Physiotherapy Management for Frozen Shoulder

Frozen shoulder also known as Adhesive capsulitis is a painful persistent stiffness of the shoulder joint that makes it difficult to carry out the full range of motion of normal shoulder movements. Frozen shoulder occurs when the flexible tissue that surrounds the shoulder joint, known as the capsule, becomes inflamed and thickened. The exact cause is not fully understood and it cannot always be identified. However, most people with frozen shoulder have experienced immobility as a result of recent injury or fracture. It is also common in people with Diabetes.
Frozen shoulder can resolve on its own without treatment, however the pain and stiffness can remain for months or years. Physiotherapy, along with medication, plays a vital role in managing pain and stiffness and helping you return to your normal daily activities.

Physiotherapy management for this condition would include Electrotherapy ( Ultrasound, IFT, electrical stimulation), Hot fomentation, Cryotherapy, Manual Therapy (Mobilisation, Myofascial Release techniques), Exercises and Stretching.

The use of modalities such as Ultrasound, IFTor TENS can help to reduce the pain. Ultrasound is a good rehab method for frozen shoulder that uses sound waves to treat pain, inflammations and muscle spasms. IFT or Interferential Therapy has been known to deliver a continuous stimulation deep into the affected tissue. The stimulation both blocks pain and reduces swelling and inflammation at the shoulder.

Hot fomentation/Cryotherapy:
Hot or cold therapy helps to reduce pain, stiffness, swelling etc. Discuss your symptoms with your physiotherapist and based on their assessment, your physio will advise you on the use of hot/cold packs.

Manual therapy:
Within Manual therapy, Mulligan’s Mobilisation and Maitland’s technique for joint mobilisation are widely used and have shown good results for the rehabilitation of frozen shoulder. Your Physio will use highly skilled hand techniques to mobilise the shoulder joint and the surrounding tissues. Myofascial Release techniques will help to stretch and release tight muscles thus reducing pain and stiffness.

As mentioned earlier, the capsule around the shoulder joint tends to get thickened in frozen shoulder and hence it is important to stretch the capsule in order to allow the shoulder to move through its range of motion. Your physio will passively stretch the capsule for you during your therapy sessions and also teach you self stretching techniques for you to do at home.

Most stiff shoulders can be managed successfully by a simple exercise programme. It is basically a question of gently and progressively getting the shoulder moving again. The basic aim of the exercises are:
1. To reduce pain
2. To increase extensibility of the thickened and contracted capsule
3. To improve mobility of the shoulder
4. To improve the strength of the muscles.
Your physiotherapist will guide and supervise you through your exercise programme as well as give you a home exercise programme.

If you are suffering from a painful stiff shoulder, kindly contact us at HealthQuest for an assessment and consultation. We would be very happy for the opportunity to help you manage your frozen shoulder.

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