Are you in danger of developing a frozen shoulder?

Increasing numbers of Australians and toughing it out with a painful shoulder rather than seeking early medical intervention. A frozen or stiff shoulder can become a debilitating complaint that takes weeks or months to recover.

I have found that a much higher percentage of country people compared to city folk are putting off seeking help for their painful shoulder post injury.

Often the first reaction to shoulder pain or injury is to shut down and cradle the arm by the side in fear of making it worse. That’s OK for a few days but stiffness can set in very quickly unless gradual movement is initiated. The key is knowing how. That’s when it’s so important to seek a qualified physiotherapist that can help.

Unfortunately, increasing numbers are presenting weeks and sometimes months after injury unable to use their arm, then comes the scream for help.

There are a number of causes of frozen shoulder.

The most common is a tear of the rotator cuff muscles that cup and support the shoulder joint. Even a minor incident can develop swelling and loss of function over time. Sometimes a tear might be significant and depending on your age, a surgical repair is warranted. Rotator cuff tears do not repair on their own. Early intervention with an ultrasound examination will reveal any damage.

Overuse over time can inflame tendons or a fluid sack protecting the tendons from the bony skeleton above, the sub-acromial bursa. Again an ultrasound examination will show an inflamed bursa and often a guided cortisone injection to the bursa will help.

Both of these types of injury are often accompanied by tight muscles pulling the shoulder blade forward compromising how the arm aligns with the shoulder blade and trunk. When you attempt to lift the arm to the side the rotator cuff tendons get jammed and pain limits.

Many of us adopt a saggy forward posture sitting watching TV or at the computer and have weakened shoulder blade stabiliser muscles as a result. A poor posture with saggy shoulders predisposes to shoulder injury at work or play. A full recovery of mobility and strength after injury is only achieved by addressing the muscular imbalance. Specifically designed exercises from a physiotherapist will help you achieve a full recovery.

A third type of frozen shoulder is called an ‘idiopathic’ or ‘True’ frozen shoulder. What that means is we don’t know why it happens. What we do know is that it is characterised by increasing pain and inflammation associated with capsular stiffness of the shoulder joint.

Painful stiffening can be rapid and if not brought under control quickly, can take up to 2 years to resolve. The cause of the inflammation may be unknown but early treatment with acupuncture and gentle mobilisation can prevent progression of the condition. It may be beneficial to inject the sub-acromial bursa to reduce inflammation in True frozen shoulder.

In my clinic in northern NSW, I use a combination of acupuncture, hands on physiotherapy and exercise to reduce pain and swelling and allow early mobilisation.

The important message from reading this article is that it is better to prevent a frozen shoulder rather than having to deal with it once it develops.

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