I Have Frozen Shoulder, What Now?

Frozen shoulder is reported to affect anywhere from 2-5% of the population. Should you have diabetes or thyroid disease, the risk increases to anywhere from 4.3 to 38%.

So what is it exactly?

Simply put, it is when the entire capsule/ligament complex of the shoulder becomes what the medical community calls “fibrotic”, or stiff, thus the term “frozen” shoulder.

When you attend a physiotherapy assessment, it would be found that you would have a loss of motion in multiple planes of motion, not only with you moving your arm, but also when your therapist moves your arm and the muscles are relaxed. The loss of rotation at the shoulder can make activities like scratching your back, putting on your seatbelt, and washing your hair quite difficult.

As mentioned above, diabetes and thyroid disease are risk factors, and individuals ages 40 to 65 years of age, and of female gender seem to be at higher risk. If you have had a previous episode of frozen shoulder in the other arm, you also are considered to be at a higher risk.

The condition will progress through a staged progression of pain and mobility deficits that usually last 12 to 18 months. If you are reading this and have frozen shoulder, you may have noticed that the onset and development of your symptoms and stiffness was gradual and progressive, with no real incident or injury, and this is common.

Your Panther Physiotherapist will ensure that the shoulder pain is not tendonitis, bursitis, arthritis, fracture, impingement, and is a true primary or secondary frozen shoulder, as the management is quite different compared to the other conditions.

Your physiotherapy may have you fill out questionnaires such as the Shoulder Pain and Disability Index to track your pain/mobility deficits over the following 12-18 months, and ensure treatment is making a clinically relevant change. Your therapist will measure active range of motion to look for key impairments specific for your case, and look for areas that may be beneficial to address:

• with you moving your shoulder (active),
• and with your therapist moving your shoulder (passive)

Many ask, well what about an injection for the pain? Injections into the joint (called an intra-articular corticosteroid injection) combined with shoulder mobility and stretching exercises are more effective in giving client’s short-term relief and improved function, yet long term may yield similar outcomes compared to non-injection candidates.

Finally, your therapist will use specific education to describe the course of the disease, help you with specific activity modifications to encourage functional/pain-free range of motion, and will always try to match the intensity of your stretching with the irritability of your frozen shoulder.

Other techniques may be combined with mobility and stretching to reduce pain and improve shoulder range of motion:

• Joint mobilization,
• Ultrasound,
• Electrical stimulation

In severe, non-responsive cases, a translational manipulation under anesthetic may be required, performed by an orthopedic surgeon to aid in disrupting the “freezing” or adhesions.

Ultimately, the presentation and treatment are unique based on your case, and an in-depth assessment can set you up on the path to aid in your recovery of pain/function over the next 12-18 months. Any questions, feel free to reach out.

Stay Mobile,

Travis Gaudet MScPT., BScKin., cGIMS., CFST-1., CAFCI