Fix That Stiff Shoulder

Fix That Stiff Shoulder – Body Mechanics

By Andy Kerk, PT, OCS, CFMT, ATC originally posted on September 9, 2010 8:26 AM

Adhesive Capsulitis, or Frozen Shoulder (sometimes called “Locked Shoulder”) is a painful condition that limits your ability to move your arm comfortably. It can occur after a fall or fracture of the shoulder, after surgery, or commonly can just develop due to unkown cause. It is often associated with tightness and/or disc problems in the neck. It is typically treated with nonsteroidal anti-inflammatory medication, steroid injections, and physical therapy to restore motion. Surgery is usually not a good option. The joint capsule, or ligaments that encompass the shoulder become inflammed, thickened, and inelastic. Patients usually complain that they cannot elevate their arm due to pain and stiffness, especially in a sideways direction, or when trying to reach backward behind the body. It is also difficult to lie on the affected shoulder.

Physical therapy works best if skilled manual mobilization techniques are incorporated that include deep tissue mobilization, myofascial release, and specific joint mobilization methods. Sessions may be mildly uncomfortable for brief moments but one should feel better and perhaps more mobile after sessions. In the early stages, adhesive capsulitis is both painful and stiff and in later stages pain subsides and stiffness persists. The shoulder should not be stretched aggressively overhead by the patient or therapist at any time, but especially in the early painful stages. Skilled therapy will apply sustained pressure into key locations to soften the adhesions, and gently manipulate the shoulder into positions that will stretch the joint capsule in specific ways.

The key thing to remember as a patient with this problem is that it takes time to get well. Often therapy may start at twice per week for 4-8 weeks, then taper to weekly or less as the patient continues specific home exercises that are instructed. Studies have shown that more frequent therapy is not necessary as a certain amount of time needs to pass (often 6-9 months) to restore full function. This does not mean to just “wait it out”, however, as the studies show that therapy speeds the progress.

Be advised, all therapy is not alike. You are best to seek physical therapists that have advanced manual therapy training and certifications as exercise alone and machines such as electrical stimulation and ultrasound are not that effective and just add to the cost. Your therapist should also spend 30-60 minutes of undivided hands-on attention to properly apply the most effective methods and to use the time to do what you can’t do on your own. Patients also do better when they do all the little things they can do to help themselves such as ice, proper positioning, and consistent specific exercise that are instructed.

Most of all, be patient and maintain your hope as this condition usually resolves completely, even though it can be a slow process. Please call or email us if you have questions! (262-695-3057)


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