AthletePlus - Springdale, Arkansas - Athlete Plus - Physical Therapy - Sports Training - Athlete Plus - Speed Training - AthletesPlus - Core Training
| AthletePlus - Springdale, Arkansas - Athlete Plus - Physical Therapy - Sports Training - Athlete Plus - Speed Training - AthletesPlus - Core Training |
Phone: 479-751-THER (8437) |
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| What is Frozen Shoulder? One of the most painful shoulder injuries.  Ages 40-70 and woman greater than men. Causes include not using shoulder after minor injury, overuse, or no apparent reason. Three phases to primary frozen shoulder. Frozen shoulder (adhesive capsulitis) can be defined as active and passive shoulder motion is restricted in all plans of motion. The patient usually has one shoulder that hurts with little or no injury, night pain, and can not raise shoulder above the head. Exactly what happens in the joint includes the following: the capsule is thickened and tight around the end of the upper arm or ball of shoulder (humeral head). There is no fluid in the joint (synovial fluid) and part of the capsule (axillary fold) is not present.(1) The three phases of frozen shoulder: 1. Painful Freezing Phase: All movements increase pain and may be worse at night. Patient can not raise their arm above their head. 2. Frozen or Stiffening Phase: The pain goes away when the patient stops using the shoulder, so the patient feels he or she is helping the situation. The patient is making the situation much worse. 3. Resolution or Thawing Phase: Movement improves and pain decreases. Some studies say it lasts 12-30 months, but our experience has been less time than that. The way a therapist diagnoses frozen shoulder is that all planes of motion are affected, unable to go above 90 degrees out the side, and patient has same movement when we move it as when the patient does all the work. Not all patients will respond to treatment and there is a chance that frozen shoulder can return if the patient does not use the arm in the new motion gained above the head. Treatment: The best treatment is prevention and education to patients. Phase 1 treatment: Manual therapy with the therapist working on the movement of the shoulder. This treatment can be painful for the patient. Phase 2 treatment: The patient can now go out to side above the level of their neck (or 90 degrees). Treatment continues with manual therapy, wand and pulley exercises, shoulder blade strengthening (core scapular strengthening), and e-stim/moist heat etc. (modalities). Phase 3 treatment: The patient gains the last part of the motion (last 20-30 degrees of flexion). Other Treatment Options: Closed Manipulation under Anesthesia - Basically, the patient is put under and the doctor manually moves the shoulder above the head, tearing part of the capsule, to gain the last amount of motion. This option is usually for those who have failed at physical therapy. Again, the frozen shoulder may return again if the patient does not use the new range of motion immediately gained from the manipulation. There should be no use of a sling. Another option is arthroscopic surgery that your doctor would advise on the use. Our Experience at AthletePlus: We have had patients improve with treatment for 1-2 months. We have also had patients who could not handle the treatment because of the severe pain. One of those chose the manipulation and improved also. Related Articles How Long Do I Ice? What is Shoulder Impingement? Should My Hand be in a Certain Position When I Raise My Arm Above My Head to Prevent Impingement? What is the Rotator Cuff? What Causes Rotator Cuff Tears? REFERENCES 1. Orthopedic Management of the Upper Quarter. North American Sports Medicine Institute. 2003 This article is provided for information and entertainment purposes only. The content is provided "as is" for general information and to educate the reader. The article is not intended to serve as medical advice, diagnosis or treatment. The content should not be considered complete and should not be relied on to suggest a course of treatment for a particular individual suffering from a particular problem, issue or medical need. The reader should always consult with a qualified health care provider familiar with the reader's general health, background and conditions and follow the advice given by the health care provider. Always consult with your physician or other qualified health care provider before starting a new diet, treatment or fitness program. Do not delay seeking specific advice or care or disregard the advice of your health care provider based on information contained in this article. Article Date: July 2009 |
So what should you do? If you have shoulder pain or can not raise your arm above your head, see your sports medicine physician or physical therapist for an evaluation. If you are diagnosed with frozen shoulder, go to physical therapy as soon as you can to begin treatment. Do not just stop using the shoulder or you will cause the situation to get worse, even though it may initially feel better. |