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Defrost your frozen shoulders

August 31, 2017

 

Shoulder pain can be a very restrictive and disabling condition. You don’t realise how much you use your shoulder for everyday tasks. Think about it, hanging out the washing, washing the car, lifting, pushing, pulling, general cleaning or any house task. Shoulder pain can restrict your activities of daily living as well as your sleep. How many of you sleep on your side? If you have pain in the shoulder, then by sleeping on it you could increase the pain which wakes you up throughout the night, which can also have a negative impact on your health. Shoulder pain is more common when you get older and can develop over time or appear suddenly depending on the cause. There are many causes of shoulder pain. Overuse of the shoulder, posture, lifting heavy objects, sports injuries and trauma such as falling are common causes

 

There are many types of shoulder pain. It is important to treat the problem before the condition progresses to what’s collectively known as frozen shoulder. Frozen shoulder is where the joint is so stiff that movement is restricted and the joint is very painful with any movement or even touching. The most common shoulder conditions are:

  • Impingement syndrome/bursitis

  • Anterior shoulder instability

  • Rotator cuff tears or inflammation

  • Acromioclavicular joint sprain and osteoarthritis

 

How exercise therapy can help

Exercise therapy can help to reduce the symptoms and it may reverse some of the damage that is causing the pain.

 

Stretching

Stretching exercises are key to rebuilding the shoulder back to its’ best. Stretching can improve your joint’s range of motion from reduced stiffness. When you try to move a stiff shoulder you are likely to be causing more problems such as tearing, strains, irritation and impingement. Improving the mobility of the shoulder is the first step to managing your symptoms.

 

Strength and stabilisation

Strengthening and stabilising the shoulder is also an important component. Having stronger muscles supporting the shoulder region reduces the risk of further damage and re-injury. It also helps with lifting and carrying objects putting the shoulder under less loading. There are different methods for rebuilding strength in the shoulder and depend on the severity of the injury and the joints range of motion. An Accredited Exercise Physiologist is well suited to guide you through your rehabilitation once it is past the acute phase.

 

Case study

Session 1:

65 year old female presented with frozen shoulder. Her range of motion was as follows:

 

Tests                                     August 2015                        Risk Factors/Normal scores

Cervical Lat. Flex.             R:30°  L:45°                          R:45°  L:45°

GHJ Extension                   R:50°  L:30°                          R:50°  L:50°

GHJ Flexion                         R:180° L:100°                      R:180° L:180°

GHJ Abduct.                       R:180° L:60°                        R:180° L:180°

GHJ Ex. Rotat.                    R:80°  L:50°                          R:80°  L:80°

 

The initial session included stretching and mobility exercises for the shoulder and neck areas. These exercises can be done at home with no equipment necessary.

 

Session 2:

Tests                                     August 2015                        September 2015

Cervical Rotation              R:45°  L:60°                          R:60°  L:60°

Cervical Lat. Flex.             R:30°  L:45°                          R:45°  L:45°

GHJ Extension                   R:50°  L:30°                          R:50°  L:50°

GHJ Flexion                         R:180° L:100°                      R:180° L:110°

GHJ Abduct.                       R:180° L:60°                        R:180° L:100°

GHJ Ex. Rotat.                    R:80°  L:50°                          R:80°  L:60°

During the assessment it was observed that the patient achieved good improvements in range of motion.

This session was used to revisit the stretching exercises to make sure correct technique and that the patient had no trouble with the exercises.

 

Session 3:

Tests                                     August 2015        September 2015               April 2016

Cervical Rotation              R:45°  L:60°          R:60°  L:60°                          R:60°  L:60°

Cervical Lat. Flex.             R:30°  L:45°          R:45°  L:45°                          R:45°  L:45°

GHJ Extension                   R:50°  L:30°          R:50°  L:50°                          R:50°  L:50°

GHJ Flexion                         R:180° L:100°      R:180° L:110°                      R:180° L:180°

GHJ Abduct.                       R:180° L:60°        R:180° L:100°                      R:180° L:180°

GHJ Ex. Rotat.                    R:80°  L:50°          R:80°  L:60°                          R:80°  L:80°

During the assessment it was observed that the patient had full range of motion.

This session was used for the implementation of the strengthening and stabilisation component of the program.

 

All exercises were demonstrated to the patient. The patient was able to try every exercise and exercise sheets with pictures and instructions were provided to complete the exercises at home.

 

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