Frozen shoulder is a hugely frustrating condition, it seems that whatever you try to do, nothing helps it. For a condition that disproportionately affects women, it is particularly frustrating when you can’t get your bra fastened properly, or put your hair up. So how do we treat frozen shoulder and what can you do to help yourself if you have this condition.
Why can frozen shoulder take so long?
Firstly, if recovery is taking a while, don’t worry you are not alone. Frozen shoulder is thought of as an auto immune condition, it makes the fluid around your shoulder joint sticky.
This is why the real name for it is “adhesive capsulitis” literally sticky capsule. The body will eventually calm down and “release” the joint but it can take anything from 1-3 years for this cycle to complete.
If you catch it early you can sometimes halt to decline with a steroid injection, but it works best in the early stages and it is incredibly hard to diagnose initially as it mimics other shoulder problems.
Is it definitely frozen shoulder?
The key defining factor is frozen shoulder, is that despite treatment, ice, heat , rest, strengthening, nothing helps it, it just keeps getting stiffer and stiffer. The only way to truly know if it is frozen shoulder is an ultra sound or MRI scan, but there are certain movements we can see in the clinic that can make us suspect a frozen shoulder.
Simply having pain on lifting your arm is not necessarily frozen shoulder, there are many reasons for this so an assessment is needed.
How can I help myself?
There are several ways that we have helped clients move through the stages of frozen shoulder more quickly than may otherwise be the case.
1. Keep moving the arm. This might sound counter intuitive, but using the arm within the movement you have is really important. Even if that movement is getting smaller, keep using what you have.
2. Stand facing a wall with your hand infant of you on the wall. Walk your fingers up the wall. Don’t force your arm to go higher than it wants to, just use the movement that you have.
3. Stand side on to a wall with your arm to the side. Again walk your hand up the wall, going to where you can with easy movement. As soon as you feel you are having to force it, stop.
These movements offload your shoulder slightly as the wall takes some of the load. You may to be able to force your arm higher than is easy, but that just tends to create abnormal movements, using the wrong muscles, and that isn’t helpful in your recovery.
4. Leaning over, allow your arm to hang and slowly rock your arm forwards and backwards, side to side, and in small rotational movements. As you are is hanging, gravity is helping to extend the joint capsule slightly, allowing a bit of space for movement to occur. Make sure the movement is easy and there is no pain involved.
How can treatment change as the shoulder changes?
The key is to work with the shoulder, rather than trying to force it. In the early days we have found Myofascial release is v helpful in providing temporary relief to the stiffness. This is a hands on massage style of treatment, it is very light and it helps to draw fluid into tissues. Clients find this very helpful and it helps to maintain the movement you have.
As the shoulder freezes up, movement will become lesser and that is fine, just keep using the movement you have available.
As it starts to unfreeze, you will notice the movement starts to increase very slowly. This is when we start clients on strength work. To be fair we will often give clients strength work on day one, just working the range they have. This means, that as your shoulder starts to unfreeze, there is some base strength to work with.
Many people continue to have problems long after the shoulder has unfrozen, due to weakness, rather than the condition itself. So for every inch more you get in movement, we grab a band or a small hand weight and strengthen that range. That way, once you fully unfreeze you have a functional arm again.
How can The Reinge Clinic help?
If we suspect a frozen shoulder we will try to get your GP to do an ultrasound scan and steroid injection in at the earliest opportunity. In reality, we will often miss this window, as clients come to us once they are frustrated with the lack of progress.
We will suggest regular sessions while the shoulder is locked, providing hands on treatments and advising on strength work to help speed you through whichever phase you are in. This is not a quick process but well worth it in the long run, we have packages available to help with the cost of this. As the shoulder starts to unfreeze, we start to space the treatments out, allowing strength work to take over and making sure your shoulder moves correctly again.
If you are having problems with frozen shoulder, take a look at our web page on this, as well as the NHS website which has useful tips.