Introduction
Frozen shoulder, medically known as adhesive capsulitis, is a condition that causes pain, stiffness, and limited movement in the shoulder joint. It can significantly impact daily activities, making simple tasks like reaching for objects or dressing up challenging. The condition typically progresses through three stages and can last for months or even years if not treated properly. Physiotherapy plays a crucial role in the recovery process, helping restore mobility and reduce pain.
Dr. Riddhi Gohel, a leading physiotherapist in Ahmedabad, specializes in treating frozen shoulder with advanced physiotherapy techniques.
In this article, we will explore the symptoms, causes, and effective physiotherapy treatments for frozen shoulder.
Symptoms of Frozen Shoulder:
Frozen shoulder develops gradually and progresses through three distinct stages: freezing, frozen, and thawing. Each stage has its own set of symptoms and duration.
1. Freezing Stage (Painful Stage)
- Duration: 2 to 9 months
- Symptoms:
- Gradual onset of shoulder pain, worsening over time.
- Pain becomes severe, especially at night.
- Limited movement due to pain and stiffness.
- Difficulty in lifting the arm or performing overhead activities.
2. Frozen Stage (Stiffness Stage)
- Duration: 4 to 12 months
- Symptoms:
- Pain may reduce slightly, but stiffness increases.
- Significant restriction in shoulder movement.
- Daily activities like dressing, combing hair, or reaching for objects become difficult.
- Muscle weakness due to lack of movement.
3. Thawing Stage (Recovery Stage)
- Duration: 6 to 24 months
- Symptoms:
- Gradual improvement in shoulder movement.
- Stiffness starts to reduce.
- Pain continues to decrease.
- The shoulder slowly regains normal function.
If left untreated, frozen shoulder can lead to prolonged disability. Physiotherapy is one of the most effective treatments to improve mobility and accelerate recovery.
Causes and Risk Factors of Frozen Shoulder
The exact cause of frozen shoulder is not always clear, but several factors contribute to its development. These include:
1. Prolonged Immobilization
- After surgery, injury, or fractures, if the shoulder is not moved for a long period, the risk of frozen shoulder increases.
2. Diabetes
- People with diabetes are at a higher risk of developing frozen shoulder. Studies suggest that 10-20% of diabetic patients experience this condition.
3. Hormonal Imbalance
- Women, especially those in the 40-60 age group, are more prone to frozen shoulder due to hormonal changes, particularly during menopause.
4. Thyroid Disorders
- Hypothyroidism and hyperthyroidism are linked to an increased risk of frozen shoulder.
5. Autoimmune Disorders
- Conditions like rheumatoid arthritis and Parkinson’s disease can contribute to joint inflammation, leading to frozen shoulder.
6. Heart Disease and Stroke
- Individuals recovering from a heart attack or stroke may experience frozen shoulder due to inactivity.
7. Poor Posture
- Maintaining incorrect posture for extended periods, such as slouching while working on a computer, can lead to shoulder stiffness over time.
Physiotherapy Treatments for Frozen Shoulder
Physiotherapy is the most effective non-surgical treatment for frozen shoulder. It helps restore mobility, reduce pain, and prevent further complications.
Dr. Riddhi Gohel follows a structured approach to treating frozen shoulder with specialized exercises and manual therapy techniques.
1. Pain Management Techniques
- Cold Therapy (Cryotherapy): Applying ice packs to reduce inflammation and numb pain.
- Heat Therapy: Using hot packs to relax stiff muscles and improve blood circulation.
- Electrotherapy: Class 4 Laser / TENS (Transcutaneous Electrical Nerve Stimulation) or ultrasound therapy to alleviate pain.
2. Manual Therapy
- Mobilization Techniques: Gentle mobilization of the shoulder joint by a physiotherapist to improve flexibility.
- Myofascial Release: Soft tissue therapy to break adhesions and restore normal muscle function.
3. Stretching Exercises
Regular stretching is essential to maintain flexibility and prevent stiffness. Some effective stretches include:
- Pendulum Stretch:
- Stand and lean forward slightly, allowing the affected arm to hang down.
- Gently swing the arm in small circles.
- Cross-Body Stretch:
- Use the opposite hand to pull the affected arm across the chest.
- Towel Stretch:
- Hold a towel behind the back and stretch by pulling it with the opposite arm.
4. Strengthening Exercises
Strengthening the shoulder muscles helps improve stability and function.
- Isometric Shoulder Exercises: Pressing the arm against a wall without movement to activate muscles.
- Resistance Band Exercises: Using elastic bands for gentle resistance training.
- Wall Push-Ups: Strengthening shoulder muscles without excessive strain.
5. Range of Motion Exercises
These exercises improve joint mobility and reduce stiffness.
- Finger Walk: Walking fingers up a wall to increase reach.
- External Rotation with Stick: Using a stick to assist with shoulder rotation.
- Sleeper Stretch: Lying on the affected side and gently pushing the arm downward.
6. Postural Correction and Ergonomic Advice
- Maintaining proper posture while sitting and standing.
- Adjusting workstation height to prevent strain on the shoulders.
- Avoiding prolonged immobility.
7. Hydrotherapy (Water Therapy)
- Exercising in warm water reduces pain and makes movements easier due to buoyancy.
8. Home Exercise Program
Dr. Riddhi Gohel emphasizes consistency in home exercises. Patients are guided through customized exercise plans to continue recovery at home.
Additional Treatment Options
In severe cases where physiotherapy alone is not enough, additional treatments may be considered:
- Medications: Anti-inflammatory drugs or steroid injections for pain relief.
- Hydrodilation: Injecting saline solution to expand the joint capsule.
- Surgery (Arthroscopic Capsular Release): Rarely needed but may be considered in persistent cases.
Preventive Measures
While some risk factors like diabetes and aging are unavoidable, you can take certain steps to prevent frozen shoulder:
- Stay Active: Engage in regular shoulder mobility exercises.
- Avoid Prolonged Immobilization: After injury or surgery, follow physiotherapy guidelines to keep the shoulder moving.
- Maintain Good Posture: Avoid slouching and keep shoulders relaxed.
- Control Blood Sugar Levels: For diabetic patients, managing glucose levels can reduce the risk.
Conclusion
Frozen shoulder can be a frustrating and painful condition, but early diagnosis and physiotherapy treatment can significantly improve recovery time. With proper stretching, strengthening exercises, and manual therapy, patients can regain shoulder mobility and lead a pain-free life.
Dr. Riddhi Gohel specializes in personalized physiotherapy treatment plans to help individuals recover efficiently. If you are experiencing symptoms of frozen shoulder, seek professional guidance to prevent long-term complications and ensure a smooth recovery.
For expert physiotherapy treatment, visit Surya Physio Care Center, Ahmedabad, or contact Dr. Riddhi Gohel at 094267 57246.