Frozen Shoulder: How To Avoid this Middle-Age Malady

For many sufferers, frozen shoulder is an unpleasant surprise. One day, everything’s fine. The next, lifting an arm overhead sends a searing pain through your shoulder. Left untreated, the shoulder joint eventually seizes up and life grinds to a halt.

Adhesive capsulitis, often referred to as “frozen shoulder,” is a stealth condition that can appear suddenly and for no particular reason. It occurs when the ligaments and soft tissue surrounding the shoulder joint capsule become inflamed, stiff and painful. Irritation stymies movement, causing the shoulder capsule to tighten, or freeze, around the joint. The inflammation spreads, affecting surrounding tissue like the bursa, limiting movement and making daily tasks difficult.  

Why Your Shoulder Freezes Up

Frozen shoulder most commonly strikes those in middle age, and women ages 40 to 60 seem to suffer the greatest. It affects up to 5 percent of the population and up to 20 percent of diabetic patients. Symptoms gradually worsen over time, diminishing range of motion and disrupting daily life. 

While frozen shoulder can begin abruptly without apparent cause, there are certain risk factors that boost its chance of occurrence. Underlying or undiagnosed health issues such as diabetes, thyroid problems, cardiovascular disease, breast cancer, polymyalgia rheumatica and Parkinson’s disease can increase the possibility of a shoulder freezing. Likewise, repetitive movements at work, overdoing it in the gym, slouching at your desk and aging can stress shoulders and overtighten muscles.

A fracture, tendinitis, arthritis, bursitis or surgery that immobilizes your shoulder for an extended period can trigger the inflammation and scar tissue that creates frozen shoulder. Inactivity also can cause the shoulder’s joint area to weaken and atrophy. Rotator cuff concerns or pathology, tendinopathy, cervical issues and partial or full tears also can cause pain and loss of motion.

The Chilling Stages

There are four stages of frozen shoulder.

1. Painful: During this initial stage, you may experience shoulder pain that gradually increases in severity. Range of motion remains intact. 
2. Freezing: The freezing phase can last six weeks to nine months. Shoulder pain intensifies while range of motion begins to decline. Pain may worsen at night making sleep difficult.  
3. Frozen: When fully frozen, the shoulder joint stiffens, and there is loss of motion. This stage can be less painful but more debilitating, lasting as long as six months if untreated. Simple activities like dressing, driving or eating can become difficult.
4. Thawing: This recovery period occurs when pain decreases, and the shoulder’s strength and range of motion begin to return to normal. Thawing generally occurs within a year.

Preventing a Deep Freeze

People usually seek medical treatment when their shoulder pain or stiffness becomes noticeable, keeping them awake at night, or limiting their daily activities like dressing or driving.

Left untreated, frozen shoulder can take anywhere from one to three years to resolve on its own. Your orthopedic doctor, however, can suggest treatments to ease symptoms, restore function and speed recovery.

Therapies include:

• Physical therapy, either done in office or via a home program, can provide specific stretching or range-of-motion exercises to help restore motion.
• Over-the-counter, non-steroidal anti-inflammatories such as ibuprofen or Motrin.
• Prescription dose anti-inflammatory medications.
• Cortisone or steroid injections to the joint under ultrasound guidance.
• Guided capsular distension injections of saline combined with numbing medication like lidocaine to expand the capsule and break up the adhesions, followed by shoulder manipulation by a physical therapist.
• Surgical manipulation of the shoulder under anesthesia to break up the adhesions.
• Shoulder arthroscopy done surgically by slicing through stiff areas of the joint capsule via tiny incisions around the shoulder.

4 Stretches To Keep You Loose

A healthy shoulder requires a combination of strength, stability and range of motion to do its job. To help thwart adhesive capsulitis, keep your shoulders flexible as you age. Choose daily stretches and exercises that move shoulder joints through their full range of motion. To keep shoulders loose and pliable, consider incorporating these exercises into your routine.

Across-the-chest stretch: Increases flexibility and range of motion in your shoulder joint.

1. Lift your right arm horizontally across your chest.
2. Place your right forearm in the crease of your left elbow and tuck your left arm to your body’s side.
3. Hold this position for 30 seconds, working up to one minute.
4. Repeat with your left arm.
5. Repeat each side three to five times.

Wall Walks: Increases flexibility while loosening tight shoulder joints.

1. Sit or stand facing a wall with your shoulder about two feet away from the wall.
2. Leaning forward, raise your arms to shoulder level with your fingertips on the wall.
3. Gently walk your fingers up the wall as high as you can.
4. Hold for the count of five, then walk your fingertips back down the wall.
5. Repeat three to five times.
6. Over time, work up to holding each stretch for 30 seconds.

Pot Stirs: Warms up shoulder joints while increasing flexibility.

1. Stand slightly leaning over with your left hand on a table, chairback or your waist.
2. Let your right arm hang down, relaxed.
3. In a large, loose motion, circle your right arm five times in each direction, as if you were stirring a pot.
4. Repeat on the left side.
5. “Stir the pot” two or three times daily.

Neck Release: Gently loosens the tension in your neck and shoulders.

1. Sit or stand with your back straight.
2. Lower your chin toward your chest to feel a stretch through the back of your neck.
3. Gently roll your head to the left, looking down, to stretch your right shoulder.
4. Hold for one minute.
5. Repeat on the opposite side.
6. Strive for three times per side per day.
7. Breathe deeply to better relax into the stretch.