At the outset, it must be said that the treatment of a frozen shoulder requires a multidirectional approach, so not only a physiotherapist, but also an orthopedic doctor, family doctor and a dietitian may be helpful in controlling the ailments.
Treatment / physiotherapy of the frozen shoulder unfortunately belongs to rehabilitation in the field of long-term therapy. From the experience of the REHAB Gdańsk team, the time needed to achieve submaximal or maximum mobility of the joint is about 6 months (however, taking into account the healing process of the frozen shoulder without therapy and the final effect – physiotherapy seems to be the most reasonable option).
The reason for such a long rehabilitation process are changes in the collagen structure of the joint capsule, which arose as a result of the inflammatory process and changes in the muscle tissue. This process, as already mentioned, is reversible, but time is needed.
What is the treatment of a frozen shoulder?
Due to the complexity of the ailments, the therapy of the frozen shoulder focuses not only on the work on the shoulder-scapular joint (although it is most severely affected), but also on the work on the shoulder girdle, the scapulo-costal joint, mobilization of the cervical and thoracic spine, and work on the ribs.
Manual therapy, which is an essential element of therapy, aims to increase the flexibility of the tissues on which the therapist is working. The techniques should focus not only on the articular capsule itself, but also on the muscles, nerves and fascia in the affected area. The work of an experienced physiotherapist allows for a slow recovery of painless ranges of motion, in a way that is safe for the joint.
Another equally important element is training the range of motion and motor control. It should be mentioned here that without the patient’s great involvement, such therapy will not be very effective. In order to maintain the effects of manual therapy, proper mobilization of the joint is also necessary at home. Exercises that the therapist should recommend must be based on maintaining the developed range of motion during manual therapy, and focus on the correct sequence of movement (i.e. motor control).
Homemade exercises for a frozen shoulder
Scientific research also recommends autostretching of articular structures. On their basis, the author of the text chose the two most effective methods of stretching the joint described.
- The exerciser lies on the stretched side (affected by the disease)
- The person’s shoulder is placed on the floor in such a way that it is well stabilized
- Shoulder and elbow joints are bent to 90 degrees (if possible)
- With a healthy hand, a person stretches his or her diseased hand to the ground.
- Stretch until you feel the stretching at the back of the shoulder joint – remember that the exercise must not provoke pain!
- 2 repetitions of 30 seconds of max stretch