RUNNING ON SUNSHINE PHYSICAL THERAPY
Christen Thieman, PT, DPT, OCS
In a Nutshell
Adhesive capsulitis, also called frozen shoulder, is a condition that can be managed with physical therapy.
The Issue
Many individuals experience shoulder pain in their lifetime. Adhesive capsulitis is a condition that causes shoulder pain, stiffness, and a limited ability to raise and rotate one’s arm. This can pose a major barrier to daily activities such as reaching, dressing, performing work activities, caring for one’s family, exercising, and even sleeping.
Adhesive capsulitis can often begin without a known cause, or it may be secondary to injury. Patients with adhesive capsulitis demonstrate a characteristic progression of symptoms over time that are identified as stages. The first stage includes pain at the end-range of shoulder movement, a shoulder ache at rest, and difficulty sleeping. The second stage is called the ‘painful’ or ‘freezing’ stage. It includes a gradual loss of the patient’s shoulder mobility in all directions. The third stage is known as the ‘frozen’ stage and includes pain and limited active and passive range of motion. The final stage, known as the ‘thawing’ stage, is when pain begins to resolve and stiffness improves.
The Opportunity
The good news is that folks with adhesive capsulitis are amenable to physical therapy treatment. Physical therapy examination includes screening to ensure patients are appropriate for physical therapy. Differential diagnosis is used to identify the cause of shoulder pain and to rule out other potential conditions. Examination assesses the person's mobility baseline and seeks to identify components that contribute to the shoulder not moving efficiently so that they can be addressed. The level of tissue irritability is determined, which is important as this guides treatment strategy and intensity.
A large focus is on treatment feeling tolerable, and “red light, green light” feedback is a useful way for patients to be empowered and to keep treatment comfortable. Education is an important part of treatment. Manual therapy is often used with joint mobilization as an excellent tool to increase mobility of the ball-and-socket joint as well as the scapula (shoulder blade) and thoracic spine (mid back). Folks are instructed on exercise “homework” to increase their mobility and within a tolerable range. Patients are educated on how to move well with the new mobility they gain. This means not only moving farther, but also in a skilled, coordinated, and efficient manner. The goal is for people to get back to doing what they love.
There is great joy in hearing patients’ stories of what they are able to accomplish and enjoy as they move better!
Reference
Kelly M et al. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther.
2013;43(5).
Christen Thieman, PT, DPT, OCS
Christen holds a doctorate in physical therapy and has practiced since 2009. She is board-certified as an Orthopedic Clinical Specialist. She founded RUNNING ON SUNSHINE PHYSICAL THERAPY. In earlier times, she spearheaded an evidence-based practice committee and presented research findings to the physical therapy department as well as the organization at large. Christen is grateful for the tremendous opportunity to learn not only from colleagues and literature, but also from her patients and views them as treasured collaborators.
Please feel free to contact RUNNING ON SUNSHINE PHYSICAL THERAPY with any questions, insights, or suggestions and to schedule an appointment.
RUNNING ON SUNSHINE PHYSICAL THERAPY
120 Bishops Way, Suite 154, Brookfield, WI 53005
414.702.2780
This information is for educational purposes only and is not intended as medical advice. Please consult your physician and/or physical therapist directly for specific recommendations regarding your care.