Reference: Filip Struyf, PT– on PHYSIOTUTORS
I just did a short online course on Frozen Shoulders (FS) on PHYSIOTUTORS and really enjoyed it. Here are a few of the interesting facts on this mysteriously painful and persistent condition.
- When it comes to FS, 70% are women and 30% are men where the average age for experiencing it is 53 years (40-65) – therefore it is called the ‘50 year old shoulder’.
- 80% of people with FS have one of these co-morbidities- Diabetes / Thyroid issues (Hyper or Hyper) / Hypoadrenalism / Hyperlipidaemia.
- In the past 3 decades the prevalence of Diabetes has increased, therefore the prevalence of FS has also increased from 2% to 5%.
- FS occurs equally on the dominant & non-dominant arms.
- Do not tell patients this but 17% get FS on the other shoulder within 5 years (Why tell patients? Based on our knowledge so far, it’s not preventable so why cause them needless fear?)
- FS lasts on average for 1-3 years – and those with either Type 1 or 2 Diabetes tend to have it for a longer period. Some say that FS is self-limiting but this remains controversial, as just leaving it alone and avoiding the use of the arm may be damaging. The advice should be to continue to use the arm as much as possible.
- Let’s not blame just the capsule as it seems like muscle guarding also plays a significant role in restrictions. Orthopedic surgeons in this study demonstrate significant improvements in shoulder mobility before and immediately after general anaesthesia, “with increases ranging from approximately 55°-110°” of shoulder abduction.
- The best single PT intervention for any patient dealing with FS in the non-inflammatory phase is proper education and the promotion of the use of the arm. Listen to this audio.
- The next best intervention is the recommendation of general exercises such as walking, jogging, cycling etc. as it does not only help general health but may also reduce the inflammatory reaction within the GH joint. Giving strengthening exercises with bands or weight is also invaluable.
- A home TENS unit may be considered in the inflammatory phase.
- If the pain is severe, seriously consider an intra-articular steroid injection – the evidence supports it!
If you wish to share this information with your patients, just share my 20-minute audio that may hopefully assure them of their condition.