Frozen Shoulder
What is Frozen Shoulder?
Adhesive capsulitis, often known as Frozen shoulder, is a painful disease in which the shoulder's range of motion is reduced.
When this occurs, the shoulder joint capsule—a thick, inflexible, and inflammatory ring of connective tissue around the shoulder joint—becomes a frozen shoulder. (The ligaments that lock the joint in place by connecting the top of the upper arm bone (humeral head) to the shoulder socket (glenoid) are found within the joint capsule. This joint is more often known as a "ball and socket" joint.)
The syndrome is termed a "frozen shoulder" because the shoulder is less likely to be used as it becomes increasingly uncomfortable. Due to inactivity, the shoulder capsule thickens and tightens, becoming "stuck" in place and making mobility even more difficult.
What are the different stages of a Frozen Shoulder?
Frozen shoulder usually develops gradually in three phases.
Freezing
Any movement of the shoulder generates discomfort, and the shoulder's range of motion is restricted. This period lasts between 2 and 9 months.
Frozen
During this period, the pain may diminish. However, the shoulder stiffens. It becomes more difficult to use. This period lasts between 4 and 12 months.
Thawing
The shoulder's mobility begins to improve. This period lasts between 5 and 24 months.
What causes a Frozen Shoulder?
The shoulder joint is encased by a capsule of connective tissue. When the capsule around the shoulder joint expands and becomes tight, it becomes frozen and immobile.
It is uncertain what causes a frozen shoulder.
It is possible to develop the disease as a result of a fall, a stroke, or a shoulder procedure. However, the majority of the time, it appears for no obvious cause.
What are the signs and symptoms of a Frozen Shoulder?
- Frozen shoulder patients frequently describe a sneaky beginning with a steady rise in discomfort and a gradual loss of active and passive range of motion.
- Loss of external rotation (ER) in a dependent posture with the arm at the side is one of the key presenting variables.
- Patients typically struggle to dress, secure clothing behind their backs, groom themselves, and execute overhead tasks.
- According to some reports, the symptoms of a frozen shoulder resolve as early as 6 months and as late as 11 years. Unfortunately, for many individuals, the symptoms may never completely go away.
According to the research, frozen shoulder develops over the course of three overlapping clinical phases:
Acute/freezing/painful Acute/freezing/painful phase
Acute/freezing/painful phase: Gradual development of shoulder discomfort at rest with severe pain at extremes of motion, as well as pain at night with sleep disturbance that may last 2-9 months.
Adhesive/frozen/stiffening phase
Pain is only felt at the furthest extremities of movement. This stage may begin at 4 months and persist for roughly 12 months.
Spontaneous, gradual improvement in a functional range of motion that can persist anywhere from 5 to 24 months throughout the resolution/thawing phase. Despite this, some research indicates that it is a self-limiting illness that can persist for up to three years. Other studies have found that up to 40% of individuals may have persisting symptoms and mobility restrictions after three years.
Does Frozen Shoulder cause sleep disturbance?
Sleep is frequently disrupted and disturbed in the early and middle stages of this condition (Freezing and frozen phases, respectively). This can worsen as the patient's health deteriorates, and there is solid evidence that sleep deprivation, pain, and depression form a tight-knit triangle, with changes in one affecting the other two. As a result, practitioners must evaluate sleep quality and employ outcome measures to quantify symptoms and signs.
How to prevent Frozen Shoulder?
Because the recovery period for Frozen Shoulder can be long and laborious, it is critical to take precautions wherever feasible to avoid the illness. A few simple things may be taken to help avoid it:
- Daily stretching of your shoulder and back muscles.
- Exercising your tendons (by rotating hands and palms to stretch different tendons).
- Good ergonomics are practiced while sitting at a desk and using a computer.
- Keeping your immune system in good shape.
- Performing range-of-motion exercises as soon as feasible following an accident or surgery.
- If you have diabetes, you must regularly monitor it.
How to diagnose Frozen Shoulder?
Frozen shoulder is a "clinical diagnostic," which means it may be diagnosed at your initial exam by your physiotherapist.
The term "frozen shoulder" refers to a joint that is confined in certain directions. This is referred to as the 'capsular pattern.'
A capsular pattern occurs when your joint is confined to lateral rotation (moving your hand away from you with your elbow tucked towards your side), abduction (moving your arm out to the side), and medical rotation (putting your hand behind your back). Most frozen shoulder patients have trouble putting on a bra, shampooing and brushing their hair, and reaching up to cabinets.
X-rays, MRIs, and diagnostic ultrasound scans can help rule out other causes of your discomfort.
Home Exercises for Frozen Shoulder?
Codamann Exercise
Standing, lean forward and place your non-affected arm on the back of a chair or the kitchen counter. Keep your back straight and the pain by your side. Swing the aching arm 15 times forward and backward, then 15 times side to side, and then drawing clockwise and anti-clockwise circles (both 15 repetitions).
Pulley Exercise
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Hold the pulley handles with both hands, elbows straight, and thumbs up. With your unaffected arm, pull down. This will cause your afflicted arm to go forward and upward. Hold the position for 2 seconds, then relax the afflicted arm to your side. In a comfortable rhythm, repeat the exercises.
Internal rotation of the shoulders with a towel
- Slide 5 of 6 shows a picture of shoulder internal rotation with a towel.
- A towel should be rolled up lengthwise. Hold the towel above and behind your head with your non-affected arm.
- Reach behind your back with your aching arm and grab the towel.
- Pull the towel upward with your arm over your head until you feel a stretch on the front and outside of your hurting shoulder.
