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Frozen Shoulder
Ever had trouble raising your arm to reach that top shelf? Or felt a sharp sting when trying to rotate your shoulder? These could be the telltale signs of a 'Frozen Shoulder.'
What is a Frozen Shoulder?
Frozen shoulder, medically termed as adhesive capsulitis, is characterized by inflammation, thickening, and contraction of the shoulder capsule leading to intense pain and stiffness. The root cause remains somewhat of a medical enigma. Why some people develop Frozen Shoulder while others don't is still not entirely clear.
Risk and Causes: Why me?
While the exact cause remains elusive, certain risk factors have been identified that could heighten the chances of developing frozen shoulder:
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Age: Predominantly found in individuals between 40 and 65 years.
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Smoking: Smokers have up to double the risk.
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Medical Conditions: Including diabetes, autoimmune conditions, thyroid disorders, heart disease, and Parkinson's disease.
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Shoulder Injury or Surgery: Sometimes precedes frozen shoulder.
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Immobilisation: Extended periods in a sling or cast can be a factor.
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Prolonged Lack of Use: Such as after a stroke.
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Genetics: A family history might increase susceptibility.
Remember, not everyone with these risk factors will experience frozen shoulder. Conversely, some might develop it without any apparent reason.
Symptoms of Frozen Shoulder
How can you be certain it's Frozen Shoulder?
There are 4 things that every frozen shoulder have in common. Do you fit the following criteria:
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You are between 40-65 years old.
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You have significant pain with associated shoulder stiffness.
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You have lost at least 25% of movement at least two directions (eg lifting the arm in front, raising to the side, reaching across your body, or rotating in or out).
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You have at least 50% reduction of shoulder external rotation.
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You have a normal X-ray. Surprising as it might sound, an X-ray of a frozen shoulder should ideally not show any anomalies.
If you can relate to these symptoms, consider a professional check-up soon.
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Addressing the Issue: Treatment Options
Physiotherapy:
A tailored combination of manual therapy, stretching, and exercises has consistently shown positive outcomes for frozen shoulder patients. We understand the debilitating pain and discomfort associated with the condition—many even find peaceful sleep elusive. Hence, our therapists initiate treatments ensuring pain is optimally managed.
Injection Therapy:
This approach involves using injections to combat inflammation, aiding in movement restoration and pain management. Hydrodilatation or corticosteroid injections are most commonly administered. Timing is key, so early detection is very important for recovery.
Michelle's Story:
Michelle's story always comes to mind when I think about frozen shoulder as it was an example of just how debilitating the condition can get in a short amount of time.
Michelle was a 52 years old when she first presented last year in desperate need of some help. She is a school teacher, lives a relatively active lifestyle, and didn't have a past history of shoulder troubles. Michelle was regularly walking her black Labrador 4km most mornings and was previously doing yoga 1-2 x per week.
Michelle reported that her shoulder started aching approximately 4 weeks earlier after a busy day cleaning at home. She decided to rest her shoulder for a few weeks, avoiding heavy lifting and her usual yoga class. Over the following fortnight Michelle's shoulder worsened to the point where she was finding it difficult to reach above shoulder height, do up her bra, and put on a seatbelt. Any pulling on the lead from her dog created a sharp, stabbing pain in the shoulder that would take her breath away and the pain would take hours to settle back down. The shoulder was aching constantly by week 4 and her sleep was very interrupted due to pain.
On initial examination here at Eastside Physio, Michelle’s shoulder was showing all the signs of potential frozen shoulder including limited passive range of motion and sharp pain with light movements and tests. She was referred for x-ray to rule out bony abnormalities or tumor/cyst at the joint as well as an ultrasound to ensure there was no significant muscle or tendon damage; both tests found no abnormalities which increased the likelihood of frozen shoulder. Michelle was therefore referred for an injection (hydrodilatation) to the joint and commenced physiotherapy which included muscle release, stretching, and specific exercises for mobility and strength.
Within 4 weeks Michelle had seen a significant change in her pain and movement. She was able to reach above shoulder height (with minimal pain) and was able to sleep through the night without pain waking her. Michelle was given the option of a second injection but as she was progressing well, she decided to continue with conservative management. In the months following, Michelle's strength and mobility continued to improve and she was back to her regular yoga.
When managing frozen shoulder, early treatment is so important for reducing the level of stiffness and pain before it reaches its peak. It is a condition that lasts many months with most sufferers still reporting some level of pain or restriction at 2 year follow up. Michelle was definitely one of the success stories and after 12 weeks of Physio and home based exercise she was back to doing her normal daily activities and was experiencing only mild stiffness with Yoga.
Michelle commented that she is so much happier after getting the shoulder under control. She made a note that she was "fed up with being cranky and tired all the time". Some other less PG-rated words were used to describe how her mood was affected; and I make a particular mention of this because knowing Michelle, she is an absolute gem. She is funny and personable, always takes time to say hello, and loves her kids and her job. Her pain had affected her productivity at work and really shortened her fuse at home. This is a great example of how pain can affect how we see ourselves and how we live our life.
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Get the Support You Need
At Eastside Physio + Co, we are committed to delivering the best care to the locals of Surrey Hills and its neighbouring areas. Our skilled and experienced surrey hills physios are dedicated to supporting the well-being of our clients, who come from a variety of nearby suburbs, including Ashwood, Ashburton, Auburn, Balwyn, Blackburn, Box Hill, Burwood, Camberwell, Canterbury, Doncaster and Hawthorn.
If shoulder pain is hampering your daily activities, don't delay seeking help. Early intervention can be a game-changer. Reach out to Eastside Physio + Co today for a comprehensive consultation
Have questions or thoughts about Frozen Shoulder? Share them with us via email or on our social media and our team will be more than happy to engage!