| I had a patient ask me the following: "I know this is a | | | | stiffness, the shoulder joint can actually deteriorate to a |
| stupid question, but is a frozen shoulder permanent?" I | | | | point where full recovery becomes very difficult if not |
| immediately assured her that her question was not | | | | impossible. These long term effects can happen with |
| stupid, but in fact a rather good question. If you've | | | | any condition that limits the joints mobility for a length |
| done any research into this condition you may already | | | | of time such as bursitis, rotator cuff tears, or |
| know that most cases of a frozen shoulder will | | | | immobilization after an arm fracture, not just frozen |
| eventually go away on its own after a 2-3 year period. | | | | shoulder. Permanent changes however can be |
| This may be true in some instances because as time | | | | reduced with early proper exercise under the guidance |
| passes the capsular adhesions begin to break and the | | | | of a physician or licensed physical therapist. |
| inflammation subsides. However, there can be much | | | | Exercise in the early stages of adhesive capsulitis |
| longer lasting effects if the shoulder is not treated | | | | should focus on gentle ROM and strengthening of the |
| properly. In some cases I have seen the effects last a | | | | supportive muscles around the shoulder and avoidance |
| lifetime. Therefore the lady's question "Is frozen | | | | of strong stretching or forced joint range of motion to |
| shoulder permanent?" turns out to be an important | | | | keep inflammatory reaction down. As the inflammation |
| question needing good answers. | | | | calms down, one can begin to add in progressive |
| During the many months of decreased shoulder | | | | stretching and joint mobilization to increase functional |
| mobility as the three stages of adhesive capsulitis take | | | | ROM. In the latter stages or thawing stage, more |
| their course, the rotator cuff muscles weaken and the | | | | forceful stretching can be applied concurrent with |
| joint capsule tissue surrounding these muscles stiffens. | | | | progressive rotator cuff strengthening to return the |
| This can place the shoulder at significant risk for cuff | | | | extremity to full mobility. A common mistake in early |
| tears, arthritis, and possible osteopenia (thinning of the | | | | treatment of this syndrome is trying to force range of |
| bone). All bones require weight bearing stress and | | | | motion or "break" adhesions which only lead to an |
| stress at the muscle/tendon juncture to maintain | | | | inflamed shoulder, frustration, followed by |
| optimum health. Therefore after many months of | | | | hopelessness. This mindset of treatment is what can |
| decreased use and range of motion due to pain and | | | | make a frozen shoulder permanent. |