frozen shoulder

 

Frozen Shoulder

Frozen shoulder (adhesive capsulitis), is a condition that causes pain and stiffness in the shoulder joint. The disease is most commonly found in patients who have been diagnosed with diabetes as well as subjects who have had their shoulder immobilised for a substantial period of time. However, we have seen many patients in our practice with no explanation for their shoulder pain and frozen shoulder. Other causes of frozen shoulder include:

  • Hormonal imbalance
  • Diabetes
  • Weakened immune system
  • Long period of inactivity due to injury, illness or surgery

The process starts as inflammation that resolves as fibrosis and includes three stages:

  • Acute inflammation of the Glenohumeral joint capsule
  • Stiffening stage
  • Thawing phase (months-years later)

Frozen shoulders come in various forms from unknown onset to traumatic onsets. They’re extremely painful, limiting and disabling conditions affecting an individual’s ability to function. Clinically it affects the front capsule and rotator mechanism of the shoulder. Adhesive capsulitis/frozen shoulder limits movements including reaching over head, out to the side and behind the back.

Diagnosis of frozen shoulder includes:

  • 3 to 4 movements that have equal loss of movement with significant pain at the end of the range of motion
  • Resisted shoulder tests
  • Diagnostic imaging- X-ray to check shoulders normal before confirming diagnosis

frozen shoulder treatmentTreatment for Frozen shoulder can involve a number of options. The first being a leave it alone approach, as many conditions spontaneously resolve after a certain period of time, Intra-articular corticosteroid injections, surgery (manipulation under anaesthetic) and physical therapies including chiropractic.

Chiropractic treatment of frozen shoulder (adhesive capsulitis) involve massage, joint mobilisations/manipulations, passive stretching, acupuncture, electrotherapy and exercises (Noten et al., Arch Phys Med Rehab, 2015). Chiropractors advise patients to complete and take-home specific stretching exercises that have been found to be the cornerstone of treatment for frozen shoulder. Prior to completing these exercises, the shoulder should be warmed up for 10-15 minutes in either a hot shower/bath or heat pack applied. The stretching exercises should be taken to a point of tension within the shoulder, although we don’t want to be eliciting any pain to the area. Stretches for frozen shoulder include:

  • Pendulum Stretch- 10 revolutions in each direction once a day
  • Towel Stretch- Hands behind back and good arm pulls affected arm, 10-20x/d
  •  Finger walk- Start at waist and slowly walk fingers up wall, 10-20x/d
  • Cross body stretch- Arm pulled in adduction via good arm holding for 15-20 seconds
  • External rotation (outward rotation)- rubber band with elbows at 90 degrees and affected arm rotates outwards by pulling on band, 10-15x/d
  • Internal rotation (inward rotation)- Attach resistance band to doorknob, affected shoulder against door and pull resistance band into your body, 10-15x/d


Eccentric Strengthening for Frozen Shoulder:

Eccentric strengthening exercise is another form of treatment used to improve joint flexibility via the process of sarcomerogenesis. This process increases the length of connective tissue to improve shoulder mobility. The exercise commences with patients lying on their back with their affected shoulder in an externally rotated position. A weight is placed in the patient's hand and lowered towards a target that’s in the tolerable range (a stack of books). Once completed, move the hand back to neutral and remove a book and lower arm further. Continue withdrawing books until patient has full range of external rotation in their shoulder.

So if you are experiencing any pain/ stiffness in the shoulder or have been diagnosed with a frozen shoulder by your doctor call Lakeside Chiropractic. Lakeside Chiropractic is located centrally to Perth Northern suburb, in Joondalup. We have a wide range of visitors who visit us from a variety of surrounding suburbs of Heathridge, Craigie, Edgewater, Sinagra, Wanneroo, Padbury, Whitfords, Kallaroo, Mindarie, Ocean Reef, Woodvale, Butler, Tapping and Neerabup. Call us for an appointment on 9300 0095 or book via our “Book Now” tab on the website www.lakesidechiro.com.au. Our Perth trained chiropractors are ready and able to help you live your life to its fullest.

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