Adhesive capsulitis a frustrating and mismanaged condition
Frozen shoulder (adhesive capsulitis) can be one of the most frustrating and mismanaged conditions for those who experience it. It is a condition in which the capsule (the connective tissue that envelops the bones of the shoulder) undergoes an inflammatory process lasting up to 18 months. The inflammation can be incredibly sore, and results in a prolonged period of stiffness and weakness of the shoulder which brings issues of its own. This makes getting the best frozen shoulder physio an important step in the process.The frozen shoulder process is often broken into 3 stages:
- The freezing stage – where the capsule is painful and begins to tighten up.
- The frozen stage – the pain may settle slightly, but the shoulder is significantly restricted on movement
- The thawing stage – the pain settles further, and small gains can be made in the range of motion of the shoulder
Frozen shoulder physio at The Movement Centre
At Movement Centre Randwick, Frozen shoulder physio starts with a clear diagnosis of the problem. Patients experiencing adhesive capsulitis have often been seen by their doctor or physio for some time – often for management of mis-diagnosed rotator cuff pathology. Clinical signs and symptoms give a clear indication when adhesive capsulitis may be at play, and imaging can help to confirm the diagnosis.Common signs and symptoms involve:
- Diffuse ache in the shoulder with no known mechanism of injury
- Pain laying on the sore side, that often worsens at night
- Pain with reaching out to the side away from the body
- Pain with rotation of the shoulder – pain with putting on seat belt, tucking in pants, reaching for back pocket of jeans
Any doctor or physio can miss this condition initially, as it often has all the hallmarks of a rotator cuff strain. However, a good practitioner will pick up quickly that something isn’t right.
Frozen shoulder physio management has been long debated. A lot of the best evidence suggests that there is very little that will shorten the duration or lessen the restrictions of a true frozen shoulder . It is important to understand this early. So often we see patients for frozen shoulder physio who have been promised solutions by previous physios and doctors. The patients spend money, time and undergo needless angst and discomfort only to be left wondering why their shoulder isn’t improving as promised.
Because of this, the patient needs to understand the process very clearly. At Movement Centre, our frozen shoulder physio management focuses on the goals and requirements of the individual. For some this involves very little input from us. Perhaps some exercises to maintain strength and mobility where possible, and advice on activity modification. For others, management may involve more hands-on work to help provide symptomatic relief for muscles around the shoulder and thoracic spine.
Clear advice and a tailored program are key
We are always happy to work with our patients, and tailor their physio program accordingly. Most importantly, we want to provide clear advice so our patients understand the incredibly frustrating process they are going through. After the “thawing stage” commences, there is sometimes a need for more physio input. This helps to ensure there is a complete restoration of range of motion, and strength around the shoulder, in particular the muscles of the rotator cuff.
After the acute adhesive capsulitis settles, complete and expedient restoration of range of motion is encouraged. This prevents ongoing rotator cuff tendon problems. Full range also allows for safe strengthening and functional movement to return. This full range is essential for overhead sports and activities like swimming. As part of our frozen shoulder physio management, we have the gym and functional rehab set-up to ensure our patients can return to the strength, sports and activities they love.
If you are experiencing adhesive capsulitis or prolonged shoulder pain that isn’t getting better with your current management, come and see our team. At Movement Centre we pride ourselves on educating our patients, and empowering them to get to the best recovery possible.