Frozen Shoulder Part 1: Freezing Stage

 In Upper Limb

Frozen Shoulder Part 1: Freezing Stage

Frozen shoulder (adhesive capsulitis) is a debilitating condition characterized by pain and stiffness in the shoulder.  A capsule of connective tissue tightens around the bones and soft tissue (ligaments and tendons) in your shoulder, restricting movement. Unfortunately there is no “quick fix” and those affected are often required to wait for the condition to take its course.

The first stage of this three-step condition is called the “freezing stage”

Frozen Shoulder 1 Illustration

What happens?

During this stage the capsule around the shoulder becomes tight and will restrict movement. This stage is often reported as the most painful of the three and can last roughly 3-9 months. Pain will gradually develop in the shoulder and will progress in intensity as will loss of movement. Aggravating activities can include:

  • Putting on clothes
  • Reaching for objects on shelves
  • Sleeping on the side of the affected shoulder

When/why does it happen?

Although the exact cause of frozen shoulder is unknown and much of the condition is poorly understood, there are a number of risk factors which are common in those affected:

  • Recent history of a condition which has caused shoulder immobilization (i.e. recent shoulder surgery)
  • Women are more affected than men
  • History of diabetes
  • Over the age of 40

Why is it relevant?

This information is important for patients to understand so they know what to expect when facing this long road. Proper education will minimize patient frustration throughout the duration of the condition.

Aim of management:

Physiotherapy management during this stage is primarily aimed at patient education and pain management. Education is so important for patients to fully understand the condition and what to expect along the way. Your physiotherapist will also give you exercises to help maximize the functional use of your shoulder. These exercises will be pain free and will be within the range you have at the shoulder. We will always avoid “pushing” for more range as this will simply cause unnecessary pain for you and it is usually unsuccessful. It can also be beneficial to consult your physician for pain medication during this phase of the condition.

Next week we will review the next stage of the frozen shoulder process.

Ben Murphy

Bond University Physiotherapy Student

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