Frozen shoulder (also called adhesive capsulitis) is a common disorder that causes pain, stiffness, and loss of normal range of motion in the shoulder. frozen shoulder exercises The resulting disability can be serious, and the condition tends to get worse with time if it’s not treated. It affects mainly people ages 40 to 60 — women more often than men.
We don’t fully understand what causes a frozen shoulder, but an inflammatory process is probably involved. Sometimes freezing occurs because the shoulder has been immobilized for a long time by injury, surgery, or illness. In many cases the cause is obscure. Fortunately, the shoulder can usually be unfrozen, though full recovery takes time — and lots of self-help.
The shoulder has a wider and more varied range of motion than any other part of the body. It pivots mainly on a ball-and-socket arrangement called the glenohumeral joint, which joins the top of the humerus (upper arm bone) to a scooped-out part of the scapula (shoulder blade) called the glenoid cavity. (See the illustration, “Anatomy of a frozen shoulder.”)
The glenohumeral joint helps move the shoulder forward and backward and allows the arm to rotate and extend outward from the body. A flexible capsule filled with a lubricant called synovial fluid protects the joint and helps keep it moving smoothly. The capsule is surrounded by ligaments that connect bones to bones, tendons that fasten muscles to bones, and fluid-filled sacs called bursae that cushion tendons and bones during motion. The band of muscles and tendons that stabilizes the shoulder and controls its movements is called the rotator cuff. This elaborate architecture of soft tissues accounts for the shoulder’s marvelous flexibility, but also makes it vulnerable to trauma as well as chronic wear and tear.
The process usually begins with an injury (such as a fracture) or inflammation of the soft tissues, typically due to overuse injuries such as bursitis or tendinitis of the rotator cuff. Inflammation causes pain that is worse with movement and limits the shoulder’s range of motion.
When the shoulder becomes immobilized in this way, the connective tissue surrounding the glenohumeral joint — the joint capsule — thickens and contracts, losing its normal capacity to stretch. Trying to avoid the pain caused by moving the shoulder leads to further contraction of the capsule. The humerus has less space to move in, and the joint may lose its lubricating synovial fluid. In advanced cases, bands of scar tissue (adhesions) form between the joint capsule and the head of the humerus.
The frozen shoulder risk is increased when you don’t receive exercise therapy after tendinitis or an injury, and when you wear a sling for more than a few days without intermittent stretching. About 10% of people with rotator cuff disorders develop frozen shoulder. Enforced immobility resulting from a stroke, heart condition, or surgery may also result in a frozen shoulder. Other conditions that raise the risk of a frozen shoulder are thyroid disorders, Parkinson’s disease
If you think you have a frozen shoulder or are developing one, see your clinician or a shoulder expert for a physical exam. To assess your shoulder’s range of motion, the clinician will ask you to perform various movements with your arm, such as reaching across your chest to touch the opposite shoulder or down your back to touch the opposite shoulder blade (the Apley scratch test). She or he may take x-rays to make sure there’s no other underlying problem, such as arthritic changes or a dislocation. An MRI may be ordered to check for a rotator cuff tear.
The treatment for a frozen shoulder is focused on relieving pain and restoring the shoulder’s normal range of motion. Your clinician may recommend an anti-inflammatory medication such as aspirin, ibuprofen (Motrin, Advil), or naproxen (Aleve, Naprosyn, Anaprox). An ice pack or bag of frozen vegetables applied to the shoulder for 10 to 15 minutes several times a day can also help with pain. You may be given a corticosteroid injection into the shoulder joint or soft tissues. But the cornerstone of treatment is physical therapy, concentrating first on exercises that stretch the joint capsule, and later, on strengthening exercises.frozen shoulder exercises A physical therapist can show you how far to push yourself and can teach you the appropriate exercises. Once you’ve learned your limitations, you can practice most of your exercises on your own at home.
