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Frozen Shoulder

​​​​​​Frozen Shoulder is also known as Adhe​sive Capsulitis or ’50-year-old shoulder’.

Frozen Shoulder
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Frozen shoulder is one of the most common painful but non-serious condition that affects females more than males, often around the age of 50.

Frozen shoulder is typically described as following 3 stages and it lasts 2 years on average.

  • 1st stage: Pain and freezing
  • 2nd stage: Frozen
  • 3rd stage: Thawing​

A normal shoulder has elastic shoulder ligaments with adequate bone-to-bone joint space. This allows our shoulder to perform full range-of-motion activities like reaching behind to scratch the back, reach for seatbelt, pick things from the top shelf, etc.

When frozen shoulder sets in, there are gradual, long-lasting changes happening to the shoulder:

  • Long-term inflammation response with changes in the collagen cells of the ligaments, causing a loss of elasticity, thickening of ligaments and pain
  • Significant loss of intra-joint volume, resulting in reduced range-of-motion of the shoulder joint in all directions.

People with frozen shoulder typically reports diffused aching in the shoulder, often radiates down the shoulder to the elbow. Stiffness in shoulder movement is also experienced but not obvious initially, with some pain during work, self-care and social activities.

Over time, unlike a typical shoulder strain that should recover in a few weeks, the pain lingers and affects your sleep. The shoulder progressively gets stiffer until it affects your normal activities significantly:

  • ​cannot reach behind your back
  • cannot reach overhead due to sharp pain
  • cannot put on a T-shirt

Frozen shoulder is usually diagnosed when other causes of painful restriction of the shoulder have been ruled out. There are similarities and differences between frozen shoulder and other competing shoulder pain hence it requires an experienced healthcare professional to make sense of your symptoms to refer you for appropriate care/investigations.

​How did I develop Frozen Shoulder?
Frozen shoulder can be ​catagorised as primary/idiopathic (no obvious cause) or secondary, which can set in after previous shoulder injury or surgery. This happens when you have immobilised the injured shoulder in a sling without sufficient movement to prevent stiffness from setting in. People suffering from diabetes are twice as likely to develop frozen shoulder and also takes a longer time to resolve.



Risk factors for Frozen Shoulder:
​
  • ​Diabetes Mellitus
  • Hypo or hyper-thyroidism
  • Recent shoulder injury/surgery
  • Previous stroke/heart attack
 

What can I do for myself?

  • ​When Pain is greater than Stiffness
    • A heat pack can be applied over the shoulder before commencing exercise to reduce pain. Exercises can be performed up to a tolerable level of discomfort.
  • ​When Stiffness is greater than Pain
    • You may push the stretch as much as tolerated, the longer the better.


Why should I stretch and exercise?

Not all frozen shoulders regain full, pain-free range-of-motion without regular stretching exercises.



The benefits of stretching for the frozen shoulder:
  • ​Less pain after exercise
  • Increased mobility after exercise
  • Better outcomes in the long-term

​
What other useful information should I know if I have a Frozen Shoulder?
  • ​Depending on the stage of your Frozen Shoulder, your doctor may recommend a combination of these: injection, medication, physiotherapy and surgery.
  • A heat pack is often useful to cope with pain.​
Contributed​ by Physiotherapy, Rehabilitation, Allied Health Services
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