When a frozen shoulder occurs.

When you hear the words “frozen shoulder”, it’s tempting to think of a shoulder that doesn’t move at all. But the more usual picture is a shoulder with restricted range of motion associated with pain and stiffness. This condition is extremely disabling. In most cases, it is difficult to reach the hand to the head, lift the arm above the shoulder or reach behind the back. Imagine the frustration in trying to perform all the common activities of daily living that require these movements.

Typically, frozen shoulder syndrome occurs in individuals over the age of 40 years. Women are affected more frequently than men. The exact mechanism is not known, and it isn’t clear why some people get this problem and others don’t. The risk is much higher in individuals experiencing prolonged immobility of the shoulder.

For instance, immobility may occur due to a broken arm that requires the person to keep their arm in a sling for several months. Or it can happen in an individual that physically cannot move the arm due to stroke or other systemic causes. Or it can happen without obvious etiology and is called idiopathic frozen shoulder or adhesive capsulitis.

Adhesive capsulitis is often associated with postural imbalances and poor shoulder function. Individuals with kyphosis in the thoracic spine are at risk. Rounding in the shoulders and upper back make it difficult for the arm to move efficiently in the shoulder joint and predisposes to injury. Individuals with a long history of impingement syndromes (rotator cuff or glenohumeral soft tissue injuries) are also at risk. Chronic pain from repeated impingement injury can result over time in diminished range of motion and strength.

Those who experience frozen shoulder

The incidence of frozen shoulder is much higher in individuals with diabetes suggesting a possible autoimmune component. It is estimated that 10-20% of individuals with diabetes will experience frozen shoulder sometime during their life and recovery may be slower than expected. Other associated risk factors include thyroid problems, cardiovascular disease and Parkinson’s disease.

Pain is almost always part of the inciting presentation. Pain is often worse at night and in cold weather. Sleep is frequently interrupted. Accidentally banging or bumping a frozen shoulder can cause sharp shooting pains that last several minutes.

Because of the pain, the shoulder is not used as frequently which in turn leads to restricted movement and, ultimately, moderate to severe limitations in range of motion. Not all movements are equally compromised. External rotation and abduction tend to be hit the worst, and flexion and medial rotation are relatively spared. Although frozen shoulder usually resolves without treatment, it may take 2-3 years to do so.

Speed up Recovery

Pilates can help you speed up recovery and get back to the things you enjoy doing. Always get permission from your physician before starting a Pilates program. Your Instructor will design a program that focuses on

1. Gentle range of motion exercises to improve flexibility and mobility
2. Strength training as permitted to improve shoulder function
3. Overall Core strengthening to improve posture and balance

Prevention of frozen shoulder is ideal. If you are at risk, Pilates will help you restore posture, strengthen the rotator cuff muscles and keep your shoulders moving smoothly through full range of motion.