Tag Archives: Shoulder

Adhesive Capsulitis – aka Frozen Shoulder

Written by: Teresa Hall, PT, DPT, OCS

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Adhesive capsulitis is the medical term for the more commonly used phrase “frozen shoulder.” The capsule of the shoulder thickens and tightens, contributing to pain and loss of motion in the shoulder. There is no known cause for adhesive capsulitis; however, risk factors include diabetes, previous shoulder surgery, and hyperthyroidism. Some statistics show that up to 20% of diabetics may develop adhesive capsulitis compared to only 5% of the general population. The condition is also more prevalent in women around menopause.

 

The first sign of adhesive capsulitis is often pain. Next is loss of motion and function of the arm. The shoulder may continue to be dysfunctional for several months. It is typically diagnosed by clinical exam, as X-ray and MRI findings are usually insignificant but can help to rule out any other causes of your symptoms.

 

Adhesive capsulitis of the shoulder can resolve on its own in about a year without treatment however, both conservative and surgical interventions can help to speed your recovery. This condition is most commonly treated with NSAID medication, steroid injections and physical therapy to restore motion. The rehabilitation process is painful and involves aggressive range of motion activities for the shoulder, as well as the therapist moving your shoulder for you. A home program is typically included as well. It is essential for the patient to perform their exercises in PT and at home to restore the movement in their arm.

People with adhesive capsulitis often make a full recovery with no residual effects. Get help from a qualified PT if you suspect you may have the beginnings of adhesive capsulitis to get moving again. Motion is lotion for the joints!

 

What is the Rotator Cuff?

Written by: Melissa Graham, PT, DPT, OCS

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The rotator cuff consists of four muscles that provide shoulder joint stability and is important for shoulder movement. The four muscles are the supraspinatus, infraspinatus, subscapularis and teres minor. All four of the muscles start on the shoulder blade (scapula) and connect to the head of the upper arm bone (humerus). The shoulder joint is a ball and socket joint which resembles a picture of a golf ball (head of upper arm bone) sitting on a golf tee (shoulder joint). The rotator cuff muscles surround the joint forming a cuff. It is important during shoulder motion to maintain the proper position of the ball in the socket. The rotator cuff muscles assist in lifting the arm out to the side and rotating the shoulder for activities such as opening doors or tucking in the back of your shirt.

 

There are differing degrees of injury to the rotator cuff. An injury to this area can vary from a strain of one muscle, to a partial tear(s), to a complete tear of one or more muscles. Injury to the rotator cuff can be caused by age-related degenerative changes, muscle imbalances in the shoulder, repetitive overhead motions or trauma. Symptoms of rotator cuff involvement include shoulder joint pain, upper arm pain and functional limitations, such as difficulty lifting arm up overhead or reaching behind your back.

 

Physical therapy can be extremely beneficial to rehab rotator cuff injuries. During the evaluation, the physical therapist will assess shoulder range of motion and strength and perform special tests to determine the cause of pain. From there, an individualized treatment program will be designed. If rehab is unsuccessful or the muscle is completely torn, surgery may be necessary.