Frozen Shoulder - Harvard Health
Frozen Shoulder - Harvard Health
Frozen Shoulder - Harvard Health
Frozen shoulder
Published: December, 2014
Most of us don't think twice about taking a book o an overhead shelf, reaching an arm back to put on a coat, or rolling a bowling ball. But if you
have a frozen shoulder (also called adhesive capsulitis), these simple movements can be painful and nearly impossible. Frozen shoulder is the
temporary loss of normal range of motion in the shoulder. It tends to get worse, and can lead to considerable disability. The condition typically
a ects adults over age 40, and women more often than men.
Experts don't fully understand what causes frozen shoulder. An in ammatory process is probably involved. Often a shoulder freezes up because
it hasn't been used for a while because of pain, injury, surgery, or illness.
In most cases, a frozen shoulder can be unfrozen, although full recovery may take months and a lot of self-help.
The main joint is a ball-and-socket arrangement called the glenohumeral joint, which joins the top
of the upper arm bone to a scooped-out part of the shoulder blade called the glenoid cavity.
The glenohumeral joint lets the shoulder move forward and backward and lets the arm rotate and
extend outward from the body. A exible capsule lled with a lubricant called synovial uid
protects the joint and helps keep it moving smoothly. The capsule is surrounded by ligaments that
connect bones to bones, tendons that fasten muscles to bones, and uid- lled sacs called bursae
that cushion tendons and bones during motion.
This elaborate architecture of soft tissues accounts for the shoulder's marvelous exibility, but also makes it vulnerable to trauma and chronic
wear and tear.
When the shoulder doesn't move, the capsule surrounding the glenohumeral joint eventually thickens and contracts, losing its normal capacity
to stretch. The upper arm bone has less space to move around. The joint may also lose its lubricating synovial uid. The less the shoulder is
moved to avoid pain, the more likely the capsule will contract. In advanced cases, bands of scar tissue form between the joint capsule and the
head of the upper arm bone.
A frozen shoulder may take several months to develop. The main symptoms include:
But the cornerstone of treatment is physical therapy, concentrating on exercises that stretch the joint capsule (see Stretching exercises for a
frozen shoulder). Muscle strengthening comes later.
A physical therapist can show you how far to push yourself and teach you the appropriate exercises. Once you've learned your limitations, you
can do most of the stretching routine on your own at home.
While you're working to stretch the shoulder capsule, try to avoid any sports or daily activities that increase in ammation or aggravate your pain.
If you diligently follow your shoulder-stretching regimen, you'll probably be able to return to your usual level of activity. Full recovery may take
several months. If you don't see steady improvement or you reach a plateau, go back to your clinician or consult a shoulder expert.
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