Frozen shoulder is a condition that results in loss of movement and/or stiffness of the arm at the shoulder joint. There is usually pain in the shoulder, and it is caused by tightening of the tissues that surround the shoulder joint. In frozen shoulder:
Frozen shoulder is progressive, meaning that it gets worse over time. It also may improve spontaneously. This improvement in mobility is called thawing.
Risk factors that increase your chances of developing frozen shoulder include:
Symptoms of a frozen shoulder include:
The doctor will ask about your symptoms and medical history, and perform a physical exam. The doctor will test the range of motion in your shoulder. Tests may include:
Treatment focuses on relieving pain and restoring function and range of motion to the shoulder.
Surgery is an option if there is no impro vement after several months. Surgeries include:
Stages of frozen shoulder
Frozen shoulder develops slowly, and in three stages:
Pain increases with movement and is often worse at night. There is a progressive loss of motion with increasing pain. This stage lasts approximately 2 to 9 months.
Pain begins to diminish, and moving the arm is more comfortable. However, the range of motion is now much more limited, as much as 50 percent less than in the other arm. This stage may last 4 to 12 months.
The condition begins to resolve. Most patients experience a gradual restoration of motion over the next 12 to 42 months; surgery may be required to restore motion for some patients.
How can I prevent frozen shoulder?
To help prevent frozen shoulder:
Your chances of a reoccurrence can be reduced if you return to practice and competition when all symptoms of the injury are gone and strength has returned to normal. Furthermore, the rehabilitation exercises should be continued to ensure protective strength, range of motion, and stability of the injured area.
Improving sports performance
The key to improving sports performance after recovering from frozen shoulder is a proper rehabilitation program, and adhering to some of those same principles after the injury is gone. Refer to the rehabilitation exercises regularly. Remember the following:
Also, the single most important aspect of improving performance is stretching before and after you step onto the field, court, ice, or golf course.
Benefits derived from stretching include:
As an athlete, your number one concern is getting back to full strength as soon as possible so that you can return to training and competition. That is why appropriate rehabilitation is extremely important. Rehabilitation for frozen shoulder focuses on relieving pain and restoring function and range of motion to the shoulder.
Non-surgical rehabilitation includes:
The major objectives of rehabilitation from frozen shoulder are to increase flexibility, obtain pain-free range of motion, and strengthen the muscles of the shoulders, upper back, front chest, and upper arms. In severe cases, you should avoid activity that causes shoulder pain altogether. In these cases, you can still maintain cardiovascular fitness by cycling, unless otherwise prescribed by your doctor.
Surgery may be needed if there is no improvement after several months. These procedures can successfully release and repair the shoulder, but it must be followed by an exercise program to maintain motion and restore function.
During the period when normal training should be avoided, alternative exercises may be used. These activities should not require any actions that create or intensify pain at the site of injury. They include:
Rehabilitation after surgery
Surgery may be needed if there is no improvement after several months. These procedures can successfully release and repair the shoulder, but it must be followed by an exercise program to maintain motion and restore function. Surgeries include:
When your doctor decides you are ready, you may start range-of-motion and strengthening exercises. You may be referred to a physical therapist to assist you with these exercises, and under no circumstance should you return to sports activity until your shoulder is fully healed.
A physical therapy program usually begins with range-of-motion and resistive exercises, then incorporates power, aerobic and muscular endurance, flexibility, and coordination drills.
When can I return to my sport or activity?
Return to full participation should be avoided until your frozen shoulder has healed, full range of motion has returned, and you can perform all skills and other requirements of your sport without pain.
the goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity is determined by how soon your frozen shoulder recovers, not by how many days or weeks it has been since your injury occurred.