Did you know that between 2-5 per cent of the general population will experience a “Frozen Shoulder?”

Did you know it’s more common in people with diabetes and thyroid diseases?

Did you know that it’s more common in women between the ages of 40-60?

Did you know that over 80 per cent of clients with frozen shoulder (one study) respond to conservative treatment?

WHAT IS A FROZEN SHOULDER?

• Evidence that there’s an “elevation serum cytokine levels”
  • Which is an over production of the cells that help with tissue repair
  • This causes ongoing inflammation and fibrosis (scar tissue formation)
• Loss of normal collagen production – new collagen is too tight and restricts the movement of the shoulder joint.
• Contracture or tightening is typically found in the “rotator cuff interval” (RCI) at the front of the shoulder.

HOW CAN I TELL IF I HAVE ONE?

• Painful and/or stiff shoulder with all movement directions
• Typically starts without any significant incident
• Accompanied by progressive loss of motion (freezing) in all directions
• Significant night pain
• Loss of outward rotation of more than 50 per cent
• Weakness of the internal rotations

WHAT CAN I EXPECT?

• Initial first three 3 months
  • Pain is greater than stiffness
  • Pain limiting movement in all directions of motion
  • Muscle guarding on passive movements
  • Difficulty finding comfortable sleeping position
• Stage Two (3-9 months)
  • Pain with all movements
  • Stiffness may be starting to be more of a problem than pain in the later stages
• Stage Three-Frozen (9-15 months)
  • Less pain but more stiffness
  • Still limited motion
  • Improved tolerance for exercises and physiotherapy techniques
• Stage Four-Thawing (15- 24  months)
  • Minimal pain
  • Motion improving

GAME PLAN

• Research supports in the early stages (more pain from hyper inflammatory) the use of a cortisone injection (results of pain reduction are best when combined with a physiotherapy-guided exercise program)
• Ultrasound and other modalities might actually aggravate the pain in the early stages
• Do range of motion exercises that don’t increase the pain in the early stages
  • Aggressive stretching in the early phases can aggravate the condition
• Physiotherapy-guided home exercise program
• Physiotherapy joint mobilizations in the frozen or thawing stages

 OTHER CULPRITS

• Rotator cuff impingement
• Rotator cuff or labral tears
• Neck problems
• Severe osteoarthritis
• Acute tendon calcification
• Tendonitis or bursitis
• Humeral fracture (proximally)

IF YOU’RE MOTIVATED:

1. Martin J. Kelley, Phillip W. McClurr, Brian G. Leggin. Frozen shoulder: evidence and a proposed model guiding rehabilitation. February 2009 | volume 39 | number 2 | journal of orthopaedic & sports physical therapy

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