Frozen shoulders can be a complicated and very frustrating issue. Typically they can last for up to 18 months. The shoulder becomes very inactive and day to day function is compromised. It is not a common presentation in the clinic here. Often people are concerned they have developed a frozen shoulder. However it is more frequently an issue to do with rotator cuff damage, or a type of shoulder impingement, or both of these together.
What is Frozen shoulder?
Frozen shoulder is medically termed as ‘adhesive capsulitis’. Fibrous adhesions start to develop within the shoulder joint and ultimately surround the shoulder capsule. The capsule itself becomes very inflamed – hence the ‘itis’ on the end of the word capsule. The result is significantly reduced shoulder function. Certain movements can cause sharp pain and as result the patient begins to move the joint less and less. It is best treated with injection therapy, some physiotherapy (aiming to preserve some range of motion), and in more acute cases there is surgical intervention. In the case of surgery the shoulder joint is manipulated under anaesthetic to restore greater movement. Although surgical intervention naturally cannot have a guaranteed success rate, it can provide a degree of improvement in the extremely frozen shoulder.
What is the Rotator Cuff?
The rotator cuff is a grouping of soft tissue structures that protect and strengthen the shoulder joint. It is comprised of muscles and tendons including the Supraspinatus, Subscapularis, infraspinatus and Teres Minor. These surround and attach into various parts of the shoulder joint and the shoulder blade. The cuff gives stability in particular, however it is vulnerable to damage as we get older.
How the shoulder joint moves
The shoulder is a relatively vulnerable joint compared to some other major joints within the body. It moves in multiple directions – as opposed to the hip or knee. There is a higher incidence of shoulder dislocation for example, because of this greater level of movement. Essentially the joint moves in multiple directions; forwards,backwards, sideways and in a rotational fashion.
Some typical Examples
The majority of shoulder issues presenting in clinic here in Rathmines relate to the rotator cuff as opposed to a frozen shoulder. Very often our clients are unaware how the issue might have developed, as it can be a very innocuous incident which causes the initial damage. Some typical examples such as starting a lawn mower, pulling a heavy suitcase or simply out walking the dog on a lead can cause an initial tear to a tendon and the issue slowly escalates from there.
What we do to treat the issue
We do an initial assessment of the joint to find out what the specific issue is. We use a number of orthopaedic examination tests to get an accurate diagnosis, without need for MRI referral. Once we have a solid diagnosis, we then work on restoring range of motion to the damaged joint. We simultaneously work on improving stability and strength. Don’t worry, there’s not too much hardship and homework – we send on video exercises to our clients so they can work away on their own schedule as suitable.
To schedule an appointment with one of our Physiotherapists, jump straight to our booking system here or call 01 4964002.