Recovering from Frozen Shoulder – What Steps Should You Take?

Frozen shoulder, also known as adhesive capsulitis, is a condition that affects the shoulder joint. It is usually characterized by immense pain and stiffness. Another form of frozen shoulder is periarthritis. This condition affect the ligaments surrounding the shoulder joint (articular shoulder capsule). The shoulder capsule swells up and becomes stiff, thus restricting the patient’s mobility.

Causes of Frozen Shoulder

Understanding the onset of frozen shoulder can be difficult as there are no clear causes to explain the condition. Generally, medical professionals believe that this condition is caused due to physical injury and blunt force trauma. Other medical conditions such as tendinitis, bicipital tendinitis, and dislocation, which affect the shoulder joint, can lead to the onset of frozen shoulder.

Risk Factors of Frozen Shoulder

While the direct causes may not be known, doctors are aware of the various risk factors that can lead to the onset of frozen shoulder in a patient. Common risk factors for frozen shoulder are:

  • Age – Being over 40 years of age
  • Complication of  Colles fracture
  • Stroke patients are also likely to be afflicted with frozen shoulder
  • Gender – 70% of women are likely to be afflicted with the condition
  • Recent surgery or arm fracture – Immobility during recovery may cause the shoulder capsule to stiffen.
  • Diabetes – This condition increases the risk of frozen shoulder
  • Patients suffering from Parkinson’s disease can also be affected
  • Hyperthyroidism & Hypothyroidism
  • Cardiovascular disease with referred shoulder pain can lead to frozen shoulder

Pathology   

Repeated overhead activities involving the shoulder, biceps, and rotator cuffs can place immense strain on the shoulder joint. The result of this is inflammation and formation of excess fibrous tissue in the shoulder. This leads to the thickening of the shoulder capsule, which results in loss of shoulder movement. If these symptoms are not taken care of at the beginning, it can cause the small scapular and bicep muscles to degenerate faster.

Clinical Features

The most pervasive symptom of frozen shoulder is a stiff shoulder joint along with continuous pain. Patients can learn how to treat a frozen shoulder by understanding the three stages of recovery.

  1. Stage I – Shoulder Movement Inability and Pain: The patient first complains of acute pain, and a decrease in various shoulder movements. These movements are defined as Abduction, External Rotation, and Forward Flexion. This stage lasts for 10 to 36 weeks.
  2. Stage II – Stiffness: In this stage, the pain gradually decreases, but the stiffness continues to affect the patient. He is only able to perform mild shoulder movements.
  3. Stage III – Recovery: This is the last stage, where the patient does not experience any pain, and the movement in the shoulder begins to improve. However, the pain may occasionally reoccur from time to time.

Treatment of Frozen shoulder

The treatment of a frozen shoulder usually requires a combination of anti-inflammatory medication and physiotherapy.  Physical therapy is essential for recovery and includes ice packs or hot packs, electric stimulation, and a variety of motion, stretching, and strengthening exercises. Along with these, patients can also perform some remedial exercises at home, which are simple, easy to do, and at regular intervals.

The following exercises should be performed in chronological order.

  1. Pendulum Exercise: Relax your shoulders and use a table or chair for support. With one arm on the table, stoop forward slightly and let your affected arm hang down like a pendulum. Slowly swing the hand front and back, left and right, and in circular motions. It would be advisable to perform this exercise twice a day with 10 repetitions.
  2. Wall Ladder Exercise: Stand with your afflicted side next to a wall. Placing your hand on the wall, and slowly raise your arm as high as comfortably possible. Keep raising your arm until you feel a stretch in the shoulder. Hold the position for at least 10 seconds and then release. You can perform the same exercise facing the wall as well.
  3. Towel stretch: Keeping your back straight, take a towel and hold it behind your back in a vertical position. Use your unaffected arm to gently pull the affected arm in an upward direction and stretch it.
  4. Doorway Stretch: Stand in front of a doorway and place your hands on either side of the door. Ensure that the door stopper has been applied and that the door cannot move. Once you are comfortable, slowly lean forward stretch your shoulder till you are comfortably tired.
  5. Shoulder Elevation: Lie down your back, lift your affected arm and support it by using your other hand. Slowly lift the hand over your head till and stretch the shoulder.
  6. Chair exercise: Sit up straight in a chair, raise your arms from the sides till they are level with your shoulders. Slowly move your arms left to right and vice versa. You can also raise your arms above your head and slowly bend your body to one side.
  7. Hands to back exercise: This exercise will help the shoulder to perform all the motions of extension, abduction, rotation, and flexion. Rotate your arm towards your back. Place the top of your hand onto the middle section of the back with your thumb pointing upwards you’re your fingers pointing out.
  8. Upward Shoulder Stretch: This is a simple exercise that can be done while sitting or when standing. Stand in a straight position, lift your arms above your head, and stretch your shoulder. Then lower your arms, bringing them to the side of your body. Repeat until comfortably tired.
  9. Cross Body Stretch: Extend your affected arm to the opposite side of your chest. Place your other arm at the elbow, and slowly push the affected arm towards the chest. This will create a stretch in the shoulder blade. Hold this stretch for five seconds and then release.
  10. Stick Exercise: In a standing position, hold out a stick or pole with both hands. Stretch your arms forward so that the shoulders will get flexed.
  11. Bed sided Exercise: Lie down on your back and hold a stick with both hands. Push the stick and your arms out toward the ceiling. Ensure that your shoulders lift off the bed slightly with each push.
  12. Standing Push Ups: In a standing position, place your hands on a table, keeping a decent space between the arms. Keeping your back and elbows straight, bring the shoulders blade together now push away from the table as far as away
  13. Seated Chair Press: Sit at the edge of the chair, with your feet firmly placed on the floor. Hold the side of the chair, keeping your hands in line with your shoulders. Raise and lower your shoulders and shoulder blades; let your hands put more pressure on the chair and elevate your body as you do so.

It is important to rest your shoulders once these exercises have been completed. You can apply an ice pack or hot pack for 10 to 15 minutes.

A complete understanding of the condition, following medical precautions, and performing the treatment exercises can help you recover from frozen shoulder without experiencing too much pain or stiffness.