Adhesive Capsulitis (Frozen Shoulder) | Plenty Physiotherapy, Bundoora

Adhesive Capsulitis (Frozen Shoulder) Document 

Adhesive capsulitis, also known as  rzen shoulder. This condition is  distinguished by an inability to lift your  arm up above your head or move your  arm in different directions, initially  because of pain and later because of stiffness. It is compromised by  inflammation and thickening of the  capsule of the shoulder joint. Adhesive capsulitis has 4 phases from its initial pain onset until resolution.  The four stages are as follows: 1. 1 Month to 3 Months: Pre-freezing describes the earliest stage of frozen  shoulder. This is when you first start to notice pain in your shoulder. Many people  in this stage will first notice the pain at night while changing positions in bed. You  may also find that you have reduced mobility in that shoulder. It may ache even  when you are not using it. Because motion may be only slightly restricted in this  stage, early frozen shoulders can be mistaken for a problem with the rotator cuff.  2. 3 Months to 8 Month: The freezing stage is the most painful phase of a frozen  shoulder. During this phase, the shoulder capsule is inflamed and can become  thickened and stiff. As this happens, shoulder movements become increasingly difficult and painful. 3. 4 Months to 12 Months: The third phase of a frozen shoulder is known as the  frozen phase. During this phase, the shoulder is notably sti=. The frozen phase is  typically much less painful than the freezing phase, but pain can result from  seemingly simple activities. Rotation of the shoulder joint is particularly limited,  making activities such as washing hair, hooking a bra, or reaching for a seat belt  painful or di=icult. 4. 5 Months to 2 Years: In this phase, the thawing phase, the capsule of the  shoulder joint has become thickened and stiff but over time it gradually loosens.  It is important to stretch the shoulder capsule and strengthen the shoulder  globally, even allowing for some discomfort, in order to ensure the shoulder joint  mobility continues to recover. Not having the extreme pain associated with the  freezing of the joint and seeing gradual gains in mobility make this phase  tolerable.  

This condition attimes can have no obvious cause for the presentation. In saying this,  frozen shoulder can occur after a shoulder or arm injury, particularly if the arm has  been immobilised in a sling. 70% of this population are women, with a large portion  being between 40 and 60 years old. Frozen shoulder is more common in the non dominant arm of women of menopausal age. It is also more common if you have 

Diabetes, Hypothyroidism, Hyperthyroidism, Cardiac diseases, have had a stroke, or  have Parkinson’s disease. Lastly, there has been a genetic predisposition link.  Although the timeframes explained above can be quite large, timely physiotherapy  and medical intervention can catalyse this period to be significantly shorter.  Compliance and managing expectations in line with education is a major factor. Management may require the commencement of anti-inflammatories or medication as  per your medical team, alongside education on load management and minimising  aggravating movements. Manual therapy techniques such as soft/deep tissue work,  mobilisations, manipulations, traction, dry needling or cupping may aid in pain  management and increasing range of motion. In addition, modalities such as heat can  be helpful for short term relief, and hydrotherapy may also be a great alternative to  land-based exercise, as tolerated. Exercise-based rehabilitation aims to improve  flexibility, enhance mobility and build strength in the a=ected shoulder joint.  There are scenarios where an injection of a corticosteroid or hydrodilatation injection  may be recommended. In more severe cases, if conservative management fails to aid in  your recovery, surgical intervention may be indicated and considered to address tightness in the shoulder capsule.