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Full Report

Welcome to your free report covering the diagnosis, management and treatment options, exercises and equipment that could help in rehabilitation. Scroll down to read more.

Diagnosis

Frozen Shoulder

A frozen shoulder is a condition which leads to a reduction in shoulder range of movement and often causes pain. From the testing you performed with a reduction in lateral rotation and abduction, and no pain on the resisted testing when the arm was in neutral, is a common presentation for a frozen shoulder.

The medical term for a frozen shoulder is 'Adhesive Capsulitis', as the cause of this condition is a tightness of the capsule which covers the entire shoulder joint. They still are not sure what causes people to suffer from a frozen shoulder, but there is a small link that an episode of trauma can trigger it, and females between 40 and 60 years old are more common to be effected. However, people with no history of trauma, who are male and not within that age bracket, can also suffer from a frozen shoulder. The timeframe to recover from a frozen shoulder can take up to 18 months, on certain occasions it can be much shorter, but unfortunately it can also take longer. It is almost impossible to predict how long someone will take to recover from a frozen shoulder. Generally speaking the individual will go through three stages; the freezing stage, the frozen stage, and finally the thawing stage. In the freezing stage the individual will begin to notice discomfort in their shoulder and certain activities will be more difficult. If someone is assessed by their family doctor or physiotherapists in the early stages of a frozen shoulder it may not be particularly obvious, and their pain may present as other shoulder issues, such as rotator cuff in origin. Eventually they will have the classic signs of a frozen shoulder, most noticeably restriction in passive range of movement in lateral rotation and abduction - moving your arm outwards. You may also find you have restriction in internal rotation, along with difficulty lifting your hand above your head. You will also find that to generate arm movements that you start hitching your shoulder up, by shrugging, to help compensate for the reduction in range. Once it is clearer that the movements are restricted you are said to be in the 'frozen' stage. Eventually these movements will begin to improve and your pain will reduce as you move into the 'thawing' phase. During each of the different stages you generally experience discomfort with a frozen shoulder, but it tends to be manageable if you reduce the amount of irritable movements you perform with your arm.

If there is a suspicion of a frozen shoulder you should be assessed by your family doctor of physiotherapist. They will be able to perform some simple mobility tests to determine if it is a frozen shoulder, or perhaps something else causing your symptoms. They may want to then refer you for an X-ray which can help confirm this diagnosis. In the early phases of a frozen shoulder it may be an option to receive a steroid injection which has shown in some circumstances to help alleviate both the pain and also improve the range, although this is best discussed with your family doctor. Another option available is to have a Manipulation Under Anaesthetic performed, or an MUA. An MUA involves a surgeon moving your shoulder whilst you are under a general anaesthetic in the hope to break up the restricted capsure which will improve your range. The evidence for this procedure is mixed, with it being helpful for some people but not others.

Further evidence has shown to help improve the symptoms of a frozen shoulder, and maintain the function of your shoulder, it is best to perform basic mobility exercises. You then need to wait for the condition to run its course and for the capsule tightness to reduce. Trying to work through the pain when performing range of movement exercises generally causes an increase in pain but without an increase in mobility. Any passive mobility treatments performed by a therapist may have a minimal short term improvement in range, but this generally comes with an increase in pain and the range quickly returns to the pre-treatment levels.

In spite of its long process to recovery, the encouraging thing to remember if that frozen shoulders do resolve over time, it just unfortunately takes a number of months to get there.

Management

Click each phase heading to see the progression of your management programme.

This phase introduces some basic exercises which you can start, along with some options to help with the symptoms and general management of the condition.

Assessment

You should arrange an appointment with your Family Doctor or another Medical Professional who will be able to perform some simple mobility tests to determine if you have a frozen shoulder, and may also refer you for an X-ray. You can continue with Phase 1 and 2 whilst you are waiting for this appointment and the X-ray result.

Medication

In the initial phase the use of over the counter medication may be an option. Medications such as simple pain relief and anti-inflammatories may allow the condition to be more manageable.  Please consult your family doctor if you have any concerns with this impacting your current medication, or if any medical history may be impacted by the option of including this medication.

Exercises

The focus on the exercises is to maintain the movement of your neck and elbow, and introduce a low level shoulder mobility exercise. 

With shoulder pain it's quite common to try and protect it, with the muscles surrounding the joint to tighten up as you are guarding it against any further damage. This can result in further discomfort, specifically neck and elbow pain.  

Exercise   Frequency 
Elbow Flexion and Extension Range of Movement 30 seconds x 2 sets 5 x daily 
Neck Active Range of Movement 30 seconds x 2 sets 5 x daily
Shoulder Pendulum Exercise 30 seconds x 2 sets 5 x daily

Some things to consider with the exercises:

  • The exercises of the elbow and neck are to simply ensure the joints above and below your shoulder remain mobile. 
  • The final exercise may bring some relief when performed.  The direction you move your arm when doing this exercise isn’t too important. Start off with small movements and increase it gradually over time. 
  • How long and how often you do the exercises at this stage is not too important. The key is little and often, and as long as you get something done every couple of hours to maintain the range that will be beneficial. 
  • You may find it helpful to do these exercises in a circuit type fashion, where you start off with exercise 1, have a rest, complete exercise 2 followed by a rest, continue this pattern until you complete all the exercises, and then restart.

Equipment

Resistance bands

Amazon Basics TPE Resistance Band, 3 Piece Set, 1500mm, Multicolor More
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Exercises