Frozen Shoulder Injury Explained

Frozen shoulder or 'Adhesive Capsulitis' is a common cause of shoulder pain in people aged between 40 and 60, with women affected more than men. Shoulder specialist Dr Robert Codman first described 'Frozen Shoulder' in 1934, although this painful shoulder condition had frustrated patients and doctors for centuries before this. The fact that Frozen Shoulder merely describes what the patient experiences, is evidence that the condition was still poorly understood.

Anatomy of frozen shoulder injury

In 1945, Nevasier used the term Adhesive Capsulitis and described the pathology as being characterised by adhesions and contractures of the fibrous capsule that surrounds the shoulder joint. While other conditions can produce a stiff shoulder and shoulder pain, frozen shoulder is characterised by adhesions of the capsule.

To date the cause of frozen shoulder has not been worked out, although it is associated with other medical problems such as diabetes, thyroid problems and a history of previous heart attack.

Frozen Shoulder Signs & Symptoms

Interestingly, the non-dominant shoulder appears to be affected more than the dominant shoulder. Those patients with frozen shoulder usually experience distinct phases with differing signs and symptoms.

The first phase is referred to as the 'Freezing' phase. During this phase pain comes on slowly and leads to a gradual loss in shoulder movement. Some patients may not notice anything until they struggle to, say, fasten a bra or comb their hair. Eventually, over the space of a couple of months, the pain becomes so severe that it interferes with sleep because there is an exquisite pain when attempting to lie on the affected shoulder.

The second phase is referred to as the 'Frozen' phase due to the continued restriction of shoulder movement, which can last for up to a year.

The final phase is referred to as the 'Thawing' phase. This can take anywhere between 5 months and two years, although some patients can experience a more rapid recovery. During this time there is a gradual increase in shoulder range of motion.

As it is the soft tissues, specifically the capsule, that are affected by frozen shoulder, x-rays are clear. However, they are useful in distinguishing the problem from shoulder arthritis and calcific tendinopathy. The main diagnostic characteristic of Frozen Shoulder is decreased joint capsule volume (the fluid in the shoulder joint is decreased) when an arthrography is performed (an investigation whereby a liquid medium or dye is injected into the joint space).

The normal fluid volume of the shoulder is around 30 cubic cm, but during arthrography in frozen shoulder the joint will only take 10 cubic cm of dye. Another characteristic of frozen shoulder is the loss of the 'axillary fold' of the capsule on the arthrograph itself. It hasn't gone anywhere; it has merely 'stuck to itself' and can't be seen as a result.

Frozen Shoulder Treatment

Ice Therapy or Heat Packs can be effective to help pain relief, depending on personal preference. Pain relieving medication prescribed by a doctor is particularly helpful during the early 'freezing'' phase.

Physiotherapy treatment is the first option for Frozen Shoulder. The main aim of physiotherapy treatment is to gently stretch the shoulder joint capsule. This is achieved through performing passive mobilisations which are done at various points in the range of shoulder movement. In addition, the patient must keep up a regular active stretching program to gently improve shoulder range of movement. All this stretching should be pain free.

Some evidence suggests that more aggressive shoulder mobilisation in conjunction with local anaesthetic and corticosteroid injections can provide pain relief and restore shoulder range of movement.

If the arm can't be lifted to the level of the shoulder after three months then manipulation under anaesthetic (MUA) by an orthopaedic consultant may be appropriate. Following the procedure, the affected arm is held 'abducted' away from the trunk in order to maintain range of movement. The day after the MUA, the patient must begin a series of active exercises to restore the full range of motion. If these conservative measures fail then surgery may be indicated to release the adhesions and restore range of movement.

It is important to avoid total disuse of the affected arm. This can lead to muscle wasting in the forearm and hand. Grip strength and dexterity can be maintained by using Therapeutic Putty to exercise the hand and fingers. This means that once the Frozen Shoulder pain resolves there will be a good level of function in the hand.

Frozen Shoulder Prevention

Because the causes of Frozen Shoulder are not fully understood, there is no proven prevention strategy for this condition.

