Managing Adhesive Capsulitis: The Role of Physical Therapy in Restoring Movement and Quality of Life

Frozen shoulder, or adhesive capsulitis, significantly impacts life by limiting your ability to perform daily tasks and reducing your quality of life. This blog explores adhesive capsulitis, its underlying factors, symptoms, and most crucially, how physical therapy can help you regain mobility and enhance your overall well-being.

Understanding Adhesive Capsulitis

Adhesive capsulitis manifests as stiffness and pain in the shoulder joint, caused by the thickening and tightening of the shoulder's connective tissue capsule. The condition develops gradually and can take one to three years to resolve fully.

Underlying Factors

Factors increasing the risk of developing adhesive capsulitis include:

• Age over 40, particularly in women.
• History of shoulder trauma or surgery.
• Systemic conditions like diabetes or thyroid disorders.
• Prolonged shoulder immobilization.

Symptoms to Expect

Adhesive capsulitis typically progresses through three stages:

1. Freezing stage: Gradual onset of shoulder pain that worsens over time and hurts more at night.
2. Frozen stage: The pain might decrease, but the shoulder becomes stiffer, and using it becomes more challenging.
3. Thawing stage: The range of motion in your shoulder begins to improve.

Diagnosis

• Medical History: The doctor will ask about the onset of symptoms, any previous shoulder injuries, the level of pain, and how the condition has affected the range of motion. They may also inquire about overall health, any chronic diseases like diabetes (which is associated with a higher risk of frozen shoulder), and any recent surgeries or immobility of the shoulder.
• Physical Examination: The doctor will examine the shoulder to assess pain and range of motion. This involves both active and passive movements. In active movement, the patient moves the shoulder on their own. In passive movement, the doctor moves the joint and notes the range of motion and the points at which pain occurs.
• Imaging Tests: While not always necessary, imaging tests like X-rays, MRI (Magnetic Resonance Imaging), or ultrasound might be used. These can help rule out other causes of stiffness and pain, such as a rotator cuff injury or arthritis. Imaging tests are more about excluding other conditions than confirming frozen shoulder, as adhesive capsulitis is primarily diagnosed based on symptoms and physical exam.

What to Expect in Physical Therapy

Physical therapy is essential in managing adhesive capsulitis, focusing on restoring mobility, alleviating pain, preventing future issues, providing tailored care, and enhancing overall well-being. Your session will begin with an initial assessment in which the therapist will evaluate your shoulder's range of motion, strength, and daily function. This evaluation helps in creating a personalized treatment plan.

Techniques Used by the Physical Therapist:

• Manual Therapy: Hands-on techniques to mobilize the joints and soft tissues, enhancing movement and reducing pain.
• Therapeutic Exercises: Tailored exercises designed to restore range of motion, improve strength, and facilitate shoulder function.
• Modalities: Use of heat, cold, or ultrasound to manage pain and inflammation.
• Stretching: Specific stretches to maintain and improve the flexibility of the shoulder joint and surrounding muscles.
• Education: Guidance on posture, ergonomics, and activity modifications to manage symptoms and prevent exacerbation.

Types of Exercises:

• Range-of-Motion Exercises: Gentle movements to increase shoulder mobility, such as pendulum exercises.
• Strengthening Exercises: Focused on improving the strength of shoulder muscles to support joint stability.
• Functional Training: Activities that mimic daily tasks to ensure the shoulder can handle regular stress.
• Pain Relief Exercises:Techniques to reduce discomfort during the recovery process.

Conclusion

Adhesive capsulitis can be a long and challenging journey, but physical therapy offers a comprehensive approach to manage pain, regain function, and improve your quality of life. With the right combination of expertise, exercises, and personalized care, overcoming the limitations of a frozen shoulder is achievable.