Frozen Shoulder: How Physical Therapy Can Restore Movement
Are you experiencing stiffness in your shoulder? Shoulder pain that worsens at night? Inability to move and rotate your shoulder? You may be experiencing what is known as “frozen shoulder”, or adhesive capsulitis. Physical therapy is the first line of treatment to manage and address frozen shoulder, bring pain relief, and help you regain normal range of motion.
What is frozen shoulder?
The shoulder is made up of a ball-and-socket joint that includes the upper arm bone (the humerus), the shoulder blade (scapula), and collar bone (clavicle). The head of the humerus fits into the shallow socket of the shoulder blade to form the joint, which is surrounded by strong connective tissue known as the shoulder capsule.
Frozen shoulder occurs when the shoulder capsule tissues thicken and become stiff, tight, and inflamed. Scar tissue adhesions (thick bands of tissue) develop, leaving less space for the ball of the shoulder joint to rotate in the socket and contributing to stiffness and pain. This decreases the synovial fluid that lubricates the shoulder joint and affects the shoulder’s ease of movement.
While the exact cause of frozen shoulder is unknown, there are pre-disposing factors that may contribute to the development of the condition. These factors include a period of enforced immobility of the shoulder joint due to trauma, overuse injuries, or surgery; and conditions such as diabetes, hyperthyroidism, cardiovascular disease, and Parkinson’s disease.
Frozen shoulder affects women more often than men and generally impacts those between forty-to-sixty years old. Although frozen shoulder can be very painful, it is highly treatable; the majority of patients improve using nonsurgical measures, the forefront of which is physical therapy.
What are physical therapy treatments for frozen shoulder?
Physical therapy can help you regain range of motion, restore movement to complete daily activities, and decrease pain. Physical therapy is recommended as the first line of treatment for frozen shoulder as it is a non-invasive, effective method to increase shoulder mobility and speed up the natural healing process.
Physical therapy treatment includes:
Manual therapy to reduce pain and improve range of motion
Heat and ice modalities to relax muscles and relieve pain
Stretching techniques for greater movement and flexibility
Strengthening exercises that target the shoulder and core muscles
Home exercise program that incorporates gentle stretching exercises
Regular fitness helps keep the body’s joints lubricated and supple. Under the supervision of your physical therapist, you can safely engage in gentle stretching exercises and aerobic exercise. As you improve and regain flexibility and motion in the shoulder joint, your therapist will progress you to shoulder strengthening exercises. Prior to engaging in stretching and strengthening exercises, it is important to warm up the shoulder with heat, such as a hot shower when at home or a moist heating pad in the clinic. When engaging in exercise, stretch to the point of tension but not of pain.
Stretching Exercises to Relieve Pain & Regain Function
Our physical therapist Sarah demonstrates three stretching exercises you can do at home to stretch the shoulder joint if you are experiencing frozen shoulder.
Sarah completed the following 3 at-home stretching exercises using a light-weight cane or broom:
1. Overhead Stretch: Lay down on a flat surface holding the cane with both hands. Bring the cane over your head while laying down, extending to the point that you feel the stretch. Complete two sets of ten reps of the stretch two-to-three times a day.
2. External Rotation Stretch: Lay down on a flat surface holding the cane in both hands. Using the unaffected arm, angle the cane diagonally toward the frozen shoulder. Gently move the cane diagonally across the affected shoulder, using the unaffected arm for strength and stretching the frozen shoulder. This stretch will help you reach behind your head. Complete two sets of ten reps of the stretch two-to-three times a day.
3. Stand and place the cane behind your back horizontally. Hold the cane with both hands behind your back. Gently lift the cane upwards using both arms. Complete two sets of ten reps of the stretch two-to-three times a day.
If you are experiencing shoulder pain and stiffness, don’t suffer in silence. Come in to Mangiarelli Rehabilitation and let us help you safely regain movement and decrease your pain so you can get back to the sports you love, the work you enjoy, and playing with the kids and grandkids.
