Adhesive capsulitis, more commonly known as frozen shoulder, is a medical condition that causes pain and limits movement in the shoulder joint. This condition can greatly impair one’s ability to move the shoulder, usually occurring on one side but in some cases, it is experienced in both shoulders. A fifth of those affected by frozen shoulders have both shoulders affected.
Adhesive capsulitis is a medical term used to describe a condition where the joint capsule becomes inflamed, causing it to become sticky and stiff. This can lead to difficulty in movement and further symptoms as a result of the inflammation. The word ‘adhesive’ in the term refers to the sticky nature of the joint capsule, while ‘capsulitis’ refers to the inflammation of the joint capsule.
Frozen shoulder is a condition that differs from arthritis and does not cause damage to other joints. While rare among the younger population, it is most common in people aged 40-70, and affects about 3% of the entire population, with women having a slightly higher likelihood of developing it. Additionally, those with diabetes are five times more prone to experiencing a frozen shoulder.
A Frozen shoulder passes through three phases; a freezing phase, a stiff phase, and a thawing phase.
Frozen Shoulder Symptoms
Symptoms of a Frozen shoulder depend on the particular phase you are at:
- Painful (freezing) phase: The onset of frozen shoulder symptoms begins with a gradual ache in the shoulder which can worsen at night, making it difficult to sleep on the afflicted side. This freezing phase can last anywhere from two to nine months.
- Stiffening (frozen) phase: During the frozen phase of shoulder pain, one may experience discomfort for 4-12 months. The shoulder joint becomes increasingly rigid, making common activities such as dressing or carrying items more difficult. Additionally, due to decreased mobility, the shoulder muscles may begin to deteriorate.
- Thawing phase: During the thawing phase of a frozen shoulder, there may be a gradual decrease in pain and improvement in range of motion. While this is happening, however, the stiffness may temporarily return, causing pain to reappear. Generally, the thawing phase lasts between 5 and 12 months.
Primary and secondary adhesive capsulitis
Adhesive capsulitis can be divided into two categories: primary and secondary. Primary adhesive capsulitis is characterized by pain or stiffness without any obvious cause. Secondary adhesive capsulitis, on the other hand, is caused by an external event such as trauma, surgery, or illness.
What causes a Frozen shoulder?
The cause of a frozen shoulder is uncertain, however, one possible explanation is that inflammation of the joint capsule results in the formation of scar tissue, reducing the space for the humerus (or arm bone) to move and limiting the joint’s range of motion.
Diabetes and Frozen Shoulder
Diabetics, especially those dependent on insulin, are more likely to experience shoulder stiffness due to glucose molecules attaching to collagen fibers in the joint capsule. This is why it is more common for diabetics to have both shoulders affected. Furthermore, hormonal changes experienced by women, especially during menopause, are believed to contribute to the higher incidence of shoulder stiffness in this demographic.
Studies have indicated that having bad posture, particularly having rounded shoulders, can cause one of the shoulder ligaments to shorten, which could be a contributing factor to this issue. Additionally, being immobile for a long time (like after a fracture) could lead to the development of this condition.
What can a Sports injury professional do?
Physiotherapy and exercises are the recommended treatment for managing a frozen shoulder. These exercises can help preserve mobility and flexibility in the shoulder. Surgery should only be considered as a last resort if all other attempts have failed.
If conservative treatment is unsuccessful in alleviating the inflammation of the shoulder joint, Dr. Daniel Danieley may suggest the use of oral steroids or anti-inflammatory medication. Additionally, direct injection of steroid medication into the joint might also help to reduce inflammation. If none of these methods are successful, surgery may be recommended.
Treatment
The exercises and other treatment methods are dependent on which phase of rehabilitation you are in.
Active Release Technique (ART)
Dr. Daniel Danieley is fully-trained and certified in the Active Release Technique (ART). ART is a soft tissue massage technique that treats problems related to overused muscles resulting from injury or chronic pain. This technique focuses on relieving tissue tension through the removal of fibrosis adhesions (muscle knots) that develop from repetitive use. It’s known to be effective against muscle and nerve dysfunction, and this technique can be adapted to any extremity, spine area, and nerve area. Those with soft tissue conditions such as chronic and sciatica pain, fibromyalgia, sports injuries, plantar fasciitis, frozen shoulders, and even concussion injuries can benefit from ART as it can show vast improvements within the first session.
At Kinetic Spine & Sports, we specialize in chiropractic care with a focus on treating and rehabilitating sports injuries. From weightlifting to lifting your kids, we are here to help you find relief from pain, restore your health, and maximize your performance.
