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Frozen shoulder

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What is a frozen shoulder?

Frozen shoulder is a condition where there is an inability to lift your arm up above your head or move your arm in different directions because of pain and stiffness. It has four phases:

  1. Pain – where it is unbearable and arm doesn’t feel comfortable in any position. Sleeping may be difficult.
  2. Stiffening – the covering around the shoulder may become stuck to the bone creating issues to move the shoulder due to pain and partially ‘freezing’ into place.
  3. Frozen – The point of the phases that the shoulder cannot move because of stiffness.
  4. Thawing – Where the shoulder is loosening therefore allowing the shoulder to move.

 The natural course of recovery for a frozen shoulder (if you do nothing), from initial pain to thawing and resolution of symptoms is 2–3 years.  

What causes frozen shoulder?

A frozen shoulder can be caused:

  • After a shoulder to an arm injury
  • By an injury-causing you to use a sling
  • After shoulder surgery, open-heart surgery, or breast cancer treatment
  • There may be no obvious cause

A frozen should is most common:

  • In the non-dominant arm
  • With women of menopausal age
  • With people who have diabetes, have had a stroke or have Parkinson’s disease.
  • With people who have a genetic history and is linked to Dupuytrens contracture.

How do I know if I have frozen shoulder?

You may have a frozen shoulder if you experience the follow (although symptoms may differ between men and women):

  • For women, trouble doing up a bra and for men, they may have trouble getting their wallet out of there back pocket
  • You may experience pain when doing simple activities like the above. 0

A quick test that your physiotherapist will do is to ask you to tuck your elbows into your side with your forearms bent to 90o, and then ask you to take your forearms out from your side. That movement will be restricted on the painful side.

How can physiotherapy help with frozen shoulder?

Your physiotherapist can help you with a frozen should by:

  • Advice about how to support your arm for sleeping
  • Strategies to minimise your driving as this will make your symptoms worse
  • Forearm support on your office chair to decrease the gravitational loading of your arm.
  • Advising use of cold and heat packs to reduce pain
  • Suggesting the use of dry needling to help reduce pain
  • Taping may be advised to help minimise the shoulder pain and help you sleep.
  • Giving you exercises to complete that should be in the pain-free stage and do not provoke pain. You may be given at home exercises to complete.
  • Advising you to complete mobilisation, massage, trigger point therapy and dry needling by your physiotherapist is helpful in improving the mobility of your shoulder in the stiffness and thawing phases.

What can I do at home?

It is important that you follow the instructions of your physiotherapist. You should ensure your shoulder is always supported especially when sleeping. It is recommended that you minimise driving to ensure that you do not worsen your symptoms. It is important that you complete the exercises prescribed to you. ‘Crawling’ your hand up the wall with your fingers is helpful in the shower as the warm water may decrease muscle spasm and you can measure your progress using the tiles.

How long will my recovery be?

Frozen shoulder is one of the most painful musculoskeletal conditions where the pain may last up to 6 months. You must ensure you do as much as possible to reduce pain/symptoms which may mean taking time off work. The stiffness stage is not painful although can be frustrating not being able to move therefore restricting daily activities. It can take 2–3 years before your arm feels normal again.

If you would like to find out more please call us or book an appointment here.

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Reference: Australian Physiotherapy Association 2019, Your Body, viewed 19 November 2019, < https://australian.physio/>.