Frozen Shoulder

What is a frozen shoulder?

The shoulder is made of the ball and socket joint which is called the glenohumeral joint and the shoulder blade (scapular). A frozen shoulder affects the ball and socket joint where the joint is encased in a fibrous capsule that thickens and tightens when you have a frozen shoulder also known as adhesive capsulitis. 

What are the causes of frozen shoulder?

No one really knows what causes the capsule around the joint to thicken and get tight and inflamed. This can happen for no known reason called an idiopathic frozen shoulder or it can happen after a traumatic injury or post surgery called a secondary frozen shoulder.

There are 3 main phases of a frozen shoulder that can vary from person to person on how long it takes to get through each of these phases.

1. Freezing phase- The shoulder gets more painful and the range of movement in the shoulder starts to get more and more stiff.
2. Frozen phase – The pain starts to ease but the shoulder is very stiff and movement is restricted.
3. Thawing phase- The stiffness gradually starts to ease on its own.

Individuals may experience these slightly differently and they may last for different amounts of time. A frozen shoulder can last upto 2.5 years before it can go away on its own. This is known as a self limiting condition. The aim of Physiotherapy is to try to speed up the process, help manage the pain and maintain as much range of movement in the shoulder as possible while the shoulder is going through this condition.

How do I know if I have a frozen shoulder?

Your GP or Physiotherapist will ask you some questions about  your medical history, symptoms and the pattern of the symptoms and movement restriction. They will then physically assess your shoulder to rule in or out other similar conditions of the shoulder. A frozen shoulder is usually easy to diagnose due to the stiffness in the shoulder, particularly when reaching out to the side with the elbow close to the side of the body called external rotation. 

What is the treatment?

Your Physiotherapist will assess the amount of movement you have to start with and give you specific exercises to help you increase this range of movement and ease the pain. Your Physiotherapist will use some hands on techniques to further increase the movement at your shoulder. Posture advice while working, sleeping and carrying out day to day activities may help manage the pain and help restore normal activity as soon as possible. The therapist will discuss techniques to help manage the pain and how regularly to perform the exercises.

Useful tips:

• Sleeping with a pillow to support the shoulder to make it more comfortable at night
• Try to keep using the arm if able to maintain the range of movement within pain limits.
• To get professional diagnosis and advice to help reduce the pain and improve movement as much as possible.
• A steroid injection or hydrodilatation may be beneficial in helping you manage the symptoms in more severe cases.
• Surgery to release the capsule is less common but an option if movement is not improving.