The term “frozen shoulder” was introduced in 1934 by Codman who described the disorder as “difficult to define, difficult to explain and difficult to treat” and in many respects this remains true today. Frozen Shoulder (FS) has been classified into two types.
Primary Frozen Shoulder is characterized by an insidious onset of idiopathic origin whereas Secondary Frozen Shoulder is associated with a known cause, such as a known intrinsic (such as rotator cuff disease) or extrinsic (such as trauma) cause.
Frozen shoulder also known as Adhesive Capsulitis is a common shoulder disease that has progressive loss of shoulder motion. FS passes through several stages, which reflect the series of process from capsular inflammation and fibrosis to spontaneous resolution of this fibrosis. However, the etiology, pathogenesis, course, and most effective treatment still remain controversial.
The goal of treatment is to relieve pain, restore movement and regain function of the shoulder. Treatment should be individualized and based on the severity and chronicity of symptoms. A multidisciplinary approach is preferable, and most patients can be managed non-operatively in a primary care setting with the expectation of a good outcome. There are many alternative forms of treatment for this condition, but evidence of their efficacy is not well-established from clinical trials, and it is unclear if several interventions used in combination are better.
Range Of Motion Exercises
Patients should begin with short-duration (1–5 seconds) ROM exercises, which should be in a relatively pain-free range.
Particularly useful for patients in this painful stage.
- Pendulum exercises:
Can be used in flexion or abduction or circular motion.
- Pulley exercises:
While seated or standing, use the pulley attached to the door or wall to move your shoulder into flexion (raise the shoulder above your head) and back down. Progress to moving the shoulder into abduction (raising your shoulder out to the side and over your head).
- Wand Exercises:
While holding a wand/cane behind your back, slowly pull the target arm towards the center of your back. In the standing position, hold a wand/cane with both arms, palm down on both sides. Raise the wand/cane up allowing your unaffected arm to perform most of the effort. Your affected arm should be partially relaxed.
These exercises that can be performed at home.
- Scapular retraction exercises gently stretch the chest muscles and serve as basic strengthening for the scapular muscles.
- Isometric shoulder external rotation can also be used for flexion or abduction, within the available range, but care should still be taken to avoid introducing aggressive exercises.
- Posterior capsule stretch can help to reduce intra-articular pressure and facilitate separation of the articular surfaces. These treatments are often used to treat disorders that cause shoulder pain, especially those affecting the posterior portion of the capsular joint.