Shoulder Rehabilitation

Frozen shoulder:

 

A condition in which your shoulder becomes very painful and there is a severe loss of shoulder movement. It occurs in 2-5% of the population. There are 3 stages of frozen shoulder.

 

Stage 1 is known as the freezing phase. The freezing phase can last anywhere from 10-36 weeks. During this phase you will encounter the most severe pain, you will also begin to lose movement.

 

Stage 2 is known as the frozen phase. This phase can last anywhere from 4-12 months. During this phase pain will begin to improve. However your shoulder will feel very stiff, this is the phase where you will notice you will lose the most movement.

 

Stage 3 is known as the thawing phase. This phase can last 12 months to years. You will eventually become pain-free during this phase, stiffness and loss of movement will slowly begin to improve. You may not fully regain all of the movement you had before.

 

Rehabilitation: Research shows that a combination of corticosteroid injections (for pain relief) and shoulder mobility and stretching exercises provide the best short term relief for pain and improve function of the shoulder. Physiotherapists provide people with the appropriate stretching exercises, and may use other techniques such as joint mobilisations, to improve pain and movement, during treatment of frozen shoulder. Stretching exercises are performed to where you feel comfortable, aim to hold stretch for 30 seconds. Below are some examples of stretching/mobility exercises. Strengthening exercises will also be required as rehab progresses (see below).

 

Rotator Cuff tears:

Your rotator cuff is responsible for providing support so your shoulder joint and improving it’s stability. The rotator cuff is made up of 4 muscles around your shoulder, your Subscapularis muscle at the front, and your Supraspinatus, Infraspinatus and Teres minor muscles at the back. If you tear one of your rotator cuff muscles, you will encounter a lot of pain and weakness in the shoulder area. A tear to one or more of the muscles will also affect the stability of your shoulder joint.

 

Rehabilitation: Research suggests that exercise therapy (predominantly mobility, stretching and strengthening exercises) should be the first line treatment for rotator cuff tears. Strengthening exercises should be completed 2-3 times a day, consisting of 8-12 reps X 3 sets. Physiotherapists can provide people with the appropriate strengthening exercises. Examples of strengthening exercises for the rotator cuff can be seen below.

 

References

 

Manual Therapy and exercise for adhesive capsulitis (Frozen shoulder). A Cochrane review. Available at;

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011275/full

 

Shouder pain and mobility deficits: Adhesive Capsulitis. Clinical practical Guidelines. Available at;

https://www.jospt.org/doi/full/10.2519/jospt.2013.0302?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed

 

Exercise therapy in the Non-operative treatment of full-thickness Rotator Cuff tears. A systematic review. Available at;

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6044593/

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