Advice
How to Release a Frozen Shoulder
Frozen shoulder (also called adhesive capsulitis) is a common disorder that causes pain, stiffness and loss of normal range of motion in the shoulder. The resulting disability can be serious and the condition tends to get worse with time if it’s not treated. It affects mainly people ages 40 to 60—women more often than men.
We don’t fully understand the causes, but an inflammatory process is probably involved. Sometimes freezing occurs because the shoulder has been immobilized for a long time by injury, surgery or illness. In many cases, the cause is obscure. Fortunately, the shoulder can usually be unfrozen, though full recovery takes time—and lots of self-help.
The shoulder has a wider and more varied range of motion than any other part of the body. It pivots mainly on a ball-and-socket arrangement called the glenohumeral joint, which joins the top of the humerus (upper arm bone) to a scooped-out part of the scapula (shoulder blade) called the glenoid cavity.
How does the shoulder become frozen?
The process usually begins with an injury (such as a fracture) or inflammation of the soft tissues, such as bursitis or tendinitis of the rotator cuff. Inflammation causes pain that is worse with movement and limits the shoulder’s range of motion.
When the shoulder becomes immobilized in this way, the connective tissue surrounding the glenohumeral joint—the joint capsule—thickens and contracts, losing its normal capacity to stretch. Trying to avoid the pain caused by moving the shoulder leads to further contraction of the capsule. The humerus has less space to move in and the joint may lose its lubricating synovial fluid. In advanced cases, bands of scar tissue (adhesions) form between the joint capsule and the head of the humerus.
A frozen shoulder may take two to nine months to develop. Although the pain may slowly improve, stiffness continues, and range of motion remains limited.
Who gets frozen shoulder?
The risk is increased when you don’t receive exercise therapy after tendinitis or an injury, and when you wear a sling for more than a few days without intermittent stretching. About 10% of people with rotator cuff disorders develop frozen shoulder. Enforced immobility resulting from a stroke, heart condition or surgery may also result in a frozen shoulder. Other conditions that raise the risk are thyroid disorders, Parkinson’s disease and diabetes (frozen shoulder affects 10% to 20% of people with diabetes).