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Frozen shoulder

Frozen shoulder also called adhesive capsulitis or periarthritis of the shoulder is a chronic inflammation of the connective tissue that covers the entire shoulder joint causing pain and stiffness.


The shoulder joint is an enarthrosis, made up of three bones: the humerus, the shoulder blade, and the clavicle. The sphere of the humerus is attached to a cavity of the shoulder blade, all wrapped in a connective tissue forming the articular capsule of the shoulder. In this affectation the capsule thickens and hardens, forming adhesions with a lesser presence of synovial fluid within the joint.


The frozen shoulder has three stages or phases in its evolution, not always reaching the same level of adhesive evolution or unfortunately recovery:

Freezing or painful stage: the range of movement begins to decrease and the pain increases. The duration is from 6 to 9 weeks.

Frozen or adhesive phase: in this phase the pain decreases but the stiffness lasts. Daily life is very difficult. The duration is usually between 4 or 6 months.

Thawing or recovery phase: in this phase the stiffness decreases slowly. Full recovery of movement and strength can last from 6 months to 2 years.


Symptoms:

Pain: a dull, fixed and continuous pain that occurs more at night and that causes decreased arm movements. More is produced in the first stage.

Stiffness: greatly limiting the movements of the arm such as fastening the bra or combing.

Decreased arm mobility: There is decreased both active and passive arm mobility.


Treatment

1st phase of treatment: In the first phase it is important to carry out a treatment that reduces pain and allows the range of motion to be maintained as much as possible. Electrotherapy, cryotherapy, relaxing massage including cervical, passive mobilization and then active respecting pain and scapular stabilization exercises will be applied.


2nd phase of treatment: This phase is where progressive stiffness is installed. To the above, thermotherapy should be added at the beginning of the session to improve tissue elasticity, pendulum exercises, maneuvers for releasing the humeral head seeking the distension of the rotator cuffs, contraction-relaxation stretching, stabilization exercises, strengthening of the periarticular musculature.


3rd phase of treatment: In this phase we begin with the recovery of mobility. We must give great importance to muscle rebalancing. Muscle reeducation exercises, proprioceptive reeducation and muscle rehabilitation will be added.




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2020 by  Oscar Artacho