You may have heard about a friend or relative who has experienced ‘frozen shoulder’ and wondered exactly what it was, or you may be experiencing shoulder movement problems yourself and are wondering if you have this condition. So first things first – just what is frozen shoulder exactly?
Before we answer that question we need to separate pseudo-frozen shoulder from true frozen shoulder.
Pseudo-frozen shoulder is when the shoulder has become stiff and displays limited range of motion as a result of muscle guarding or deconditioning. Muscle guarding is when your muscles stiffen as a protective response from your brain to, for example, an accident. Deconditoning from a reduction in the demand placed on the shoulder over time can mean that it becomes stiffer due to decreased strength and general tissue health. This is different from true frozen shoulder in that there is no physical ‘block’ preventing the shoulder from moving, rather it is usually more a question of progressively re-acquainting the shoulder with the strength and range of motion that it is normally capable of.
True frozen shoulder, also known by the more formal term adhesive capsulitis, is when the non-muscular tissues inside the joint progressively stiffen over time for seemingly no reason. While it can affect anyone it is more common in females over 50. It is usually initially accompanied by pain, and later a significant loss in range of motion that makes some simple daily tasks such as putting on clothes or reaching up to a cupboard difficult or impossible.
So what causes true frozen shoulder? Even with the latest research the fact of the matter is that no one really knows. What we do know is that, if left alone, it will usually self-resolve. But here’s the kicker – that can take as long as several years.
At this point you’re probably thinking, I don’t want to wait several years!
The headline here is that, even with true frozen shoulder, you do not have to wait up to several years for it to self-resolve. Your physiotherapist’s first step will be to perform a full assessment to determine the nature of the issue, and whether it’s true or pseudo-frozen shoulder. Once you know what you’re dealing with there can be several possible options for you that your physiotherapist can guide you through, with physiotherapy as the basis for your recovery. In certain cases this may be complimented by other treatments such as an injection in to the shoulder, or a minor outpatient procedure in the most resistant cases.
It all depends on what’s right for you and what you as an individual respond to, but physiotherapy will always be the essential foundation of the treatment plan.
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