Overcoming Frozen Shoulder
Adhesive capsulitis, also known as Frozen Shoulder, is a condition which involves shoulder pain and shoulder range of motion limitations. Typically, frozen shoulder is of insidious/gradual onset with no known of mechanism of injury, however history of shoulder trauma and surgery can increase risk of adhesive capsulitis. If a person has a history of diabetes mellitus, stroke, rotator cuff tendinitis, high blood pressure, Parkinson’s Disease, or arthritis (among other causes), then they are at a higher risk of frozen shoulder. Adhesive capsulitis occurs due to constant inflammation of structures/musculature of the shoulder joint, which results in fibrosis/scarring.
One of the hallmark signs of adhesive capsulitis involves what therapists call a capsular pattern and tenderness to the coracoid process. A capsular pattern includes restrictions of range of motion in a particular order of movement, from greatest restrictions to least restricted. Those movements include (from greatest restriction to least): external rotation, flexion, and internal rotation. These movements can be tested by reaching behind the head (external rotation), elevating/raising the arm straight forward (flexion), and reaching behind the back (internal rotation). Tenderness to the coracoid process includes touching the bone underneath the collar-bone, which is located towards the end of the shoulder.
Frozen shoulder undergoes three stages: freezing, frozen, and thawing. The freezing stage is the first stage which includes insidious onset of pain. Freezing, the second stage involves restrictions in range motion (capsular pattern), with decreased pain. Thawing involves the gradual restoration of shoulder range of motion and strength.
If managed properly this condition, typically takes up to 18 months to resolve however, can take years for symptoms to go away! While symptoms can last months to years, PT can help return a person back to “normal” faster than if not addressed at all.
Thomas Kain, DPT