FROZEN SHOULDER

What is Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis or “50-year-old syndrome” (due to its common occurrence in people in their 50s), is a condition characterized by

painful and progressively restricted shoulder movement. It typically starts with inflammation, which leads to thickening and tightening of the shoulder capsule (the fibrous layer around the glenohumeral joint), a process known as fibrosis.

Sometimes, it can be challenging to differentiate between frozen shoulder and osteoarthritis, and an X-ray may be helpful in clarifying the diagnosis.

Phases & Timelines

  • Acute/Freezing Stage: Gradual onset of shoulder pain, especially at rest, which worsens with extreme motion. This stage lasts 2-9 months.
  • Frozen Stage: Pain begins to subside, but there is a progressive loss of range of motion, particularly in a specific Pain is mostly felt only at the extremes of movement. This phase lasts 4-12 months.
  • Resolution/Thawing Stage: Gradual, spontaneous improvement in shoulder movement and function. This phase can take anywhere from 5-24 months.

Risk Factors

  • Age: Most common in those aged 50-59
  • Gender: More prevalent in females
  • Medical conditions: Diabetes (up to 20% prevalence), stroke, thyroid disorders
  • Shoulder injuries: Falls onto an outstretched hand (FOOSH), direct impact, or dislocations

Management Options

Physiotherapy

  • Education: Understanding your condition is key to managing expectations and reducing This helps improve compliance with your treatment plan.
  • Home Exercise Plan: A tailored program of strengthening and range of motion exercises.
  • Manual Therapy: Includes gentle shoulder mobilization, muscle releases, acupuncture, dry needling, and kinesiology taping to relieve pain.

Medical Interventions

  • Pain Relief: Medications to help manage pain during the acute
  • Corticosteroid Injection: For pain relief in the acute
  • Shoulder Hydrodilatation: Injection of saline and cortisone to reduce inflammation and expand the shoulder capsule.

Surgical Options

  • Manipulation under Anaesthesia (MUA): A procedure to improve range of motion under general anesthesia.
  • Arthroscopic Capsular Release: Minimally invasive surgery to release the tightened shoulder capsule.

Imaging

  • X-ray: Not diagnostic of frozen shoulder but can help rule out other conditions like osteoarthritis.
  • MRI: Can show thickening and tightening of the shoulder capsule, supporting the diagnosis of frozen shoulder.

Who to See

  • Kate Kennedy – Physiotherapist
  • Rebecca Wood – Physiotherapist
  • Alex Hancox – Physiotherapist
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