Frozen shoulder is a condition that leads to stiffness of the shoulder joint, therefore causing restriction in movement. Simple activities such as reaching overhead, sideward, and behind the back can become very difficult and painful.
Although the cause of FS is still unknown, some risk factors identified were diabetes, stroke, sedentary lifestyle, thyroid disease, and a previous history of shoulder injury.
Studies also found that frozen shoulder is two to four times more common in women between 40-60 years of age and with the nondominant shoulder being more affected.
Frozen shoulder, if not secondary to any shoulder injury or preexisting condition such as diabetes, is primarily a diagnosis of exclusion, based on thorough history taking, physical examination and appropriate imaging.Common clinical findings include: stiff and painful shoulder for at least 4 weeks, severe shoulder pain affecting work and daily activities, pain at night, and restriction of both active and passive shoulder motions.
Although frozen shoulder can be painful, it is important to move the affected shoulder in all directions to maintain and increase available range. Stretching and mobilization exercises should also be done daily to prevent progressive stiffening of the shoulder joint.
Physical therapy has been shown to be beneficial in conservative management of frozen shoulder. Typical program will include mobilization, stretching, and strengthening exercises. Home exercises and self-management techniques are also vital parts of a comprehensive physical therapy program to promote patient independence.
Before initiating any exercise, the affected shoulder should be warmed up first either by taking a warm shower or placing a hot compress on the affected area for 10-15 minutes. Pain can be present when performing exercise but as long as the pain is tolerable it is safe to continue.
1. Pendulum stretch/Codman`s exercise
Goal: Stretch the shoulder joint
Procedure:
a.) Stand and lean slightly over a table using the good arm as a support and letting the affected arm to hang down
b.) Swing the arm in small circles in clockwise, and then counterclockwise directions for 10 revolutions each
c.) Do this once daily and as symptoms improve, progress to bigger swing diameter
d.). If comfortable and pain-free, you can hold a light weight (3-5 lbs) on the affected arm to gently increase the stretch on shoulder.
2. Self-mobilization Technique
Goal: Mobilize the shoulder
Procedure:
a.) Lie on your stomach, propped up on both elbows
b.) Shift your body weight downward between the fixed arms
c.) Return to previous position, and repeat
d.) Do this or 10-20 times at least twice daily
3. Finger ladder
Procedure:
a.) Face the wall at least three-quarters away with your hand at the level o your waist
b.) With your elbow slightly bent, slowly walk your fingers up the wall, until you`ve raised your arm as high as you can
4. Cross-body stretch
Goal: Stretch the back of your shoulder
Procedure:
a.) In sitting or standing position, use good arm to lift the affected arm at the elbow
b.) Bring the affected arm up and across your body, gently stretching the back of the affected shoulder
c.) Hold the stretch or 10-15 seconds and repeat three times
d.) Do this twice DAILY!
Goal: Increase shoulder flexion
5. Towel stretch
Procedure:
a.) Hold a towel behind your back
b.) Good arm holds the one end above, while the affected arm holds the other end below
Goal: Increase shoulder inward rotation
If you are suffering from frozen shoulder you can consult one of our Singapore Physiotherapist or Manila Physiotherapist.
Call us for an appointment or send your queries to: info@physioasia.com
REFERENCES:
Cifu, D. X. (2016). Braddom’s Physical Medicine and Rehabilitation (5th ed.) (D. L. Kaelin, K. J. Kawalske, H. L. Lew, M. A. Miller, K. T. Ragnarsson, & G. M. Worsowicz, Eds.). Philadelphia, PA: Elsevier
Donatelli, R. (2012). Physical Therapy of the Shoulder (5th ed.). St. Louis, MO: Elsevier/Churchill Livingstone.
Dutton, M. (2012). Dutton’s Orthopaedic Examination, Evaluation, and Intervention (3rd ed.). New York: McGraw-Hill Medical.
Ferri, F. F. (2017). Ferris Clinical Advisor 2017: 5 Books in 1. Philadelphia, PA: Elsevier, Inc
Kisner, C., & Colby, L. A. (2012). Therapeutic Exercise: Foundations and Techniques (6th ed.). Philadelphia, PA: FA Davis Company
Micheo, W. (2011). Musculoskeletal, Sports, and Occupational medicine. New York: Demos Medical.
Rockwood, C. A. (2017). Rockwood and Matsen’s the Shoulder (5th ed.). Philadelphia, PA: Elsevier.
Sueki, D., & Brechter, J. (2010). Orthopedic Rehabilitation Clinical Advisor (1st ed.). Maryland Heights, MO: Mosby Elsevier.
Wyss, J., & Patel, A. (2013). Therapeutic Programs for Musculoskeletal Disorders (1st ed.). New York: Demos Medical Publishing