What is frozen shoulder?
Frozen shoulder, also known as adhesive capsulitis, is a condition that causes stiffness and pain in the shoulder joint. It is most common in people ages 40-65 years old and in females more often than males. It can occur after an injury to the shoulder or may come on without known cause. Individuals with systemic conditions such as diabetes or thyroid disease are at an increased risk for developing frozen shoulder.
What are the early signs and symptoms of frozen shoulder?
The onset of frozen shoulder is often very slow. The tightening of the soft tissues around the shoulder joint will lead the person to feel a gradual increase in pain and stiffness. Stiffness may cause difficulty lifting the arm overhead or reaching behind the back. Individuals may also start to experience significant pain at night, disturbing sleep.
What is the scientific evidence surrounding physical therapy for frozen shoulder?
There are two common beliefs about frozen shoulder:
- Is a self-limiting condition that will resolve fully over time (approximately 2-5 years) without supervised treatment.
- The largest gains in shoulder range of motion should be expected later on in recovery.
Researchers have recently revisited the above statements to assess whether these pieces of information are true.
A 2016 study by Wong CK et al. critically evaluated the recovery of individuals with frozen shoulder who DID NOT receive physical therapy. They established two important conclusions:
- Range of motion was not regained, and a full return to function was not supported.
- The greatest gains in range of motion are achieved in the early stages of the condition, hence physical therapy should be initiated as soon as diagnosis is made.
Why seek early physical therapy for frozen shoulder?
Many people wait until the motion loss and pain is unbearable before seeking physical therapy. This new evidence suggests that seeing your PT as soon as you suspect you may have frozen shoulder will allow you to capitalize on the greatest gains that can be expected early! This may lead to better outcomes overall with full recovery of motion and full return to shoulder function.
How will my PT treat frozen shoulder?
Your physical therapist will use a combination of hands on techniques including deep tissue massage, joint mobilization, and stretching to keep your shoulder moving. They will then guide you through a series of exercises to maintain and gain new motion and improve shoulder strength. Your PT may also use heat, ice, therapeutic ultrasound, or cold laser to facilitate the healing process and reduce pain.
Meghan King, Columbia University Medical Center, Doctoral Degree Progam in Physical Therapy (DPT)