercises in the room and exercise room. In the treatment we take into account the reactivity of the shoulder together with the phase in which the shoulder is located. At the beginning of the treatment period the emphasis lies on relatively painless 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 exercises are performed towards all end positions. Sometimes a corticosteroid injection may be chosen. Especially in the first phase of the course, this can provide relief from the symptoms. In later stages it has little or no added value. Other painkillers can possibly provide some relief and provide some rest between treatments. 

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