November 20, 2020 · Physiotherapy, Rehab, shoulder

Frozen Shoulder

Living with frozen shoulder is not nice. Heres everything you need to know about frozen shoulder. Causes, assesment, treatment and more.

Book an assessment Call (07) 5572 6222

Frozen Shoulder on the Gold Coast — this guide from Ace Health Centre walks you through what matters most: when to seek help, what treatment looks like, and what to expect from your recovery. Call (07) 5572 6222 to book.

The Frozen Shoulder

Adhesive capsulitis (aka frozen shoulder, painful stiff shoulder or periarthritis) is a self-limiting condition where the bones, tendons or ligaments cause pain on movement. Frozen shoulder later progresses too restricted active AND passive glenohumeral ROM. There is disagreement whether it stems from an inflammatory, fibrosing or algoneurodystrophic (a form of complex regional pain syndrome without demonstrable nerve lesions) conditions.

Frozen shoulder can affect the antero-superior joint capsule, axillary recess and the coracohumeral ligament. Common findings may include a small joint with loss of axillary fold, tight anterior capsule, and synovitis but no adhesions. The space surrounding the GHJ has been suspected to reduce from 15-35 cubic centimetres to 5-6cm.

Ethology of frozen shoulder

Frozen shoulder is classified as either primary (idiopathic onset) or secondary (a direct cause). Secondary onsets could include:

systemic (diabetes/metabolic conditions/hypothyroidism)
extrinsic (CVA, Parkinson’s, direct trauma)
intrinsic (rotator cuff/other shoulder muscle pathologies) factors of origin

It is also known as the 50 year old shoulder since it is much more prevalent in this age group. It is especially common in females over the age of 40 and those who are recovering from a mastectomy are at greater risk.

Frozen shoulder can be challenging to differentiate in the early stages from other shoulder pathologies. One of the main presenting factors is loss of external rotation. Restrictions in a capsular pattern present as ER limitations > Abd limitations > IR limitations. Patients may also complain of difficulties with dressing, overhead activities, grooming. Symptoms may also worsen at night.

The time frame for recovery varies greatly from 6 months to 11 years which could be spontaneous complete recovery or nearly-complete. Most tend to resolve around 3 years. Unfortunately, some patients’ symptoms may never fully resolve (estimated to be around 15%).

The three overlapping phases include:

1. Acute/freezing/painful phase: sharp pain with sleep interruptions – 2-9months

2. Adhesive/frozen/stiffening phase: pain decreases lingering at end ROM, ROM decreases in a capsular pattern – 4-12months

3. Resolution/thawing phase: spontaneous improvement in ROM – 5-24months Physical exam is usually sufficient to diagnose frozen shoulder, however X-rays, US or MRI can help rule out other issues.

A definitive treatment for frozen shoulder remains unclear, however, daily HEP along with an exercise therapy program and patient education are key to aid in the patient’s rehabilitation. It is key to manage your patient’s expectations to allow for a successful recovery. PNF has been found to be effective at decreasing pain and increasing ROM/function. MWMs may be helpful and superior than stretching alone during the second stiffening phase.

During the third phase of frozen shoulder rehab , strengthening should be increased with stretching being increased in frequency and duration but at the same intensity. The strongest evidence supports manual therapy and exercise in adjunct to corticosteroid injection.

For the ultimate frozen shoulder rehab contact us today.

What to Expect From Frozen Shoulder at Ace Health Centre

Patients who book Frozen Shoulder with our team get a clinic-grade assessment, a clear plain-language plan, and a structured progression rather than a one-off appointment. Furthermore, we coordinate care across podiatry, physiotherapy, dietetics and exercise physiology where relevant, so you are not bouncing between clinics. Authoritative information on this topic is also available from Healthdirect Australia if you would like to read further before booking. As a result, you walk in informed and walk out with a plan you understand.

For more on what we do, see our main service page.

Frequently Asked Questions About Frozen Shoulder

Do I need a referral? No referral is needed for physiotherapy in private practice. With a GP Chronic Disease Management plan you may be eligible for bulk-billed sessions.

Is physiotherapy covered by health funds? Most private health extras with physio cover offer a rebate. We process HICAPS on the spot, so you walk out knowing your gap.

How many sessions will I need? Acute issues usually settle in 4-6 sessions. Longer-standing conditions may need a 6-12 week structured program. Your physio will give a clear plan at the first assessment.

Book Your Frozen Shoulder Appointment

Ready to get started? Call (07) 5572 6222 or book online. In addition, new patients can use our no-gap initial consult — straightforward, no surprises.

HICAPS on the spot with every major fund · Medicare CDM, DVA, NDIS & WorkCover accepted where applicable.