Mentholatum Deep Relief Gel

£6.49 inc VAT RRP £7.99 Save £1.50

Deep Relief dual action gel with ibuprofen is a clear, non-sticky and non-greasy gel with a mild, pleasant menthol fragrance.
More Details

Mentholatum Deep Relief Gel has a rating of 5.0 stars from 2 reviews (2 reviews)

Availability: In Stock

Quantity

Empi Direct TENS

£52.69 inc VAT

The Empi Direct TENS machine (transcutaneous electrical nerve stimulator) is a compact dual channel handheld device which utilises a range of nerve stimulation programmes to aid in the treatment and management of chronic and acute conditions.
More Details

Empi Direct TENS has a rating of 5.0 stars from 1 reviews (1 review)

Availability: In Stock

Quantity

PhysioRoom.com Resistance Exercise Band

£4.49 inc VAT RRP £5.49 Save £1.00

Latex Bands provide light, medium to heavy resistance during training exercises and are designed for increasing strengthening exercises during rehab and sports training. 99.99% free from latex allergens.
More Details

PhysioRoom.com Resistance Exercise Band has a rating of 5.0 stars from 11 reviews (11 reviews)

Availability: In Stock

Quantity

PhysioRoom.com Resistance Band Exercise Loop

£1.94 inc VAT RRP £2.49 Save £0.55

These multi-coloured tubes provide four levels of resistance, ideal for progressing strengthening exercises.
More Details

PhysioRoom.com Resistance Band Exercise Loop has a rating of 5.0 stars from 27 reviews (27 reviews)

Availability: In Stock

Quantity

PhysioRoom.com Hand Grip Exerciser

£3.99 inc VAT RRP £6.99 Save £3.00

Durable handles and resistance springs demonstrates the high quality of the Hand Grip Exerciser by PhysioRoom.com. Use it to strengthen muscles in the hands, arms and wrists.
More Details

PhysioRoom.com Hand Grip Exerciser has a rating of 4.0 stars from 2 reviews (2 reviews)

Availability: In Stock

Quantity

PhysioRoom.com Exercise Band Loop (medium) - Pack of 5

£6.99 inc VAT RRP £14.99 Save £8.00

These red coloured tubes provide medium resistance, ideal for progressing strengthening exercises.
More Details

PhysioRoom.com Exercise Band Loop (medium) - Pack of 5 has a rating of 5.0 stars from 1 reviews (1 review)

Availability: In Stock

Quantity

PhysioRoom.com The PhysioRoom Rehab and Fitness Exercise Pack

£43.99 inc VAT

The ultimate rehab and fitness kit, also perfect for yoga and pilates. Everything you will need for exercise or rehab following a sporting injury, for use at home.
More Details

Availability: Out Of Stock (Awaiting Due Date)

Quantity

PhysioRoom.com 5.5m x15cm Resistance Band Box - Choose between 5 Levels

£8.49 inc VAT RRP £14.99 Save £6.50

Latex Bands provide light, medium to heavy resistance during training exercises and are designed for increasing strengthening exercises during rehab and sports training.
More Details

PhysioRoom.com 5.5m x15cm Resistance Band Box - Choose between 5 Levels has a rating of 5.0 stars from 25 reviews (25 reviews)

Availability: In Stock

Quantity

PhysioRoom.com Hand Grip Strengthener With Foam Handle

£3.99 inc VAT RRP £4.99 Save £1.00

The hand grip strengthener features a foam handle to ensure of a comfortable grip. The hand grip strengthener has durable foam handles and resistance springs to increase the strength of the forearm and the hand grip.
More Details

PhysioRoom.com Hand Grip Strengthener With Foam Handle has a rating of 5.0 stars from 1 reviews (1 review)

Availability: In Stock

Quantity

PhysioRoom.com 5.5mx15cm Resistance Bands All Strengths 5 Boxes 5 Levels Of Resistance

£37.99 inc VAT RRP £59.99 Save £22.00

This resistance exercise band pack features five boxes each of which has varying levels of resistance. Each latex band measures 5.5mx15cm and can be cut accordingly to suit your preference. Latex bands provide light, medium to heavy resistance during exercise and are specifically designed to increase strength during rehab and sports training.
More Details

PhysioRoom.com 5.5mx15cm Resistance Bands All Strengths 5 Boxes 5 Levels Of Resistance has a rating of 5.0 stars from 2 reviews (2 reviews)

Availability: In Stock

Quantity

PhysioRoom.com x2 Hand Grips With Foam Handles

£5.49 inc VAT

The x2 hand grips with foam handles ensure of a totally comfortable grip. The hand grips with foam handles feature resistance springs which help to increase the strength of the forearm and hand grip.
More Details

PhysioRoom.com x2 Hand Grips With Foam Handles has a rating of 5.0 stars from 1 reviews (1 review)

