Frozen shoulder results from the gradual loss of movement in the shoulder joint.the joint consists of a ball and socket. Normally,it is one of the most mobile joints in the body.when the shoulder becomes frozen,the joint has become stuck and its movement is limited.
|PAINFUL STAGE(FREEZING STAGE)||Shoulder pain is the hallmark of this stage.it starts gradually and progressively worsens.|
|FROZEN STAGE||Pain may reduce in this stage,although shoulder stiffness and restriction increases. Shoulder range of motion is dramatically reduced.|
|THAWING STAGE||This stage is characterized by spontaneous thawing. The motion will gradually increase and the shoulder will be more responsive to stretching exercises and treatment.|
The most fundamental component of treating frozen shoulder is movement. The most common treatments for frozen shoulders are mobility exercises and anti-inflammatory drugs. In rare cases,manipulation under anesthesia(MUA) or surgery may be indicated. INTERVENTIONAL PROCEDURES
In the event that more conservative measures do not work, more intrusive treatments can be employed. These interventions include steroidal injections, MUA and surgery. Steroid injections appear to be as effective as MUA but have less of dangers associated with anesthesia and sedation. Surgery is usually reserved for more resistant cases of adhesive capsulitis. In MUA,the patient is sedated to reduce the level of pain and muscle resistance. The orthopedic surgeon manipulates the shoulder to break free the adhesions.an intensive regime of physical therapy is required for a couple weeks following MUA to prevent new adhesions from forming following the manipulation.
In cases that are resistant to all other forms of treatment arthroscopic surgery may be utilized to remove the restrictive adhesions.
Shoulder motion is the primary treatment for frozen shoulder.it is important to continue to use the arm as much as tolerated while healing. If the shoulder is overly protected from motion the condition will worsen. The exercise program that follows is intended to increase motion in all planes of shoulder motion.
Remember that healing from a frozen shoulder will take time. These exercises need to be done every day.
Initiate active assisted range of motion using a cane in the lying position to provide stabilization and control of scapula. Motions usually included are flexion(movement in frontal plane),abduction(movement sideways) and rotations.
Gently contract a group of muscles while slight resistance is applied-just enough to stimulate a muscle contraction without provoking pain.
Manual stretching techniques are used to increase mobility in shortened muscles and related connective tissues.As the joint reaction becomes predictable and the patient begins to tolerate stretching, self-stretching techniques are taught.