This week our resident physical therapist, Tomas Ryan, will discuss the condition of Frozen Shoulder in greater detail. Frozen Shoulder is a condition that causes shoulder movement, restriction accompanied by severe pain. It can last for periods of six months to two years in duration. There are four different stages each with differing symptoms that I have outlined below.
How do you know that you have Frozen Shoulder:
â€¢ Difficulty moving the shoulder when putting on a coat
â€¢ Pain when reaching with your hand to pick up your coat from the backseat of the car
â€¢ Reaching with your hand overhead and placing your hand behind your back become difficult and painful
â€¢ Pain radiates to the outside area of the shoulder and down into the forearm.
â€¢ Intense burning during the painful and freezing stage progressing to dull pain after six months
â€¢ Sharp pain can be felt at the end of range movement
Stage One (Painful/inflammatory stage) lasts for the initial first three months. There is inflamation of the synovial membrane causing mild loss of motion in a) lifting the arm upwards, b) lifting the arm upwards from your hip, c) placing your hand behind your head. Frozen shoulder is often misdiagnosed as Shoulder Impingement Syndrome in stage one.
Stage Two (Freezing Stage) between months three to six. There is severe pain on shoulder movement, due to the synovial capsule becoming partially glued to the head of the Humerus bone in the shoulder socket. Shoulder movement is severely reduced.
Stage Three (Frozen Shoulder) between months six to 12. The severity of pain has decreased with pain at the extremes of shoulder motion; a rigid end point feeling is noted when attempting to force the movement beyond its restriction.
Stage Four (thawing stage) between 15 â€“ 24 months. There is a gradual increase in shoulder movement during this phase with a decrease in pain.
Treatment and management:
The accepted consensus for treating Frozen Shoulder is non-operative treatment. For each of the four stages of Frozen Shoulder outlined above a different graded approach to mobilising the joint and to exercise is required. For example in stage one, the goal is to reduce inflamation with shoulder movement carried out in a light and easy manner and these easy exercises repeated between 8-10 times per day. In stage two, the focus on reclaiming shoulder movement is slightly more aggressive than stage one
with higher grades of joint mobilisation was carried out on the joint by the physical therapist. Physical therapy treatment is important as studies have shown that shoulder joint tightness can continue to exist many years later from when frozen shoulder was first diagnosed in the Patient.
TomÃ¡s Ryan (BSc. Ph.Th. MIAPT) is a registered physical therapist with The Irish Association of Physical Therapy and is
based in Clonmel & Thurles.
Contact Number: 0504 26672
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