Frozen Shoulder/ Periarthritis Shoulder

PERIARTHRITIS SHOULDER :

If you can’t move your shoulder around like you used to, you could have periarthritis shoulder. When it hurts to move your shoulder or you don’t have as much movement in your shoulder as before, your shoulder may become “frozen.” Because of this, doctors sometimes refer to this problem as Adhesive capsulitis or Frozen Shoulder.

SIGNS AND SYMPTOMS :

You should be able to move your shoulder in all directions without pain. To test yourself, do these things:

  • Shoulder stiffness
  • Inability to raise arm
  • Limited shoulder mobility
  • Shoulder pain
  • Shoulder immobility
  • Radiating pain down arm
  • Shoulder pain; usually a dull, aching pain
  • Limited movement of the shoulder
  • Difficulty with activities such as brushing hair, putting on shirts/bras
  • Pain when trying to sleep on the affected shoulder

STAGES :

  • The painful stage. At first, your shoulder may ache and feel stiff. Then it may get very painful. This stage may last about 3 to 8 months.
  • The adhesive stage. During the second stage, you may not actually have as much pain, but your shoulder keeps getting stiffer. This stage usually lasts about 4 to 6 months.
  • The recovery stage. The final stage, which usually lasts about 1 to 3 months, isn’t very painful. It becomes very hard to move your shoulder even a little bit. Then after a while, the stiffness slowly goes away. You can move your shoulder again. Although you may not get the full movement of your shoulder back, you should be able to do many more activities. As your shoulder movement increases, you may still have pain at times.

REHABILITATION PROGRAM :

The basic aim of frozen shoulder exercises are:

  • To reduce pain.
  • To increase extensibility of the thickened and contracted capsule of the joint.
  • To improve mobility of the shoulder.
  • To improve strength of the muscle. However it may be remembered that strengthening of muscle is secondary to mobilization.

PT Treatment :

  1. Improves pain through advanced modalities.
  2. Reduces inflammation.
  3. Reduces spasm.
  4. Reduces tightness.
  5. Increases strength resisted band exercises
  6. Alignment correction through manual therapy
  7. Taping technique
  8. Laser therapy for instant pain relief

 

ROTATOR CUFF INJURY:

Rotator cuff injuries are a common cause of shoulder pain in people of all age groups. They represent a spectrum of disease, ranging from acute reversible tendinitis to massive tears involving the supraspinatus, infraspinatus, and subscapularis.

A normal rotator cuff and rotator cuff tear are shown below.

Often, younger individuals with rotator cuff injuries relate a history of repetitive overhead activities involving the rotator cuff or, less commonly, a history of trauma preceding clinical onset of symptoms. In contrast, older individuals usually present with a gradual onset of shoulder pain and, ultimately, after radiographic testing is shown to have significant partial or full rotator cuff tears without a clear history of predisposing trauma.

Common causes of rotator cuff injuries include:

  • Normal wear and tear. Increasingly after age 40, normal wear and tear on your rotator cuff can cause a breakdown of fibrous protein (collagen) in the cuff’s tendons and muscles. This makes them more prone to degeneration and injury. With age, you may also develop calcium deposits within the cuff or arthritic bone spurs that can pinch or irritate your rotator cuff.
  • Poor posture. When you slouch your neck and shoulders forward, the space where the rotator cuff muscles reside can become smaller. This can allow a muscle or tendon to become pinched under your shoulder bones (including your collarbone), especially during overhead activities, such as throwing.
  • Falling. Using your arm to break a fall or falling on your armcan bruise or tear a rotator cuff tendon or muscle.
  • Lifting or pulling. Lifting an object that’s too heavy or doing so improperly — especially overhead — can strain or tear your tendons or muscles. Likewise, pulling something, such as a high-poundage archery bow, may cause an injury.
  • Repetitive stress. Repetitive overhead movement of your arms can stress your rotator cuff muscles and tendons, causing inflammation and eventually tearing. This occurs often in athletes, especially baseball pitchers, swimmers and tennis players. It’s also common among people in the building trades, such as painters and carpenters

Signs and symptoms of rotator cuff tears are:

  • Recurrent, constant pain, particularly with overhead activities.
  • Pain at night that prevents you from sleeping on the affected side.
  • Muscle weakness, especially when attempting to lift the arm.
  • Catching and grating or cracking sounds when the arm is moved.
  • Limited motion

Goals of Physiotherapy:

  1. Improves pain through advanced modalities.
  2. Reduces inflammation.
  3. Reduces spasm.
  4. Reduces tightness.
  5. Increases strength resisted band exercises
  6. Alignment correction through manual therapy
  7. Taping technique
  8. Laser therapy for instant pain relief

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