Steemit Learning Challenge-S21W1: Physical Therapy Intervention: Frozen Shoulder

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Frozen Shoulder is the disorder that is caused by adhesions, shoulder joint capsular restrictions, thickening, inflammation, and age related changes mainly in old age with diabetes history ( rheumatoid or osteo arthritis). This disorder onset occurs between 40 to 60 years.

Types of Frozen Shoulder

There are 2 types of frozen Shoulder on the basis of it's causes.

Primary Frozen Shoulder

• If there is no known cause of frozen shoulder then it's primary type. It can be due to wrong posture (overuse of the shoulder joint), provoking chronic inflammation like muscles of rotator cuff, biceps tendon or joint capsule.

Secondary Frozen Shoulder

• If frozen shoulder occurs due to above written causes like osteoarthritis, rheumatoid arthritis or any trauma (Road traffic accident) than it's called secondary frozen shoulder.

Clinical Signs and Symptoms

There are following sign and symptoms of frozen shoulder associated with pain that can lead to hypomotility of shoulder joint.

• In acute phase pain and muscle protection from further damage limit motion, the main range of motions affected in any patient are external rotation and abduction of shoulder joint. Pain may be radiating and experienced below elbow and disturb sleep. There maybe joint tenderness that can observe by palpating the joint in depth.
• In subacute phase, there is capsular tightness in shoulder joint that limited shoulder range of motions especially external rotation and abduction. Internal rotation and flexion are the least affected, patient feel pain at the end range of motion.
• In chronic phase, restrictions progress that limit more joint range of motion and patient is unable to perform overhead activities, move hand behind the back, and aching in deltoid region.

Stages of Frozen Shoulder

There are 4 stages of frozen shoulder that are on the basis of symptoms and that can reduce symptoms at stage 4.
Stage 1.

• In this stage there is increase of pain with movement and pain present at night. The ranges lost at joint is external rotation and this stages lasts for less than 3 months.

Stage 2

• This stage is refer to freezing stage, there is persistent and intense pain present even at rest. All ranges of motions are limited and can't be regain with intra-articular injection. This stage last for 3 to 9 months.

Stage 3

• This stage is the frozen stage at which pain occur only with movement, atrophy of muscles start at that stage especially of deltoid, rotator cuff, biceps and triceps brachii muscles. This stage lasts for 9 to 15 months.

Stage 4

• This is the thawing stage of frozen shoulder in which minimal pain presents, no inflammation or tenderness, Range of motions gradually improve at stage 4. This stage lasts for 15 to 24 months or longer. Some patients unable regain normal ROM. But some research indicates that patient can gain range of motion in 2 years from onset.

Physical Therapy Intervention for Frozen Shoulder

Physical therapy intervention for Frozen shoulder are from weeks to months to regain normal ranges and subside pain with movement or at rest. Here are the few exercises videos that you have to perform to treat frozen shoulder patients. Treatment protocol vary from patient to patient. But the main thing is you have to evaluate the exact cause of frozen shoulder.