What is Frozen Shoulder?

Frozen shoulder occurs when the connective tissue surrounding the shoulder joint (joint capsule) becomes thickened and inflamed. This inflammation leads to scar tissue formation, which limits the range of motion.

Symptoms of Frozen Shoulder

The symptoms generally develop gradually and worsen over time. They can be categorized into three stages:

1. Freezing Stage:

   • Pain increases, especially at night.
   • Limited range of motion begins.
   • Lasts for 6 weeks to 9 months.

   Illustration: A depiction of a shoulder joint experiencing inflammation and pain.

2. Frozen Stage:

   • Pain may decrease, but stiffness worsens.
   • Activities involving the shoulder become challenging.
   • Can last 4 to 6 months.

   Illustration: A detailed depiction showing severe stiffness in the shoulder joint.

3. Thawing Stage:

   • Gradual improvement in shoulder mobility.
   • Pain continues to subside.
   • Recovery can take 6 months to 2 years.

   Illustration: A gradual recovery with improved shoulder movement.

Causes and Risk Factors

Frozen shoulder’s exact cause is unknown, but several factors contribute:

• Injury or Surgery: Shoulder immobilization following injury or surgery.
• Medical Conditions: Diabetes, thyroid disorders, or Parkinson’s disease.
• Age and Gender: Common in individuals aged 40–60, especially women.
  

  Diagnosis

  Diagnosis involves:

  • Physical Examination: Assessing pain and range of motion.
  • Imaging Tests: X-rays or MRI to rule out other shoulder conditions.

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  Treatment Options

  1. Physical Therapy:

     • Gentle exercises to restore motion.
     • Focus on stretching and strengthening.

       An effective exercise plan for frozen shoulder focuses on improving range of motion, reducing stiffness, and relieving pain. The following plan is divided into three phases to match the stages of frozen shoulder: freezing, frozen, and thawing.

       Key Guidelines

       • Perform exercises gently to avoid aggravating symptoms.
       • Warm up the shoulder before exercises (e.g., a warm shower or heat pack for 10 minutes).
       • Maintain consistency; exercises should be done daily or as recommended.
       • Stop if you experience sharp pain and consult your healthcare provider.

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       Phase 1: Freezing Stage (Pain Management and Gentle Mobility)

       Focus on reducing pain and maintaining a basic range of motion.

       1. Pendulum Stretch

          • How to Do: Stand with the unaffected arm on a stable surface for support. Let the affected arm dangle. Swing it gently in small circles (clockwise and counterclockwise).
          • Duration: 1 minute in each direction.
          • Repetitions: 2–3 times daily.

       2. Towel Stretch

          • How to Do: Hold a towel behind your back with both hands, one hand overhead and the other behind your lower back. Gently pull the towel upward with the overhead hand.
          • Duration: Hold for 10–15 seconds.
          • Repetitions: 5–10 times.

       3. Finger Walk

          • How to Do: Stand facing a wall. Use your fingers to “walk” up the wall as high as you can go without pain. Slowly walk your fingers back down.
          • Duration: 2–3 minutes.
          • Repetitions: 5 times.

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       Phase 2: Frozen Stage (Improving Mobility and Strength)

       Exercises aim to increase the range of motion and shoulder flexibility.

       1. Cross-Body Stretch

          • How to Do: Use the unaffected arm to gently pull the affected arm across your chest.
          • Duration: Hold for 15–20 seconds.
          • Repetitions: 10 times.

       2. External Rotation with a Towel or Stick

          • How to Do: Hold a stick or towel with both hands. Keep your elbows close to your body, then gently push the affected arm outward using the unaffected hand.
          • Duration: Hold for 10–15 seconds.
          • Repetitions: 10 times.

       3. Passive Internal Rotation

          • How to Do: Use a towel or resistance band to gently pull the affected arm behind your back, keeping it close to the body.
          • Duration: Hold for 15 seconds.
          • Repetitions: 5–10 times.

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       Phase 3: Thawing Stage (Strengthening and Full Mobility)

       Focus on restoring strength and achieving full range of motion.

       1. Wall Push-Ups

          • How to Do: Stand a few feet from a wall. Place your hands on the wall at shoulder height and slowly perform a push-up.
          • Repetitions: 10–15.
          • Sets: 2–3 times.

       2. Overhead Shoulder Stretch

          • How to Do: Lie down and hold a stick with both hands. Extend your arms overhead as far as possible.
          • Duration: Hold for 10 seconds.
          • Repetitions: 5–10 times.

       3. Resisted Shoulder Rotations

          • How to Do: Use a resistance band anchored at waist level. Perform internal and external rotations with the band, keeping your elbow close to your body.
          • Repetitions: 10–15.
          • Sets: 2–3 times.

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       Progression and Monitoring

       • Gradually increase the range of motion and intensity of exercises as tolerated.
       • Monitor for improvements in mobility and reduction in pain.
       • Follow up with a physiotherapist to adjust the plan based on recovery progress.

       Consistency and proper technique are crucial to the success of this exercise plan. If you experience persistent pain or limited improvement, consult a healthcare provider for further assessment and care.

  2. Medications:

     • Pain relievers such as NSAIDs.
     • Corticosteroid injections for inflammation.

  3. Surgical Intervention:

     • Rarely required but may include manipulation or arthroscopic surgery to loosen the joint capsule.

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  Preventive Measures

  • Avoid prolonged immobilization after injury or surgery.
  • Regular shoulder exercises and stretches.
  • Managing underlying conditions such as diabetes.

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  Conclusion

  Frozen shoulder can be a painful and limiting condition, but timely diagnosis and treatment can ensure recovery. If you suspect you have symptoms, consult a physiotherapist or orthopedic specialist to develop a personalized care plan. Early intervention and consistent physical therapy are key to regaining shoulder mobility.