Frozen shoulder, clinically known as adhesive capsulitis, is a debilitating condition characterised by pain, stiffness, and limited range of motion in the shoulder joint. While the exact cause of frozen shoulder remains elusive, the condition typically progresses through distinct stages, each presenting unique challenges and symptoms. In this blog post, we'll explore the stages of frozen shoulder, from onset to resolution, providing insights into the diagnosis, treatment, and rehabilitation of this complex shoulder condition.
Stage 1
Freezing Stage The freezing stage marks the onset of symptoms and is characterised by gradually increasing shoulder pain and stiffness. During this stage, individuals may notice difficulty with everyday tasks such as reaching overhead, dressing, or sleeping on the affected side. The pain is typically dull and achy, localised to the shoulder joint, and may worsen at night. Range of motion becomes progressively restricted, particularly in external rotation and abduction. Diagnosis during this stage is crucial for initiating early intervention and preventing further progression of the condition.
Stage 2
Frozen Stage The frozen stage represents the peak of symptoms, with severe shoulder stiffness and significantly limited range of motion. Shoulder pain may persist, but it often becomes less intense compared to the freezing stage. Individuals experience a profound loss of mobility, with difficulty performing even simple movements such as combing hair or reaching behind the back. The shoulder joint feels "frozen" in place, and attempts to force movement may exacerbate pain and discomfort. Physical examination reveals marked restriction of passive and active range of motion, particularly in external rotation and abduction.
Stage 3
Thawing Stage The thawing stage signals the gradual resolution of symptoms and restoration of shoulder mobility. During this stage, pain and stiffness gradually subside, and range of motion begins to improve. Individuals may notice a gradual increase in shoulder flexibility, allowing for more comfortable and functional movement. While recovery can be slow and variable, most individuals experience significant improvement in symptoms over several months to years. Rehabilitation during this stage focuses on restoring full range of motion, strength, and function in the shoulder joint.
Treatment and Rehabilitation
Pain Management: Use a combination of modalities such as ice therapy, anti-inflammatory medications, and pain-relieving exercises to alleviate shoulder pain and discomfort.
Stretching and Range of Motion Exercises: Implement gentle stretching and range of motion exercises to maintain flexibility and prevent further stiffness in the shoulder joint. Gradually progress to more challenging stretches as tolerated.
Strengthening Exercises: Incorporate strengthening exercises targeting the muscles surrounding the shoulder joint, including the rotator cuff muscles, deltoids, and scapular stabilisers. Focus on gradual progression and proper form to avoid exacerbating symptoms.
Manual Therapy: Consider manual therapy techniques such as joint mobilizations, soft tissue mobilisation, and myofascial release to improve shoulder mobility and reduce stiffness.
Modalities and Heat Therapy: Use therapeutic modalities such as ultrasound, electrical stimulation, or heat therapy to promote tissue healing, reduce inflammation, and alleviate pain in the shoulder joint.
Activity Modification: Modify activities and movements that exacerbate symptoms to prevent further irritation of the shoulder joint. Avoid overhead activities, heavy lifting, and repetitive movements that may worsen pain and stiffness.
Patient Education: Educate individuals about the stages of frozen shoulder, expected recovery timeline, and importance of compliance with rehabilitation exercises and treatment protocols. Encourage active participation in self-care strategies and home exercises to facilitate recovery.
Frozen shoulder is a challenging condition that progresses through distinct stages, each presenting unique symptoms and challenges. Early diagnosis and intervention are essential for optimising outcomes and preventing further progression of the condition. By understanding the stages of frozen shoulder and implementing targeted treatment and rehabilitation strategies, individuals can effectively manage symptoms, restore shoulder function, and improve quality of life.
At Urban Physiotherapy, we offer expert guidance and personalised care to help you navigate each stage of this condition. Contact us today to learn more about how our comprehensive treatment plans can support your journey to improved shoulder mobility and comfort.
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