Frozen Shoulder

“You find that you have peace of mind and can enjoy yourself, get more sleep, rest when you know that it was a one hundred percent effort that you gave – win or lose.”
– Gordie Howe 

Adhesive Capsulitis

 

Frozen shoulder (also known as Adhesive Capsulitis) is a painful condition of the shoulder that leads to progressive stiffness over time. During a frozen shoulder, the strong connective that surrounds the ball and socket joint thickens and becomes stiff and tight. The hallmark sign of this condition is intense pain with the inability to move the joint - either on your own or with the aid of someone else. The condition is typically divided into three phases:

  1. Freezing - Painful with progressive loss of motion

  2. Frozen - Less painful but stiffness persists

  3. Thawing - gradual return of motion that can be associated with pain

Overall, this process may take up to 18 months to 3 years to complete its course

Associated Conditions

A frozen shoulder typically occurs in individuals aged 40-60, and is more common in females. Additional associated conditions include:

  • Diabetes

  • Thyroid disorders

  • Cervical Spine (neck) disease

  • Atherosclerosis or cardiac disease

A frozen shoulder can additionally occur after long periods of immobilization, such as sling use after surgery or a shoulder fracture. This is typically referred to as Arthrofibrosis.

Treatment

Initial management is directed toward pain management and gentle physical therapy for return of motion:

  • NSAIDS - Anti-inflammatory medications like ibuprofen or naproxen intended to reduce pain and swelling.

  • Injections - Corticosteroids injections also intended to reduce pain and swelling

  • Moist heat and cryotherapy (ice)

  • Gentle Physical therapy

    • Gentle stretching

    • Typically recommended to be performed 5 times per day for 5 minutes each session with stretching in all planes (Forward Elevation, External and Internal Rotation)

  • Surgical Treatment

    • Intended for cases that fail to respond to nonsurgical management with continued pain and stiffness