One of the most misunderstood medical conditions is the frozen shoulder. It can be frustratingly long-lasting and debilitating. Due to this, it makes sense to consider whether or not seeing a physiotherapist can help. Physio can usually help, but there is much more to know first. Read on to find out more!
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What Is a Frozen Shoulder?
The technically correct name for frozen shoulder is adhesive capsulitis which, affects around 5% of the population. People feel stiffness with excruciating pain as the shoulder capsules are inflamed, limiting the fibrotic adhesion of shoulder movement.
The joint capsules shrink initially, then thicken, leaving extreme stiffness and pain. Many people confuse it with a rotary cuff injury. Yet, the two are different and need different treatments. A frozen shoulder gives you severe pain with the loss of shoulder function.
What Causes a Frozen Shoulder?
When it comes to the frozen shoulder, there is still a considerable debate going on as to what causes it. While that’s true, it is expected after the shoulder has not been used for a long time, such as after an arm injury.
Some people are at a high risk of developing the frozen shoulder symptoms as follows:
- Over 40 years old
- Metabolic syndrome and Hypothyroidism sufferers
- Some risk factors are a stroke, thyroid conditions, diabetes mellitus, and shoulder injury.
If you have shoulder pain with stiffness, it helps to have a checked out by a physiotherapist to give you a diagnosis.
Signs That Frozen Shoulder Is Starting To Thaw
In the early stage, you will experience extreme shoulder pain with stiffness. Understanding the feeling is like an ice cube freezing. It is the stage where it is not yet entirely frozen but is starting to solidify as it freezes.
The first stage can last from three to nine months, but it remains a long time to suffer. Aggressive treatment is not recommended at this stage, but some pain relief treatments, like anti-inflammatory medication, can help.
The next stage is your freezing stage, as you experience more stiffness. Again, the transition from stage one to two is difficult. It will start dominating your life in stage two as you will not be able to move your shoulder as the pain begins subsiding.
The phase can last from nine to 15 months, and physiotherapy can help improve your movement with treatment. Lastly, you have the thawing stage, and using the ice cube is an excellent way to describe it.
You have stiffness and pain that gradually starts to melt away. The shoulder-motion range returns as it thaws. This can last 15 to 24 months, with physiotherapy as the initial treatment. The pain you must go through can take 30 months on average through all the stages.
Yet, with physiotherapy, you can speed the process up to prevent most of these stages.
Frozen Shoulder Physiotherapy
A few things can help you diagnose a frozen shoulder, but the best method is to make an appointment with a physiotherapist to check it out. Some signs are the inability to reach above shoulder height, toss a ball, go quickly for something, or get behind you or to the side. You may even have difficulty sleeping on that side.
The treatment varies when you visit a physiotherapist, depending on your frozen shoulder stage. The primary treatment is pain relief, which includes medication in the freezing stage.
Alternatively, you can get corticosteroid injections and take preventive measures. During the frozen stage, you will do gentle peri arthritis shoulder exercises, as overdoing things exacerbate the problem.
Specific massage treatments are performed that have been proven to be helpful at the frozen stage. While in the thawing stage, you will do mobilization with strengthening exercises as it helps speed the recovery process up.
If all else fails, the last option is surgery. However, with post-capsular surgery, you still need to work with a physiotherapist during the recovery phase.
How Can Physiotherapy Help A Frozen Shoulder?
When you work with a physiotherapist, they will provide you with a detailed and tailored plan for the best exercises you can do.
First, you start with stretching, such as doing the pendulum stretch. Next, you must relax the shoulder while leaning slightly to let your arms hang loosely during the exercise. You will then swing the arm in small circles performing up to ten rotations in any direction per day.
The more your mobility improves, you increase the circle diameter and add some weights to get a deep stretch. Another great technique is using a tea towel behind the back, grabbing opposite ends.
Next, you place your fingers on your frozen shoulder arm on the wall to walk your fingers up it as high as you can reach. You do this by keeping it parallel to the ground and lifting your elbow of the unaffected arm to stretch the other shoulder. Or you can stand with your face to the wall at about ¾ arm’s length.
Here, you use the finger muscles, not the shoulder muscles, to stretch. Then you use your healthy arm to release and repeat it 20 times throughout the day.
Next, you add strengthening exercises to your other stretch exercises. First, you hold each end of a resistance band in your hand. For example, you can do an outward rotation with your elbows bent at a 90° angle tucked towards your ribs. Now, you rotate your lower part of the frozen shoulder outwards and hold it there for 5 seconds. Then you repeat it up to 15 times.
After this, you do an inward rotation by attaching the resistance band to the doorknob of a closed door. You grab the end using your frozen shoulder arm with your elbow bent at 90° as close to the ribs as possible. Next, rotate your lower part towards your body to hold it there for 5 seconds and repeat up to 15 times.
Good Posture Advice
Working with a physiotherapist also helps to practice good posture—the best when sleeping is to lie on your back with your arms by your side. It would help if you also had good head and neck support to help keep the spine aligned, relieving pressure from the shoulders. It also helps to sit or walk with your back up straight and the shoulders back to ease tension in your body and spine.
Pain Relief Advice
Suppose you have a frozen shoulder and suffer from severe pain. In that case, your doctor can prescribe you painkillers to help or give you steroid injections in your shoulder. We still recommend you go for physiotherapy to help with the exercises.
Do’s and Don’ts for Frozen Shoulder
Exercise regularly as per your physical therapy program but do not overdo it. Take your pain relievers as per your GPs instructions and do not drink or smoke. For example, you can use an ice pack to relieve pain for ten minutes about four times a day.
Keep doing your mobility exercises and stretching to strengthen both sides of the shoulders, and pay attention to how you sleep. Try not to sleep on your sore side, and where possible, sleep on your back. Never stop moving the frozen shoulder, even if it is painful, and do not do strenuous activities like sudden movements or heavy lifting.
Frozen Shoulder Diet Guide/Plan
As you must not neglect the exercises recommended by your physiotherapist, you must not neglect your diet. It helps to eat healthy anti-inflammatory food to speed up recovery. This includes:
- Olive oil
- Nuts like almonds and walnuts
- Fatty fish like sardines, tuna, and salmon
- Strawberries, oranges, cherries
- Green leafy veg from kale, and collards, to spinach to your diet
What is the fastest way to heal a frozen shoulder?
The fastest way to heal your frozen shoulder is to start with a physiotherapy program using an exercise plan with painkillers prescribed by a doctor.
What is physiotherapy treatment for frozen shoulders?
It is a set of gentle shoulder exercises to enhance mobility. At the same time, it stretches and strengthens your shoulder using different techniques to achieve the best results in the different phases.
Can physical therapy make frozen shoulder worse?
No physical therapy cannot worsen a frozen shoulder. However, if the therapist works with you for up to 12 months and your shoulder stiffness does not improve, they will recommend surgery to help relieve the tightness.
What is the best therapy for frozen shoulders?
Doing shoulder exercises is the best therapy to help with frozen shoulders. A physiotherapist will talk you through activities you can do and a plan tailored to you. Aside from this, it also helps to practice excellent posture and change your diet.