Frozen Shoulder (Adhesive Capsulitis)

Frozen Shoulder, also known as ‘Adhesive Capsulitis’ is a complex condition that causes pain and stiffness in the shoulder.

It is most commonly seen in patients between 35-50 years of age and patients with comorbidities such as diabetes, inflammatory conditions, autoimmune disease, hyperthyroidism, some cancers, or following shoulder trauma or surgery. Frozen shoulder can start spontaneously for no apparent reason, or it may start following shoulder, breast or neck surgery. It may occur in conjunction with other shoulder injury such as rotator cuff tear, or it may be the sole pathology in the shoulder.

A typical Frozen Shoulder goes through three basic stages:

Freezing: pain around the shoulder region, followed by a decrease in range of movement.

Frozen: pain may be minimal or even non-existent during this stage, but range of movement will plateau.

Thawing: gradual improvements in range of motion. Weakness around the shoulder following disuse and pain as a result from increasing the use of the weekend muscles and moving stiff joint, not due to the pathology itself may still exist.

Each stage of Frozen Shoulder can last a period of a few months. Frozen Shoulder can take between 12-18 months to recover if left alone. However, research shows physiotherapy can optimise long term recovery outcomes.

Symptoms:

  • Shoulder gradually becoming less mobile, or “stiffer”
  • Having difficulty hanging clothes on line, putting seatbelt on, doing up bra, throwing ball etc
  • Unable to reach ‘quickly’ for something
  • Pain to sleep on that side

Management:

  • Gentle shoulder range of motion exercises to encourage mobility and prevent further stiffness.
  • Massage to release muscles and connective tissues that have tightened and are restricting range.
  • Joint mobilisation to reduce shoulder stiffness and improve range of motion.
  • Basic strengthening of the posterior chain of muscles to maintain good posture to prevent further complications.
  • Avoid long periods of inactivity.
  • Hydrodilatation or Cortisone Injection.

Your physiotherapist will help confirm your diagnosis and guide you through the stages of your rehabilitation. We will set up a home exercise program and progress it according to how quickly your presentation progresses through each stage of the condition.