Have you noticed persistent shoulder pain and stiffness that won’t just go away? There are many possibilities causing this, but one potential possibility may be known as adhesive capsulitis or frozen shoulder. Adhesive capsulitis predominantly occurs in women between the ages of 40 and 60 years old. Characteristically it starts off slowly and develops over time. Adhesive capsulitis can make it hard to lift your arm overhead, which can affect everyday activities like getting dressed or brushing your hair. Ke Ola Kino strives to provide a holistic approach when addressing a patient’s pain problem. Adhesive capsulitis is not solely limited to women, and all patients arrive frustrated by the loss of mobility and discomfort that is associated with adhesive capsulitis or frozen shoulder. These changes can be linked to hormonal shifts that commonly occur during this stage of life for women, but are still common with men too, as their joints do not get lubricated due to old age. While this condition may improve on its own with time, most people don’t want to wait the estimated two years it takes to get better.
Frozen shoulder is often times considered to be a mere stiffness problem, but there are many individual factors which play a role in the states of stiffness, pain, and progress of each person․ Everyone has their own symptoms, levels of pain, daily experiences, and challenges in the recovery process, so each person’s state of progress should not be treated like a “checklist”․ Individualizing care in such a way that lifestyle, pain tolerance, personal goals and stress level are taken into account can provide a feeling of progress which is more meaningful and sustainable․ A well-thought-out approach to hands-on physical therapy, prescribed home exercises and useful coping strategies can provide great improvement over time․ The pain may decrease gradually, range of motion of the shoulder improves, sleep improves, and one can dress and reach or carry objects more easily․ A major philosophy is to treat the person rather than the diagnosis of adhesive capsulitis (frozen shoulder, or shoulder stiffness)․
It is also vital for the patient to understand that there is more than just the shoulder joint that is affected by the frozen shoulder. In the first few weeks of a frozen shoulder, the patient may feel pain that is severe and unending throughout the course of the day, as the patient’s nervous system is likely to develop heightened sensitivity to non-painful stimuli. As a result, the patient may find movement to be painful or even have a fear of movement, even though there is no bodily injury. This is why skilled physical therapy is important to frozen shoulder recovery. Rather than trying to “push through the pain” or “force the shoulder to move when it is not ready”, a skilled physical therapist will control the patient’s symptoms, methodically place the shoulder through its full range of motion, and help the patient feel confident with their ability to move. Understanding what is actually happening to your body will play a large part in helping the patient to understand how and why they are progressing.
At Ke Ola Kino Physical Therapy, we know patients heal the best when they feel their problems are being listened to, feel supported, and educated. In addition to using researched treatment, we create a custom plan for all of our patients to meet their unique needs and goals. We help you improve your shoulder mobility and confidence in your ability to move during normal activities by working with you to relieve pain, increase mobility, and gain confidence. We want you to feel confident returning to your regular activities and not be rushed or discouraged along the way.
Resources
- Roncaglia I. (2023). One size does not fit all – A transdisciplinary rehab program for adhesive capsulitis: A case report. Journal of bodywork and movement therapies, 33, 150–153. https://doi.org/10.1016/j.jbmt.2022.09.022
- Sawyer, E. E., McDevitt, A. W., Louw, A., Puentedura, E. J., & Mintken, P. E. (2018). Use of Pain Neuroscience Education, Tactile Discrimination, and Graded Motor Imagery in an Individual With Frozen Shoulder. The Journal of orthopaedic and sports physical therapy, 48(3), 174–184. https://doi.org/10.2519/jospt.2018.7716
Marc Ellis Del Rosario, SPT
Student Physical Therapist
Touro University Nevada
Edited by Dr. Ryan Valenciano, PT, DPT, OCS
