Urmston Physio Clinic

Transcription

1 Urmston Physio Clinic Patient Information Frozen Shoulder Prepared for Mr B. Roy Consultant Orthopaedic Surgeon 102 Church Road, Urmston, Manchester, M41 9DB Tel:

2 Frozen Shoulder - Why does this happen? The shoulder is a ball and socket joint. The round head of the humerus sits in a shallow socket on the shoulder blade. There is a loose layer of tissue The Capsule surrounding the joint which attaches to the ball and socket. This helps to hold the joint together. A Frozen Shoulder or Adhesive Capsulitis occurs when The Capsule becomes irritated and inflamed. The Capsule will tighten as fibrous tissue is formed which results in a loss of movement. Frozen Shoulder is a condition where the shoulder becomes painful and stiff. Frozen Shoulder is most common in people between the ages of 40 and 60. It is 5 times more common in people with diabetes. About 10 % of people who have a Frozen Shoulder will also experience the same condition in their other shoulder within 5 7 years. In some cases the onset of a Frozen Shoulder can be related to a minor injury. Page 1

3 What are the symptoms? The typical symptoms are pain and persistent stiffness in the shoulder joint. Activities including dressing, driving and sleeping are usually affected in the early stages. Symptoms are experienced in three stages: Stage I - Freezing or Painful Phase (2 to 9 months) The shoulder starts to ache and feel stiff. It gradually becomes very painful. Often it becomes more painful during the night. Most people will find the pain increases to a point where they are unable to lie on their shoulder. The pain is usually felt on the outside of the upper arm but it can spread down to the elbow. Stage II - Frozen or Stiff Phase (4 to 12 months) The shoulder will become stiffer. In this stage the level of pain will remain the same as Stage I. Stage III - Thawing or Recovery Phase (5 to 24 months) During this phase the movement will gradually improve. The pain will fade as the stiffness eases. Although the full range of movement may not return, most people will be able to perform their day to day activities more easily. Diagnosing a Frozen Shoulder Your Consultant can usually diagnose a Frozen Shoulder simply by examining your arm, knowing where your pain is and how it started. An X-ray may be taken to rule out other medical conditions. In the case of a Frozen Shoulder the X-ray will be normal. Page 2

4 What is the treatment? A Frozen Shoulder will usually get better by itself. This can take up to 2 years. There are actions you can take to aid recovery. During the initial painful stages it is important to manage the pain. Trying to force movement through the pain has been shown to increase the symptoms and recovery time. Painkillers and anti-inflammatory medications - These may be prescribed by your Consultant if the pain is constant and you are struggling to sleep. This is a temporary measure to break the pain cycle, but can continue as required. Exercise - Exercise is useful to help stretch The Capsule which will regain movement. It is very important not to force movement through the pain. The shoulder responds well to large rhythmic movements and body weight stretches. A list of exercises is suggested in this information sheet. Physiotherapy - If exercise alone does not improve symptoms or if there is joint stiffness, neck pain or other factors that make doing the exercises difficult then physiotherapy treatment may be required. Surgery - In some cases when symptoms are slow to resolve by the treatments detailed above, surgery may be considered. The tight capsule can be released with Arthroscopic (Keyhole) Surgery. Remember an important part of treatment is your home exercises and modifying activities. Page 3

5 Frozen Shoulder - Recommended Exercises Correct Posture Good posture should not feel like hard work. Imagine a balloon filled with helium is attached to your head and is pulling you up (Balloon Posture). You should feel your back straighten and your chest widen. Pull your shoulder blades back and down. This places the shoulder in good alignment and allows a wider range of movement. Key Points When Doing Exercises The following exercises should be within the limits of pain. When you start you may find that you can only move a small distance without pain but this will improve. Do not be tempted to push through the pain. Repeat the exercises four times a day. The number of repetitions that are recommended is what you should aim for. If you find them hard to do or can only move a little way aim to build up to the total number of repetitions over a few days or even a couple of weeks Page 4

6 Exercise 1 - Arm Swings If the arm has very limited movement this may be the best exercise to start with. Stand next to a table with your pain free hand on the table. Lean forwards so your sore arm is dangling. Gently swing the arm forwards and backwards using momentum to help the movement. Repeat x 15 four times daily This exercise can also be performed in a side to side movement, swinging the arm out then back under the table. Page 5

7 Exercise 2 - Table Slides (1) Find a cloth that will slide easily on your kitchen units or kitchen table. Sit facing the table or work surface. Think of your Balloon Posture. Now lean forward and gently slide your arms forward on the cloth. Lean back and return to start position. Get into a slow steady rhythm and gradually your range of movement will increase. Work to the point at which you start to feel pain. Do not push past this point. Repeat x 15 four times daily Page 6

8 Exercise 3 - Table Slides (2) Sit next to a table (kitchen or dining table height) with your elbow bent at your side and the forearm of your sore arm resting on a cloth that will slide easily. Sitting with Balloon Posture, gently slide your hand away from your body. Keep your elbow still so your hand moves around your elbow. Do this in a slow steady rhythm to the point of pain. Relax and return to start. Rhythmic movements back and forwards are most effective. Repeat x 15 four times daily Page 7

9 Exercise 4 - All Fours Start on all fours with your hands under your shoulders and slightly turned out. Your knees should be in line with your hips. Now sit down on your heels keeping your hands still. This will gently move your shoulder. Rhythmic movements back and forwards are the most effective. To progress this exercise take your knees further away from your hands. Repeat x 15 four times daily If you cannot kneel on all fours you can do this exercise in standing with your hands on a table in front of you. Bend your knees and stick your bottom out as you bend your knees you will move your shoulder. Page 8

10 Exercise 5 - Wall Slides Find a smooth wall or wall mirror and a cloth that will slide easily on the wall. This exercise also works if you put a sock on your hands. Stand facing the wall with the palms of your hands in contact with the wall. Think of your Balloon Posture with your shoulder blades pulled back and down. Gently push into the wall and slide your hands upwards. This must not hurt. Relax and return to start position. You should be gently pushing against the wall through the full movement. Repeat x 15 four times daily Page 9