- Hold for 15–30 seconds.
- Relax and return the towel to its original position.
- Repeat 2–4 times more.
Wand Exercise for Frozen Shoulder
AAROM Shoulder Abduction
Holding a wand or cane with the palm of the injured side facing up and the palm of the undamaged side facing down, slowly raise your wounded arm to the side.eight times more than 12 seconds of holdingComplete both sets. Two times every day.
AAROM Shoulder Flexion
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When holding the cane/wand in the posture depicted while standing, let your unaffected arm to push up your afflicted arm.Shoulder Rotation
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Hold a cane or wand in both hands while standing.Maintain a bent elbow position. Side-to-side swing your arms and cane or wand. You should just partly relax the afflicted arm.You exert most of your effort with your unaffected arm.Shoulder Extension.png)
Use the unaffected arm to assist in pushing the afflicted arm back while standing and using a wand or cane, as illustrated.Throughout, the elbow should stay straight.
Internal Rotation.png)
Drag the target arm toward the middle of your back while holding a wand or cane behind your back.
Shoulder Flexion Standing.png)
Hold a cane or wand in both hands, palms facing down, while standing. Allow your unaffected arm to exert the majority of the work as you raise the cane or wand. Your afflicted arm ought to be only slightly relaxed.
Shrugging of shoulder bladder
Squeeze the shoulder blades together as you stand with your arms at your sides. While you are squeezing, avoid lifting your shoulders.six seconds of holding,4 to 10 times
Standing, lean forward and place your non-affected arm on the back of a chair or the kitchen counter. Keep your back straight and the pain by your side. Swing the aching arm 15 times forward and backward, then 15 times side to side, and then drawing clockwise and anti-clockwise circles (both 15 repetitions).
Pulley Exercise
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Hold the pulley handles with both hands, elbows straight, and thumbs up. With your unaffected arm, pull down. This will cause your afflicted arm to go forward and upward. Hold the position for 2 seconds, then relax the afflicted arm to your side. In a comfortable rhythm, repeat the exercises.
Internal rotation of the shoulders with a towel
- Slide 5 of 6 shows a picture of shoulder internal rotation with a towel.
- A towel should be rolled up lengthwise. Hold the towel above and behind your head with your non-affected arm.
- Reach behind your back with your aching arm and grab the towel.
- Pull the towel upward with your arm over your head until you feel a stretch on the front and outside of your hurting shoulder.
- Hold for 15–30 seconds.
- Relax and return the towel to its original position.
- Repeat 2–4 times more.
Wand Exercise for Frozen Shoulder
AAROM Shoulder Abduction
Holding a wand or cane with the palm of the injured side facing up and the palm of the undamaged side facing down, slowly raise your wounded arm to the side.eight times more than 12 seconds of holdingComplete both sets. Two times every day.
Holding a wand or cane with the palm of the injured side facing up and the palm of the undamaged side facing down, slowly raise your wounded arm to the side.
eight times more than 12 seconds of holding
Complete both sets. Two times every day.
AAROM Shoulder Flexion
When holding the cane/wand in the posture depicted while standing, let your unaffected arm to push up your afflicted arm.Shoulder Rotation
Hold a cane or wand in both hands while standing.Maintain a bent elbow position. Side-to-side swing your arms and cane or wand. You should just partly relax the afflicted arm.You exert most of your effort with your unaffected arm.Shoulder ExtensionUse the unaffected arm to assist in pushing the afflicted arm back while standing and using a wand or cane, as illustrated.Throughout, the elbow should stay straight.
Internal RotationDrag the target arm toward the middle of your back while holding a wand or cane behind your back.
Shoulder Flexion StandingHold a cane or wand in both hands, palms facing down, while standing. Allow your unaffected arm to exert the majority of the work as you raise the cane or wand. Your afflicted arm ought to be only slightly relaxed.
Shrugging of shoulder bladder
Squeeze the shoulder blades together as you stand with your arms at your sides. While you are squeezing, avoid lifting your shoulders.six seconds of holding,4 to 10 times
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When holding the cane/wand in the posture depicted while standing, let your unaffected arm to push up your afflicted arm.
Shoulder Rotation
.png)
Hold a cane or wand in both hands while standing.
Maintain a bent elbow position. Side-to-side swing your arms and cane or wand. You should just partly relax the afflicted arm.You exert most of your effort with your unaffected arm.
Shoulder ExtensionUse the unaffected arm to assist in pushing the afflicted arm back while standing and using a wand or cane, as illustrated.Throughout, the elbow should stay straight.
Internal RotationDrag the target arm toward the middle of your back while holding a wand or cane behind your back.
Shoulder Flexion StandingHold a cane or wand in both hands, palms facing down, while standing. Allow your unaffected arm to exert the majority of the work as you raise the cane or wand. Your afflicted arm ought to be only slightly relaxed.
Shrugging of shoulder bladder
Squeeze the shoulder blades together as you stand with your arms at your sides. While you are squeezing, avoid lifting your shoulders.six seconds of holding,4 to 10 times
.png)
Use the unaffected arm to assist in pushing the afflicted arm back while standing and using a wand or cane, as illustrated.
Throughout, the elbow should stay straight.
.png)
.png)
Hold a cane or wand in both hands, palms facing down, while standing. Allow your unaffected arm to exert the majority of the work as you raise the cane or wand. Your afflicted arm ought to be only slightly relaxed.
Squeeze the shoulder blades together as you stand with your arms at your sides. While you are squeezing, avoid lifting your shoulders.
six seconds of holding,4 to 10 times
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