Management of frozen shoulder with physiotherapy
The shoulder joint is a ball and socket joint. The head of the humerus and the socket of the scapula make glenohumeral joint which provides a great degree of range of motion. This wide range of mobility is due to laxity of its fibrous capsule and the four times large size of the head of the humerus as compared with the shallow glenoid cavity.
The frozen shoulder usually occurs due to lack of movement and lack of the hormone oestrogen in females. The lack of movement leads to adhesion of capsules in the shoulder joint which leads to a phenomenon called adhesive capsulitis. The adhesive capsulitis might be categorised into primary capsulitis and secondary capsulitis which if not treated may lead to further damage as well. The lack of oestrogen in females who are more than 50 years of age or less than 50 years of age leads to weakness of bones and joints hence the shoulder joint also affected and frozen shoulder occurs. The capsule adhesion form as a result of inflammation in the capsule and synovium. This disease is also very common in diabetics.
Symptoms- the name frozen shoulder itself tells a lot about the symptoms. The pain and stiffness in the shoulder joint is so much that the patient is unable to move his shoulder joint or lift his arm in any direction. Hence the shoulder becomes immobilized or frozen.
physiotherapy management of frozen shoulder-
1)- hot fomentation- this increases blood flow in the shoulder joint which leads to reduction in pain and relaxation of the shoulder joint muscles. Hot fomentation also improves the laxity of the shoulder joint hence permitting certain degree of movement even in the frozen shoulder.
2)- transcutaneous electrical nerve stimulation is applied in the painful region so that the pain in the arm can also be reduced and the nerves affected can also be regenerated.
3)- I.F.T – interferential therapy is also given to the patient to reduce the pain and swelling in the shoulder joint.
4) – once the pain in the shoulder joint has reduced to a great extent then only the strengthening of the shoulder muscles and neck and arm muscles is started.
5)- mobilization of the shoulder joint is also done in various direction and in various posture to regain the complete range of motion of the shoulder joint.