frozen shoulder (michael)

• Conditions resulting from shoulder hypomobility generally fall under the “frozen shoulder” category.  Frozen shoulder serves as an umbrella term for disorders such as rotator cuff tendonitis and tears, biceps tendonitis and tears, and other painful shoulder syndromes.
• Has 3 stages:

1. Pain phase – Inflammation of synovial lining, thickening of joint capsule, synovial fluid loss, and decreased range of motion
2. Frozen phase – Thickening of rotator cuff tendons, loss of joint space, and joint capsule fibrosis are seen.  Individual may experience decrease pain.
3. Resolution phase – Joint ROM increases and individual gradually returns to normal daily activities. 

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symptoms

• Slow pain onset
• Inability to sleep on affected side
• Painful, restricted movements (particularly shoulder elevation and external rotation)

causes

• Previous shoulder or arm injury 
• Risk factors:
  • Old age
  • Women
  • Some chronic health conditions (e.g., diabetes, thyroid conditions, etc.)

treatment

• Physiotherapy
• Acupuncture
• Daily activity modification

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how does physiotherapy help?

• Manual therapy can help relieve tension in stiff muscles of the shoulders, neck, and back, as well as improve blood circulation to promote healing and reduce pain
• Intramuscular stimulation (IMS) induces local inflammation to improve blood flow, aid in healing, and reduce pain 
  • Promotes relaxation of the injured and surrounding muscles, reducing any spinal nerve or joint compression, and thus allows for improved mobility
• Ice/heat therapy improves blood flow and reduces pain
• Exercise prescription and modification will help in strengthening muscles of the neck, upper back and shoulders, which is beneficial to help improve strength, gain stability, and enhance range of motion