Frozen Shoulder

Adhesive Capsulitis, more commonly known as Frozen Shoulder, is a condition characterised by  pain and stiffness in the shoulder joint.  Over time, the range of motion in the shoulder becomes very limited.  

What is Frozen Shoulder?

The shoulder (glenohumeral) joint is surrounded by a capsule of connective tissue. Under normal conditions, the capsule is elastic and allows for stretch during shoulder movements.  However, in a frozen shoulder, inflammation occurs within the capsule and scar tissue is formed creating a thickening of the connective tissue.  This scar tissue formation is very fibrotic and inelastic, resulting in limited stretch of the capsule, thereby decreasing the range of motion.

The inflammation and scar tissue formation also produces pain, and this pain is further exacerbated when the capsule is stretched or the shoulder is moved.  This whole process occurs gradually and progresses through three overlapping stages.

The 3 Stages of Frozen Shoulder:

Stage 1: Freezing stage (Painful stage)

• Shoulder pain increases, especially at night
• Range of motion starts to decrease
• Lasts about 6 weeks to 9 months

Stage 2: Frozen stage (Stiffness stage)

• Pain may reduce, but shoulder becomes stiffer
• Daily activities become harder
• Can last 4 to 12 months

Stage 3: Thawing stage (Recovery stage)

• Shoulder movement slowly improves
• Pain continues to fade
• Can last 6 months to 2 years

What Causes Frozen Shoulder?

The cause of Frozen remains unclear. However, there are some risk factors that increases the likelihood of developing frozen shoulder:

1. Age and Gender:

Individuals 40 and older, particularly women, are more likely to have frozen shoulder.

2. Immobility or Following Shoulder Injury:

Individuals who limit their shoulder mobility are at higher risk of developing frozen shoulder. Restricted movement can be the result of many factors, including:

• Rotator cuff injury
• Fractured arm
• Post Stroke
• Post Surgical

3. Systemic diseases:

Individuals who have certain diseases appear more likely to develop frozen shoulder. Diseases that might increase risk include:

• Diabetes
• Thyroid Dysfunction (hyperthyroidism or hypothyroidism)
• Cardiovascular disease

How is Frozen Shoulder Diagnosed?

A comprehensive assessment of your shoulder range of motion both actively and passively will be conducted.  In Frozen Shoulder, both of these movements will be limited. The fibrotic capsule and scar tissue does not show up clearly on scans, but imaging helps include/exclude other issues like rotator cuff tears, arthritis, or bone spurs.  As mentioned, prior shoulder injury may lead to the development of frozen shoulder, so for example a rotator cuff injury may be present with diagnostic imaging.

What are the Treatment Options for Frozen Shoulder?

Physiotherapy is integral for the full recovery of a Frozen Shoulder.  It is essential for regaining the range of motion and strength necessary for daily activities and return to sport.  The Physiotherapists at The Physio Approach have a wealth of experience managing Frozen Shoulder.  Through precise manual therapy, we will break down the scar tissue formed in the joint capsule and normalize your range of motion.  We will guide you every step of the way with exercises you can do at home to help facilitate this process.

Massage Therapy is also an adjunct treatment option to help with pain relief and improving mobility.  Tension and trigger points will develop as the condition progresses.  Our experienced Registered Massage Therapist will help to improve the extensibility of the muscles surrounding the shoulder to help ease the pain and stiffness.

If you or anyone you know is suffering from a Frozen Shoulder, don’t hesitate and book your consultation now. Who better to treat your frozen shoulder than a trained practitioner who understands the complexities of joint mobility and specializes in restoring pain-free movement?  Our Physiotherapists have spent years learning, playing and coaching competitive tennis and volleyball, both sports requiring an in depth knowledge of the mechanics involved with shoulder movements. Our North York team of experienced healthcare practitioners will provide a personalized treatment plan to help restore mobility, reduce pain, and get you back to doing what you love.