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Shoulder pain

Frozen Shoulder

Shoulder pain � Frozen shoulder

Medically this is known as Adhesive capsulitis. It is a common and often very painful condition of the shoulder that can occur through injury to the shoulder, overuse of the shoulder or occasionally following surgery to the shoulder. It can also occur for no known reason. It is associated with a gradual loss of range of movement in the shoulder and can be divided into three stages.

Stage one � painful stage

The individual becomes aware of pain in the shoulder with certain movements such as placing the arm in a coat, fastening a seat belt or reaching out with the arm.

Stage two � freezing stage

The individual becomes aware of a gradual loss of movement in the shoulder. It is thought that this is due to the capsule which surrounds the shoulder joint becoming thickened and contracted. Typically this process may occur over a period of four to twelve months. In some cases the freezing stage is also associated with a reduction in pain and stiffness in the shoulder is the main complaint.

Occasionally the stiffness can also cause other structures in the shoulder to become inflamed and irritated leading to secondary conditions such as bursitis (inflammation in the small fluid filled sac which sits between the bone and tendons in the shoulder) and inflammation of the tendons in the shoulder. When this occurs, the individual may also have pain whilst trying to sleep on the affected side.

Stage three � Thawing stage

This stage is associated with a gradual improvement and restoration of movement in the shoulder. It can take 18 months to two years for a frozen shoulder to resolve.

Diagnosing a frozen shoulder

The gold standard for diagnosis for frozen shoulder is to have an X-Ray to rule out any other cause for the stiffness in the shoulder. A diagnosis of frozen shoulder is normally given following a normal X-Ray. Physiotherapists normally rely on the history of onset and examination to determine the diagnosis. It is not fully understood why a frozen shoulder occurs. It tends to affect more women than men around the ages of 40-60 years. It has been suggested that people with diabetes are more susceptible to getting a frozen shoulder.

Physiotherapy for frozen shoulder

The good news is that a frozen shoulder is a self-limiting condition and in many cases will resolve itself without any intervention. The bad news is that symptoms can last a very long time making every day functional tasks very difficult. Seeking advice and treatment from a physiotherapist can significantly reduce the time symptoms can last.

Treatment for a frozen shoulder normally entails passively and gently stretching and mobilising the shoulder and shoulder capsule to encourage more movement. Exercises are also taught so the patient can work on improving their shoulder movement at home.

Shoulder impingement/sub acromial bursitis

This term refers to a catching or pinching of the structures which lie between the shoulder joint and the roof of the shoulder (the acromion). When the shoulder is moved, structures such as tendons of the rotator cuff muscles can become pinched which causes inflammation and pain. Occasionally, the bursa (a small fluid-filled sac which sits between a bone and a tendon) can also become inflamed which causes pain whilst trying to sleep on the affected side.

There are several causes for why a shoulder impingement may occur ranging from poor posture, overuse, trauma to the shoulder and degenerative changes/arthritis.

It is common to identify muscle imbalances which prevent the shoulder joint from sitting in its correct anatomical position. When this is the case, corrective exercises are prescribed with the aim of restoring the normal biomechanics of the shoulder thus preventing the impingement from occurring.

For more information or to book an appointment please call 01322 275 402 or email info@westhillphysio.co.uk. Alternatively please feel free to complete the form below.
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