A frozen shoulder is an inflammation of the capsular ligament of the shoulder which is responsible for the stability and smooth range of movement of the shoulder. There are different aspects of a frozen shoulder, including its signs and symptoms, treatment plans, disease progression method, precautions, and the underlying mechanisms behind severe conditions.
Frozen Shoulder Symptoms:
Pain
One of the great hallmark symptoms of a frozen shoulder is a persistent sharp pain in the shoulder joint. Pain is more severe during the early stage of a frozen shoulder.
Stiffness
Patients mostly experience a limited range of motion in the affected shoulder joint.
Progressively Loss of Mobility in Joint
Over time, the shoulder’s mobility decreases, then very challenging, and makes it difficult to perform everyday tasks and activities of daily living.
Severe Night Pain: Most of the individuals with frozen shoulder complaints increased pain and discomfort at night which disturbs their sleep pattern.
Mechanisms of Frozen Shoulder
Inflammation
Usually starts while overuse of shoulder muscle mostly starts with strain to the capsular ligament.
Capsular Thickening
Explain how the joint capsule thickens and tightens, restricting mobility.
Collagen Deposition
Explore the accumulation of collagen within the joint capsule.
Synovial Fluid Changes
Describe alterations in synovial fluid composition.
Stages of Frozen Shoulder
The major three stages of a frozen shoulder, freezing, frozen, and thawing. Each type has different characteristics according to symptoms.
Freezing Stage
In the initial phase, pain and stiffness gradually worsen, making it difficult to move the shoulder.
Frozen Stage
Mobility of the joint is severely restricted in this stage, and the shoulder is often “frozen” in this stage.
Thawing Stage
In the final stage, there is a gradual improvement in mobility and a reduction in pain which leads to the flexibility of joints.
Treatment for Frozen Shoulder Pain
Physiotherapy for Frozen Shoulder
The role of physical therapy in a frozen shoulder is very important in restoring shoulder mobility. The treatment method used in physiotherapy management:
Heat and Ice Therapy
As explained Earlier heat pack is used to relax surrounding muscles and the cold pack reduces the inflammation and the swelling around the shoulder joint.
Ultrasound
Ultrasound is a basic modality in pain management because it helps to reduce all inflammation by acting as an anti-inflammatory effect and it also works as a Micro massager for the deep adhesions in the shoulder joint.
TENS
A little electrical current is used in transcutaneous electrical nerve stimulation (TENS), which is used to manage pain. By stimulating sensory nerves and activating the pain gate mechanism, TENS relieves symptomatic pain.
Hot Pack
Uses of The hot pack in physiotherapy management acts as a muscle relaxing because it reduces all the tightness and relaxes all the surrounding muscles of the shoulder joint that can be tightened due to restriction in the mobility of the shoulder joint by applying hot pack we use our relaxation effect and it also acts as a pain management method.
Dynamic Cupping
This is the most effective way to relax muscles and other soft tissues by the mechanism of compression and decompression of muscles that reduce all the stiffness of muscles. It also enhances blood circulation in the shoulder region.
Mobilization / Manipulation
This is the most effective method to break all the adhesion from the joint because, in a frozen shoulder, there are huge chances of adhesion and stiffness formation within the joint that reduce shoulder mobility.
Progressive Mobilization
Has the best results in increasing the range of motion of frozen shoulder joints. It is best to apply the mobilization technique with the scapula stabilized and glides given with accurate traction.
Precautions / Care
This means to modify or restrict the movement of effected joint so that soft tissues around the joint should not get more stressed or inflamed. Here are a few precautions.
- Don’t lift too much weight on the effected shoulder
- Do not put Your body weight during sleep on an effected shoulder
- Do not overuse effected shoulder
- Do all the exercises according to a physiotherapist
5 Frozen Shoulder Exercises for Quick Relief:
Clockwise and anti-clockwise rotation:
During this exercise, you have to make a circle on your side by your arm this circle can be clockwise or anticlockwise and this circle is initially very small but you can in large it day by day to increase shoulder mobility in all directions.
Shoulder towel exercise
In this exercise, we ask the patient to hold a towel on the back side of the body and then move that towel upward and downward. In this exercise Head humorous rotates inside the glenoid cavity so that adhesions and contractures break and allow the movement of the humorous.
Finger ladder exercise
In this Exercise there is a wooden finger ladder hanging on the wall with many steps so we ask the patient to move his fingers slightly upward to the next step on the finger ladder. So in this moment shoulder most slightly upward and the head of the humorous moves downward, so in the same way we ask the patient to do the same exercise in a reverse way so the patient puts his finger downward and the head of the humorous moves upward during in this moment flexers and extensors do work and the shoulder regain its moment.
Bilateral shoulder abduction and adduction
Doing slowly and smoothly rhythmically shoulder abduction hand addiction is beneficial to gain the proper range of every muscle in the shoulder joint. 5. Shoulder flexion: The shoulder flexion is an exercise in which we move our arms forward and upward.
Shoulder shrugging exercise
In this exercise, you have to shrug your shoulder slowly upward and slowly downward this helps to work on your shoulder surrounding muscles.
Shoulder backward rotation
In this method, you have to rotate your shoulder backward slowly and smoothly, In this exercise we work on all the muscles of the scapula neck, and shoulder.
Home Remedies for Frozen Shoulder
Recommended that do not start any exercise without your physiotherapist’s consultation. If inflammation is very high and you start doing exertional exercise it can cause a side effect and lead to muscle tears so firstly visit your nearest physiotherapist and then start exercising according to your physiotherapist’s suggestion.
Precautions and Lifestyle Tips:
- Avoid Overexertion: Advise patients to avoid activities that may worsen the condition.
- Posture and Ergonomics: It is very important to maintain proper posture and ergonomics.
- Gentle Stretching: Encourage regular, gentle stretching exercises.
- Pain Management: Discuss strategies for managing pain and discomfort.
- Diet and Nutrition: Mention the role of nutrition in overall joint health.
Conclusion
A frozen shoulder is a challenging condition that can significantly impact one’s quality of life. However, with proper understanding, early intervention, and a combination of treatment modalities, patients can find relief and regain mobility. By following precautions and lifestyle adjustments, individuals can manage their symptoms effectively and work towards a healthier, pain-free shoulder.
This comprehensive overview should give you a starting point to create a more detailed thousand-word article on frozen shoulder.
When should you worry about your shoulder? Physiotherapy Treatment for Frozen Shoulder
If pain in your shoulder is limiting your daily activity difficulty in doing small tasks or if it is affecting your sleep, you should consult with a qualified Physiotherapist.
Assistant Professor Dr. Azhar Ayyub is a qualified, highly skillful, and competent consultant physical therapist with 15+ years of experience. His specialty is in the rehabilitation of musculoskeletal, neuromuscular, and rheumatological diseases. He is currently working as a consultant Physiotherapist and Head of the Physiotherapy department at Joint Care Clinic.
He is the Best Physiotherapist in Lahore for the assessment and treatment of Frozen shoulders. He treats frozen shoulders through special mobilization techniques and progressive strengthening and ROM exercise plan.
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