Frozen Shoulder – A Physiotherapist’s Role
By Stacey Van Schyndel PT
Frozen Shoulder (or Adhesive Capsulitis) is a painful rheumatological condition that has no known origin and therefore cannot be prevented. It is more prevalent in women, individuals with diabetes, hyperthyroidism, low body mass index, and those of British descent. It usually affects individuals between the ages of 40-60. It can last anywhere from 4 months to 2 years and typically follows three stages: the painful inflammatory phase (0-4 months), the freezing/stiffening phase (4-12months) and the thawing/recovery phase (12-18 months).
Typically, the shorter the painful inflammatory phase, the shorter the entire episode of frozen shoulder will be. Therefore, it is important to do whatever we can to decrease the length of this phase. This is one condition where a physiotherapist will encourage the use of cortisone shots. Assuming the cortisone shot is administered correctly and ends up in the right place, the earlier the cortisone shot, the shorter the inflammatory stage. Additionally, the cortisone shot will help relieve pain at rest and allow you to sleep more comfortably. Physiotherapy during this stage involves providing you with a home exercise program to maintain as much shoulder movement and strength as possible.
During the freezing, or stiffening stage, your physiotherapist will encourage you to use your arm as much as possible but regular physiotherapy visits may not be necessary. We will track your range of motion and if you are making improvements then we will keep regular appointments. If your progress plateaus, follow ups are spread out to monthly (or further) to monitor your progress and change your home exercise program as needed. Manual therapy during this stage is generally counter-productive as we will likely be unable to change the course of the freezing stage. Occasional check-ins with your therapist are still important as they will help to indentify when you have moved into the thawing phase and when it is time to start aggressively treating your shoulder.
Physiotherapy plays the biggest role during the thawing, or recovery, phase – the stage when the pain at rest disappears and only comes on with movement. It is during this time that physiotherapists will work aggressively with individuals to regain as much range of motion as possible. Manual therapy and home exercises will produce lasting changes in your shoulder mobility during this phase and we will work with you to ensure a full recovery.
No matter what phase you find yourself in, physiotherapists have a significant role to play, and we will help you through this journey.
For more information on frozen shoulder treatment or if you think you have frozen shoulder and would like an assessment, please contact us at 705-788-1480 or check us out on our website at www.proactiverehab.com.