Frozen shoulder, medically referred to as adhesive capsulitis, is a disorder in which the capsule (a bag like structure surrounding the shoulder joint) becomes inflamed and stiff, greatly restricting motion and causing severe pain.
Adhesive capsulitis is a painful and disabling condition that often causes great frustration for patients and caregivers due to slow recovery. Movement of the shoulder is severely restricted.
Pain is usually constant, worse at night, when the weather is colder, and along with the restricted movement can make even small tasks impossible. In addition to difficulty with everyday tasks, people who suffer from adhesive capsulitis usually experience problems sleeping for extended periods due to pain that is worse at night and restricted movement/positions.
The condition also can lead to depression, pain, and problems in the neck and back. Treatment may be painful and taxing and consists of physiotherapy, medication, massage therapy, and mobilisation.
MyPhysio has a shoulder specialist in Lizzy Craft who has worked extensively over the last few years as an Extended Scope Physiotherapist working with patients who have this problem.
The shoulder is a shallow ball and socket joint that has a large amount of movement, it relies on the capsule, ligaments and rotator cuff muscles to support it, and control the movement of the shoulder, and shoulder blade. Sometimes the delicate biomechanics that keep everything working in synchronisation can go wrong, with small muscle tears, calcium deposits (calcific tendonitis), inflammation of the soft tissue shock absorber in between the muscle and bone (bursitis) or arthritis of the collar bone. All of these different changes can cause the shoulder to be pinched or caught when lifting the arm out to the side hence being termed “impingement”.
MyPhysio can help to address the stiff, tight and weak structures that can be side effects of the condition, and advise on pain relief, injections etc to get back to normal, or refer on to the Orthopaedic Consultants if the problem does not settle.
The Rotator Cuff muscles are made up of 4 muscles that as the name suggests surround like ball and socket joint line a “cuff” to keep the ball in the socket and stabilise the joint whilst moving your upper limb. The four muscles originate from the shoulder blade and insert into the front shoulder joint on her head of the humerus (ball). The names of the 4 muscles are Supraspinatus, Infraspinatus, Subscapularis and Teres minor.
Rotator cuff strains and tears can commonly occur with shoulder impingement as described above. Sometimes you can injure this muscle from a traumatic injury such as falling onto your shoulder or reaching out of the base of your support suddenly. Physiotherapy is the mainstay for treating Rotator Cuff injuries and rehabilitating stability back into the shoulder joint. Very occasionally the Rotator Cuff can have a large tear in the muscle that often requires keyhole surgery to repair it. This is called an Arthroscopic Rotator Cuff Repair.
Shoulder instability is a term used when the ball slips a little or completely out of the socket (subluxation or dislocation). This can happen for a number of reasons but is generally classified into two main groups. The first type is the “traumatic group”, this means that they experience a complete dislocation of their shoulder and is often associated in sports such as rugby tackle.
Physiotherapy can be used to rehabilitate the rotator cuff muscles to restabilise the joint so it does not occur again.
A traumatic dislocation of the shoulder can also be associated with a labral (this is a rim of cartilage surrounding the socket to provide stability) or rotator cuff muscles tear. The most common method for repairing a rotator cuff or labral lesion is usually surgery.
The other type of shoulder instability is the “hypermobile group”. This occurs when a person’s shoulder and other joints have more movement than the average person. Sometimes this is known as being double jointed or hypermobile. In this type of instability the shoulder often does not truly dislocated but slips or partial dislocated out the socket. This is known as subluxation.
Physiotherapy is used to rehabilitate the shoulder using the stabilisers of the shoulder and shoulder blade to regain full function into the shoulder. MyPhysio are specialist in assessing the diagnosing should instability with Laura and Lizzy both being members of the South West Shoulder interest group.