Availability: In Stock

Quantity

Fitness Mad Studio Pro Adjustable Power Grip

£9.83 inc VAT RRP £9.99 Save £0.16


More Details

Fitness Mad Studio Pro Adjustable Power Grip has a rating of 4.5 stars from 6 reviews (6 reviews)

Availability: In Stock

Quantity

PhysioRoom.com Instant Ice Pack

From £0.49 inc VAT     1+ £2.99 each
    6+ £1.99 each (Save 33%)
  12+ £1.49 each (Save 50%)
  24+ £0.99 each (Save 67%)
  50+ £0.49 each (Save 84%)

A mouldable pack that becomes an instant, single use ice pack, without the need for refrigeration.
More Details

PhysioRoom.com Instant Ice Pack has a rating of 5.0 stars from 21 reviews (21 reviews)

Availability: In Stock

Quantity

Physicool Cooling Bandage (10cm x 2m) - Ideal for wrists, ankles, elbows

£6.59 inc VAT RRP £9.99 Save £3.40

Physicool is an innovative and uniquely designed reusable strapping that combines the healing characteristics of cold therapy with the support qualities of a compression bandage. Differing from the more traditional treatments currently available, Physicool works by drawing heat away from the body to provide an instant long-lasting cooling effect which can be utilised for extended periods.
More Details

Physicool Cooling Bandage (10cm x 2m) - Ideal for wrists, ankles, elbows has a rating of 5.0 stars from 7 reviews (7 reviews)

Availability: In Stock

Quantity

Physicool Cooling Bandage (12cm x 3m) - Ideal for thighs, legs, shoulders, elbows

£8.89 inc VAT RRP £12.99 Save £4.10

Physicool is a new and unique way to instantly apply cold therapy whilst on the move, this portable and reusable compression bandage is applied quickly and easily allowing the healing process to begin immediately. By taking heat away from the body Pysicool have developed a product which differs from move traditional methods meaning it can be used for longer periods.
More Details

Physicool Cooling Bandage (12cm x 3m) - Ideal for thighs, legs, shoulders, elbows has a rating of 5.0 stars from 13 reviews (13 reviews)

Availability: In Stock

Quantity

PhysioRoom.com Instant Heat Pack

From £0.49 inc VAT     1+ £1.99 each
    6+ £1.49 each (Save 25%)
  12+ £0.99 each (Save 50%)
  24+ £0.75 each (Save 62%)
  50+ £0.49 each (Save 75%)

A mouldable pack that becomes an instant single use heat pack. Ideal for soothing warm pain relief.
More Details

Availability: In Stock

Quantity

ProCare Shoulder Sling (with foam straps)

£14.79 inc VAT RRP £21.99 Save £7.20

A shoulder sling with comfortable foam straps for use following shoulder injuries and shoulder surgery.
More Details

ProCare Shoulder Sling (with foam straps) has a rating of 5.0 stars from 11 reviews (11 reviews)

Availability: Selected options in stock

Quantity

Bauerfeind OmoTrain Shoulder Support

£111.19 inc VAT

Active shoulder support that provides functional treatment and pain relief following shoulder injuries.
More Details

Availability: Delivered in 7-10 days

Quantity

PhysioRoom.com Shoulder Support Strap

£13.99 inc VAT RRP £24.99 Save £11.00

High quality custom fit shoulder strap to aid injuries such as bursitis, myositis and tendonitis.
More Details

PhysioRoom.com Shoulder Support Strap has a rating of 4.5 stars from 67 reviews (67 reviews)

Availability: In Stock

Quantity

Donjoy UltraSling IV ER

£70.19 inc VAT RRP £79.99 Save £9.80


More Details

Availability: Delivered in 7-10 days

Quantity

Aircast Shoulder Cryo Cuff with Cooler

£103.79 inc VAT RRP £157.99 Save £54.20

The ultimate shoulder ice therapy. Provides 6 hours continuous cold and compression to minimise bleeding, swelling and pain.
More Details

Aircast Shoulder Cryo Cuff with Cooler has a rating of 4.5 stars from 4 reviews (4 reviews)

Availability: In Stock

Shoulder Cryo/Cuff Quantity

Donjoy UltraSling III ER

£69.99 inc VAT RRP £76.99 Save £7.00

A sling that provides immobilisation to the shoulder and arm, following shoulder injury or shoulder surgery.
More Details

Availability: Delivered in 7-10 days

Quantity


Shoulder Injuries