How to Fix a Frozen Shoulder - Harvard Health (2023)

How to Fix a Frozen Shoulder - Harvard Health (1)

Simple activities like tying a bra or taking a book from a hanging shelf can be impossible when you have a frozen shoulder. But what exactly is a frozen shoulder?

Frozen shoulder (also called adhesive capsulitis) is a common condition that causes pain, stiffness, and loss of normal range of motion in the shoulder. The resulting deficiency can be severe and the condition worsens over time if left untreated. It mainly affects people between the ages of 40 and 60, more women than men.

We don't fully understand what causes a frozen shoulder, but an inflammatory process is likely involved. Sometimes frostbite occurs because the shoulder has been immobilized for a long time due to injury, surgery, or illness. In many cases the cause is unclear. Fortunately, the shoulder can usually be thawed, although full recovery will take time and a lot of self-help.

The shoulder has a wider and more varied range of motion than any other part of the body. It rotates primarily in a ball and socket arrangement called the glenohumeral joint, which connects the top of the humerus (upper arm bone) to a cupped portion of the shoulder blade (shoulder blade) called the glenoid fossa. (See Frozen Shoulder Anatomy figure.)

The glenohumeral joint helps move the shoulder back and forth and allows the arm to rotate and extend away from the body. A flexible capsule filled with a lubricant called synovial fluid protects the joint and helps it move smoothly. The capsule is surrounded by ligaments that connect bone to bone, tendons that connect muscle to bone, and fluid-filled sacs called bursae that cushion tendons and bones during movement. The band of muscles and tendons that stabilize the shoulder and control its movement is called the rotator cuff. This intricate architecture of soft tissue is responsible for the shoulder's wonderful flexibility, but also makes it vulnerable to trauma and chronic wear and tear.

Anatomy of a Frozen Shoulder

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Normally, the humeral head moves smoothly into the glenoid fossa, a depression in the scapula. A shoulder is "frozen" when the capsule that protects the glenohumeral joint contracts and hardens. Scar tissue (adhesions) can also form between the joint capsule and the head of the humerus.

How is a frozen shoulder formed?

The process usually begins with an injury (such as a fracture) or inflammation of the soft tissues, often due to overuse injuries such as bursitis or rotator cuff tendinitis. The inflammation causes pain that worsens with movement, limiting the range of motion of the shoulder.

When the shoulder is immobilized in this manner, the connective tissue around the glenohumeral joint (the joint capsule) thickens and contracts, losing its normal ability to stretch. Trying to avoid pain from shoulder movement leads to further capsular contraction. The humerus has less range of motion and the joint can lose its lubricating synovial fluid. In advanced cases, bands of scar tissue (adhesion) form between the joint capsule and the head of the humerus.

It can take two to nine months for a frozen shoulder to develop. Although pain may slowly improve, stiffness remains and range of motion remains limited.

Whose shoulder is frozen?

The risk of frozen shoulder is increased if you don't receive exercise therapy after a tendinitis or injury and if you wear a sling for more than a few days without intermittent stretching. About 10% of people with rotator cuff disorders develop a frozen shoulder. Forced immobility as a result of a stroke, heart disease, or surgery can also lead to a frozen shoulder. Other conditions that increase the risk of frozen shoulder are thyroid disease, Parkinson's disease

Frozen shoulder treatment

If you think you have or are developing a frozen shoulder, see your doctor or a shoulder specialist for a physical exam. To assess your shoulder range of motion, your doctor will ask you to perform various arm movements, such as: B. Crossing your chest to touch the opposite shoulder or reaching back to touch the opposite shoulder blade (Apley scratch test). He or she may take X-rays to make sure there aren't any other underlying problems, such as arthritic changes or a dislocation. An MRI may be ordered to look for a rotator cuff tear.

Treatment for a frozen shoulder focuses on relieving pain and restoring normal range of motion in the shoulder. Your doctor may recommend an anti-inflammatory medication such as aspirin, ibuprofen (Motrin, Advil), or naproxen (Aleve, Naprosyn, Anaprox). An ice pack or a bag of frozen vegetables placed on the shoulder for 10 to 15 minutes several times a day can also help with pain. You may be given a corticosteroid injection in your shoulder joint or soft tissue. The focus of the treatment, however, is physical therapy, which initially focuses on exercises to stretch the joint capsule and then on strengthening exercises. A physical therapist can show you how far you need to go and teach you the right exercises. Once you know your limits, you can do most of your exercises at home yourself.

When working on shoulder capsule stretches, you should avoid any activity that requires head tilt, elevation, or anything else that aggravates your pain. If you carefully follow your exercise program for frozen shoulder, you will likely be able to return to your normal level of activity (more than 90% of people improve with these non-surgical measures). But full recovery from a frozen shoulder takes time, from several months to two to three years. If you don't improve consistently or if you plateau, see your doctor again or see a shoulder specialist. Rarely, recalcitrant cases require surgery.

Stretching exercises for frozen shoulder

Always warm up your shoulder before doing your exercises. The best way to do this is to take a hot shower for 10 to 15 minutes. You can also use a damp heating pad or microwavable damp towel, but this may not be as effective.

In the following exercises, stretch yourself to the point of tension, but not pain.

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pendulum strain.Do this exercise first. relax your shoulders Stand and lean slightly, allowing the affected arm to hang down. Swing your arm in a small circle about a foot in diameter. Do 10 turns in each direction once a day. As your symptoms improve, increase the diameter of your swing, but never force it. When you're ready for more, increase the stretch by holding a light weight (three to five pounds) in the swingarm.

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stretch towel.Hold a yard-long towel behind your back with both hands and hold it horizontally. Use your good arm to lift the affected arm straight up. You can also do this exercise with the towel on your good shoulder as an advanced version. Grasp the bottom end of the towel with your affected arm and pull it towards your lower back with your unaffected arm. Do this 10 to 20 times a day.

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Finger way.Facing a wall three-quarters of an arm's length away. Reach down and touch the wall at waist height with the fingertips of the affected arm. Keeping your elbow slightly bent, slowly run your fingers along the wall until you raise your arm to shoulder height or as high as you can. Your fingers should be doing the work, not your delts. Slowly lower your arm (using your good arm if necessary) and repeat. Do this exercise 10 to 20 times a day.

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Querreichweite.Sit down or stand up. Use your good arm to lift the affected arm at the elbow and bring it across the other side of your body, applying slight pressure to straighten the shoulder. Hold the stretch for 15 to 20 seconds. Do this 10 to 20 times a day.

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armpit stretch.Raise your affected arm onto a rest with your good arm at chest height. Gently bend your knees and open your armpits. Slightly deepen the squat, gently straighten the armpit, and then straighten. Stretch a little more with each squat, but don't force it. Do this 10 to 20 times a day.

begins to strengthen

As your range of motion improves, you can add rotator cuff strengthening exercises. Be sure to warm up your shoulder and do your stretching exercises before doing any strengthening exercises.

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external rotation.Hold an elastic exercise band between your hands with your elbows at a 90-degree angle by your sides. Rotate the bottom of the affected arm five to three inches outward and hold for five seconds. Repeat 10 to 15 times, once a day.

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interne Rotation.Stand next to a closed door and wrap one end of an exercise elastic band around the doorknob. Hold the other end with your hand on the affected arm and keep your elbow at a 90-degree angle. Pull the band five to three inches toward your body and hold for five seconds. Repeat 10 to 15 times, once a day.

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