Frozen Shoulder

 
 
 
 
 
 

Frozen Shoulder

 
 

What is Frozen Shoulder (Adhesive Capsulitis)?

Adhesive capsulitis is the stiffening of the shoulder due to scar tissue, which results in painful movement and loss of motion. The actual cause of adhesive capsulitis is a matter of debate. Some believe it is caused by inflammation, such as when the lining of a joint becomes inflamed (synovitis), or by autoimmune reactions, where the body launches an “attack” against its own substances and tissues. Other possible causes include:

  • Reactions after an injury or surgery
  • Pain from other conditions—such as arthritis, a rotator cuff tear, bursitis, or tendinitis—that has caused you to stop moving your shoulder
  • Immobilization of your arm, such as in a sling, after surgery or fracture
  • Often, however, there is no known reason why adhesive capsulitis starts.
physical therapist working with patient

How Can Physical Therapy Help?

Your physical therapist’s overall goal is to restore your movement so that you can perform your activities and life roles. Once the evaluation process has identified the stage of your condition, your therapist will create an exercise program tailored to your needs. Exercise is most effective for those in state 2 or higher. 

Stages 1 and 2
Your physical therapist will help you maintain as much range of motion as possible and will help reduce the pain. Your therapist may use a combination of stretching and manual therapy techniques to increase your range of motion. The therapist also may decide to use treatments such as heat and ice to help relax the muscles prior to other forms of treatment. The therapist will give you a home exercise program designed to help reduce the loss of motion.
Stage 3
Treatment will focus on the return of motion, with your therapist using more aggressive stretching and manual therapy techniques. You may begin strengthening exercises, and your home exercise program will change to include these exercises.
Stage 4
In the final stage, your therapist will focus on the return of “normal” shoulder body mechanics and your return to normal, pain-free activities. The therapist will continue to use stretching, strength training, and various manual therapy techniques.

Sometimes, conservative care cannot reduce the pain. If this happens to you, your physical therapist may refer you for an injection of anti-inflammatory and pain-relieving medication into the joint space. Research has shown that although these injections don’t provide longer-term benefits for range of motion and don’t shorten the duration of the condition, they do offer short-term benefits in reducing pain.

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How Does it Feel?

Most people with adhesive capsulitis have worsening pain in conjunction with loss of range of motion. Adhesive capsulitis can be divided into 4 stages, and your physical therapist can help determine what stage you are in:

Stage 1 – “Pre-Freezing”
During this stage, it may be difficult to identify your problem as adhesive capsulitis. You’ve had symptoms for 1 to 3 months, and they’re getting worse. There is pain with active movement and passive motion (movements that a physical therapist does for you). The shoulder usually aches when you’re not using it, but pain increases and becomes “sharp” with movement. You’ll have a mild reduction in motion during this period, and you’ll protect the shoulder by using it less. The movement loss is most noticeable in “external rotation” (this is when you rotate your arm away from your body), but you might start to lose motion when you raise your arm (called “flexion and abduction”) or reach behind your back (called “internal rotation”). You’ll have pain during the day and at night.
Stage 2 – “Freezing”
By this stage, you’ve had symptoms for 3 to 9 months, most likely with a progressive loss of shoulder movement and an increase in pain (especially at night). The shoulder still has some range of motion but is limited by pain and stiffness.
Stage 3 – “Frozen”
Your symptoms have persisted for 9 to 14 months, and you have a significantly decreased range of motion. During the early part of this stage, there is still a substantial amount of pain. Towards the end of this stage pain generally decreases, occurring only when you move your shoulder to end ranges.
Stage 4 – “Thawing”
You’ve had symptoms for 12 to 15 months, and there is a big decrease in pain, especially at night. You still have a limited range of motion, but your ability to complete your daily activities involving overhead motion is improving quickly.
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Customer Testimonials

  • Patricia C.

    "Everyone is so friendly and kind. The atmosphere is very relaxed and comfortable. The PTs explain and instruct very clearly. All PTs are very professional and patient. All the staff seem to get along so well and work so well together. The reception team has been very positive, relaxed and effective."

    Patricia C.
  • Katherine T.

    "My experience here at Request has been excellent. The staff is very efficient and very focused on my needs for recovery following my surgery. I've learned how to safely use my body always maintaining proper form to protect my back for necessary body movement."

    Katherine T.
  • Jen L.

    "Very positive experience! With the staff's knowledgeable, professional and friendly approach, along with "homework", my outcome was better and quicker than I ever expected! Thank you."

    Jen L.
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2601 Manatee Avenue West Ste E Bradenton, FL 34205

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