Frozen Shoulder

How to recognize and avoid the “Frozen Shoulder”


The term “frozen shoulder” has been used for many years to describe a shoulder that becomes tight or frozen with the inability to lift the arm overhead, across your body, or behind your back.  The medical description for this condition is called “adhesive capsulitis”.  In this condition, the capsule of the shoulder begins to tighten with micro adhesions forming between the folds of the capsule.  As the condition progresses, the shoulder becomes tighter with less ability to move and function normally. The condition can become very debilitating and painful. 


A frozen shoulder will begin to manifest itself by usually a minor insult to the shoulder through activity of the arm during repetitive functional activities, or one activity that may cause injury.  After the injury occurs, usually something that may go unnoticed at the time of the injury; the person begins to favor that arm with less movement when performing activities throughout the day.  The shoulder begins to tighten with the person noticing that they cannot reach across their body to get a seatbelt on in the car, reach behind their back, or reach overhead to grasp an object.  The initial phase of the condition is almost unnoticeable.  The person will begin to notice pain at night while sleeping on the involved shoulder.  As the condition progresses, the person will notice decreased mobility in the shoulder and now they will have pain with all motions and activities.  This is usually the time when they will consult a physician.  Usually by this time, the condition has manifested into a significant limitation in function and the initial insult to the shoulder, whether a sprain or strain, should be resolving.  Sometimes this condition goes misdiagnosed as a tendonitis or bursitis. Although that may have been the original condition that started the process, the problem at hand is the adhesions that limit the motion of the shoulder joint with the inability in movement of the shoulder with functional activities.  Looking at this condition in another way, the body will always try to heal itself when an injury occurs.  After the initial insult to the shoulder occurs, the body will recognize the injury and try to put the shoulder into a “sling” and this is the stage the adhesions begin to tighten the capsule.  There is also shortening of the soft tissue around the shoulder that occurs with this condition within a few weeks. 


To avoid this condition, one must recognize the symptoms.  If you have an injury to a shoulder that is minor, one that does not bring you to an emergency room or immediately to a physician’s office, and you just feel some pain in the shoulder area, you need to know that maintaining your range of motion in that shoulder is vital.  We often have aches and pains in areas of the body that end up going untreated or treated with over-the-counter medication.  This is the type of injury to the shoulder that if left untreated, may progress into a “frozen shoulder” condition that will leave you significantly limited in your motion and ability to use the shoulder with daily activities.  This condition becomes very painful and needs aggressive attention to help restore normal motion.  Physical therapy helps in restoring your motion to normal and returning you to a normal and healthy lifestyle.

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