By Alan Williams, PT, OTR/L, ATC, CSCS

When I was a child back in the “dim times,” my family didn’t have a freezer. We had an ice box. Once a week, the ice man would deliver ice, which we would place in our ice box and use to keep our perishables cold until the next week’s delivery. When we were finally able to afford an actual freezer, our lives changed dramatically. And I really like frozen things – mostly as beverages and desserts. Shoulders, however, are a totally different story.

Frozen shoulder (called adhesive capsulitis) occurs when the tissue surrounding the shoulder joint becomes stiff, inflamed, and develops into abnormal bands (known as adhesions), which make movement painful and extremely difficult. Symptoms develop gradually as the shoulder “freezes over.” Generally the condition presents with aching which worsens with activity and limited or no mobility. Because this is similar to other shoulder injuries (such as a torn rotator cuff), it is important that you see your physical therapist for a correct diagnosis.

While the exact causes of frozen shoulder are unknown, suspected contributing factors run the gambit from injury to disease to the ever-popular idiopathic (meaning “unknown” in medical terms). Risk factors include recent injury or upper body surgery – anything that would require the shoulder to remain immobile (such as in a sling) for long periods of time. Frozen shoulder is most common in women over 40 years old. Because there’s also a possible autoimmune component, individuals who suffer from certain conditions (such as stroke, diabetes, rheumatoid arthritis, lung or heart disease, etc.) may also have increased risk.

A frozen shoulder goes through three stages: the “freezing” stage, the “frozen” stage, and the “thawing” stage. During the “freezing” stage, mobility decreases as pain increases; this may last from a few weeks to several months. In the “frozen” stage, pain decreases slightly, but the shoulder continues to stiffen, eventually culminating in total immobility in the severest cases; this may also take several months. Finally, the “thawing” stage is characterized by a slow, steady improvement with increases in mobility. And when I say slow, I mean slooooow; depending on the severity of the condition, it may take several months under the care of a physical therapist to regain complete function in the joint.

The good news that is most cases of frozen shoulder don’t require surgery. However, because of the long time period needed for recovery, it’s of the utmost importance that you begin treatment for your frozen shoulder immediately after diagnosis. One of the greatest dangers of frozen shoulder is muscle atrophy, and this must be directly addressed in order to minimize muscle loss.

Treatment for frozen shoulder consists of stretching, exercises, and other modalities performed under the guidance of an experienced therapist. And I’ll be very honest here – this can be quite painful. I’ve had a frozen shoulder myself. Just as the “freezing” stage is characterized by pain, so is the “thawing” stage, and the shoulder must be MADE to move until it remembers HOW to move. However, compared to a life of impaired function, any discomfort is well worth it in the end.

Your therapist will also educate you in pain management techniques for the” long haul “of your recovery. These will include the use of ice and/or heat, ultrasound, electrical stimulation, and over-the-counter pain relievers if approved by your doctor.

Fortunately, prevention for frozen shoulder is simple – just get moving! When your shoulder is active, there is no chance for adhesions to form. Even if you have other risk factors, keep your shoulder in mind and work it into your daily activities – washing your hair, dusting, and waving to a friend are just a few simple ways to keep your shoulders active without really trying. And if you develop pain and stiffness in your shoulder, don’t hesitate to see your doctor or physical therapist. Some things are best when frozen, but your shoulder isn’t one of them.

Call 463-0022 today for your FREE Shoulder Pain Assessment!