What’s a frozen shoulder?

Written by: Paul Kochoa, PT, DPT, OCS, CKTP, CGFI

If you’ve ever had shoulder pain and searched on the internet for some answers, you’ve probably come across the term, “frozen shoulder”.  It’s a term that’s been used to describe shoulder pain with limited motion.  Actually, the proper name for this diagnosis is “adhesive capsulitis”.

Adhesive capsulitis is characterized by pain, stiffness, limited range of motion, and limited function in the shoulder joint.  It usually starts with pain followed by the loss of motion.  It is a thickening and tightening of the joint capsule that holds the shoulder joint together.  Most common in women, it can also affect men.  There is no definite physiological cause of this pathology, but there are basically two types of adhesive capsulitis: idiopathic(primary) and secondary.

Idiopathic or primary adhesive capsulitis occurs without any previous event or trauma.  It’s an inflammatory response thought to be an abnormal immune system response.  Secondary adhesive capsulitis occurs after a shoulder injury or surgery and is often accompanied by other medical issues such as diabetes, stroke, or rotator cuff injury.

There are three stages to adhesive capsulitis: painful stage, frozen stage (hence its name), and thawing stage.  Each stage can last weeks to months, with the possible overall time lasting over a year.  If caught early, the painful stage can be reversed and the frozen stage can be prevented.  Otherwise, progressive tightness and decreasing range of motion in reaching overhead, out to the side, and rotating outward occur with the accompanying decrease in overall arm function.

The shoulder joint (ball and socket) is covered by a joint capsule and is connected together by ligaments.  With adhesive capsulitis, the connective tissue and ligaments of the capsule becomes thicker and shorter.  Not only do these structures become tight, but there is associated changes in the surrounding muscle and fascia.

Physical therapy intervention can include stretching, joint mobilization, soft tissue mobilization, exercise, as well as other modalities.  Stretching to the surrounding structures as well as soft tissue mobilization can restore flexibility and range of motion.  Joint mobilization can restore shoulder joint capsule mobility and elasticity.  Exercise and movement training can re-train muscles in the shoulder complex to fire correctly and restore normal shoulder kinematics and prevent movement compensations.  Also, posture correction is important to correct the abnormal positioning of the shoulder to promote normal and pain-free function.

Physical therapy has been scientifically proven to restore function, range of motion, and decrease pain in patients with adhesive capsulitis.  If you’re having shoulder pain and tightness, a physiotherapist can help.

If you would like more information, please call Professional Physical Therapy and Training at 973-270-7417.  Our offices our located within the YMCA locations in Madison and Summit, NJ.  You do not need to be a member of the YMCA to visit with us.