How do you know if your shoulder is frozen?

Maybe you are experiencing stiffness and pain in the shoulder, and you never know that your shoulder is frozen? Here are some points that you should definitely know!

What is frozen shoulder

• Frozen Shoulder, also known as Adhesive Capsulitis, is characterized by pain and stiffness in the shoulder joint.
• Approximately 3-5% of the general population and over 20% of diabetic patients experience this condition.
• 25.3% of patients who have a history of the cerebrovascular disease may result in Adhesive Capsulitis within 6 months.

The condition is called ‘Frozen’ Shoulder because there is more pain and less likely the movement occurs at the joint; as a result, the tissue that surrounds the shoulder joint called the shoulder capsule becomes inflamed, thick, and tight, hence ‘frozen’ in this position and the mobility of the joint is affected. Also, there is less synovial fluid to lubricate the joint.

This condition is most common in women than in men and commonly affects people between the ages of 40 and 60. In some patients, it does not recur in the same shoulder but appears on the opposite side.

Causes of frozen shoulder

There is no clear cause of the Adhesive Capsulitis but it may be due to immobility of the shoulder joint following any trauma or injury. If you are suffering from any systemic disease like diabetes, cardiovascular disease, tuberculosis, Parkinson’s disease, etc, or you have a weak immune system, you are prone to frozen shoulder. It is also seen in patients after recovery from stroke or surgery that prevent movements for a long time, inactivity results in inflammation and tightness of the shoulder capsule that causes Adhesive Capsulitis.

Symptoms

• Pain in the shoulder joint that may radiate towards the arm.
• Stiffness in joint.
• Difficulty in performing overhead activities.
• Restricted range of motion of the shoulder joint.
• Difficulty in sleeping on the affected side.
• Inability to perform usual activities carried out by shoulder joint.

 Self-Assessment

If you feel any of the above-mentioned symptoms, you would have to contact your doctor. Still, during this pandemic and lockdown situations, it is difficult to visit hospitals and clinics. So, by following this method, you can assess Frozen Shoulder by yourself.

You need an observation either by yourself or by any family member. A physical exam will help you diagnose the condition by the quantity and the quality of movement. Your starting position during observation should be erect, and your arms should by the side of the body. Some important movements are mentioned below for the assessment of adhesive capsulitis.

1. Lift your arms gently in front of you, upward towards your head (Flexion). If you have a frozen shoulder, your movement would be restricted and painful on the affected side. Also, your involved shoulder may move up with the arm unusually with the increasing pain. Now, lower the arm gently.
2.  Then raise your arm upward by the side of the body (Abduction). Observe the quantity and quality of movement, the movement may be painful, and the shoulder may move up with the arm as described in the previous movement.
3. By keeping the arm attached to your side of the body, bend elbow to 90°, stuck the elbow by side and forearm in front of your body, now rotate the arm by moving forearm away from the body, i.e., parallel to the floor, this movement is called External Rotation and is very important in the assessment of adhesive capsulitis because the patient is unable to rotate the arm in this condition or it can be performed with severe pain.
   
   

How to release a frozen shoulder

The condition can get worst and may extend for years if you leave it untreated. The treatment for the recovery of frozen shoulder involves; NSAIDs (Non-Steroidal Anti Inflammatory Drugs) for pain management, Joint Distension helps to restore the lost joint mobility, Shoulder Manipulation to stretch the shoulder capsule, and Surgery (in rare cases). But the most effective and recommended treatment for adhesive capsulitis is Physical Therapy; its goal is to stretch the capsule, hence restore the lost range of motion. Also, it provides strength to weak muscles and reduces pain.

Here are a few Physical Therapy exercises that you can perform at home regularly.

 1. Pendulum stretch

1. Stand up and relax your shoulders.
2. Lean slightly by supporting the unaffected arm with a table or chair.
3. Allow the affected arm to hang down and start swinging it.
4. Move the arm front to back(10 times) and then side to side(10 times).
5. Do this massage at least once a day.
6. Gradually increase your speed and add repetitions day by day to accelerate the healing. (for all exercises)

2. Finger walk or wall walk:

Stand against a wall, keeping an arm’s length distance from it.

Touch the wall with the help of your fingertips of the affected arm at your waist level.

Allow your fingers to walk slowly upward on the wall, as far as you can reach easily.

Now walk your fingers back to the starting position.

3. Towel stretch:

1. Take a towel, stand straight, and grab one end of the towel with your hand.
2. Bring the towel to your back and hold its opposite end with your other hand.
3. The unaffected arm should be placed up, and the affected one should be placed down. 
4. Pull the towel upward with one hand and simultaneously pull it down to stretch the shoulder.
5. Do this exercise 10-20 times a day, regularly.

4. Cross-body arm stretch

1. Stand or sit in a comfortable position.
2. Use your unaffected arm to hold the affected arm at the elbow.
3. Now, slowly bring it up and across the body as far as tolerable, exert gentle pressure to stretch the shoulder capsule.
4. Hold this position for at least 10 seconds.
5. Relax and repeat the process 10 times.

5. Arm circles

1. Stand or sit on a plane surface 
2. Place your hand on the shoulder(affected side).
3. Move your arm in a circular pattern both clockwise and counterclockwise with 10 repetitions each.
4. Perform this simple exercise daily and at least 2-3 times a day.