Adhesive Capsulitis, commonly known as frozen shoulder is characterized by shoulder pain and a of movement. A large part of rehab involves regaining that movement, however, it is important not to push too hard too soon. Frozen shoulder can be broken down into different stages; freezing, frozen and thawing. Each phase has a different short-term goal all working towards a long term goal of full range of motion and return to activities you enjoy.
Phase 1: Freezing – this phase is characterized by pain and progressive stiffness. The main goal is symptom management aiming to interrupt the inflammatory cycle. Physiotherapy focuses on gentle, pain free mobilizations and exercises. At home a patient will do low intensity, short duration exercises and stretches multiple times per day. Exercises may include pendulums and active assisted range of motion with a pulley or a stick as well as isometric exercises.
Phase 2: Frozen – in this phase, pain is easing but stiffness is at its peak. Physiotherapy will introduce more aggressive stretching with longer duration holds. The intensity of the stretch is often kept low to reduce irritation of tissues. A dull ache is acceptable but pushing through pain and discomfort is not. As range is restored isometric exercises are replaced with gentle strengthening through range.
Phase 3: Thawing – pain is no longer a major component in this phase, however, stiffness remains. The goal is to restore functional range of movement and strength. Again, physiotherapy will include an increase in stretch duration as well as intensity. Strengthening is also more important in this stage to regain control in the new range and return to regular activities.
The challenging part can be determining when to progress exercises, there is no defined timeframe and unfortunately recovery can take many months. When considering being more aggressive with your exercises make sure to take into consideration your irritability to activities and exercises.
For more information on frozen shoulder head over to our patient guide found here: https://www.activelifephysio.ca/Injuries-Conditions/Shoulder/Shoulder-Issues/Adhesive-Capsulitis-Patient-Guide/a~4871/article.html
If you have any questions about managing your frozen shoulder or a topic you would like to see on our blog, please contact us at: firstname.lastname@example.org or by phone at 844-987-5433.