The shoulder rehab protocol for adhesive capsulitis, known as a frozen shoulder, depends a great deal upon the initial diagnosis and severity the injury.
Frozen shoulder is characterized by extreme stiffness, lack of shoulder mobility, and pain when performing normal activities. Adhesive capsulitis can develop from an injury, pain or a chronic health condition such as diabetes or stroke.
When a person experiences shoulder pain the tendency is to guard movement thus setting the stage for a frozen shoulder. There are typically three stages involved with a frozen shoulder (1) painful stage (2) the frozen stage and (3) the thawing stage. Most of the time a doctor refers a patient to a physical therapist to start treatment that can last between one and two years.
The first step of shoulder rehab protocol revolves around managing the initial pain during this stage immediately following diagnosis. At this point the injured shoulder area will experience sharp pain whenever the patient begins to move the arm, especially when lifted above the head or rotated. If the patient is experiencing excruciating pain the doctor will most likely inject a steroid in order to ease pain and get the patient started on therapy.
The shoulder rehab protocol at this time will consist of modalities (heat/ice; electrical stimulation; ultrasound) followed by passive ROM exercises. Passive stretching in this stage prevents the build-up of scar tissue. Shoulder wheels and pulley systems are utilized. The therapist will outline a daily home program usually consisting of pendulum and wall climbing exercises. There will be a fair amount of discomfort brought on by the exercises which can be managed by a competent physical therapist.
During this stage patients are relieved that the pain finally begins to subside. The mistake that many patients make during this time is believing that the syndrome is in its final phase. However, it is vital to keep working with a physical therapist during this time because while the pain will be lessened, the stiffness of the shoulder persists. During this time the emphasis provided by the physical therapist is aggressive stretching.
The goal of shoulder rehab protocol here is pushing the shoulder to move beyond the point of comfort. Patients will not perform motion beyond the point of pain on their own. By working with a physical therapist who knows when to push and when to hold back, a patient can accelerate their healing and remain safe. This phase can last for eight to ten months.
During this phase, the shoulder rehab protocol focuses on further increasing the range of motion by aggressive stretching and mobilization techniques. The therapist also incorporates a progressive strengthening program especially of the rotator cuff musculature. Strengthening makes use of resistive bands and upper body ergometer. The range of motion will begin to increase on its own as the shoulder begins to become unlocked.
Maintaining an exercise schedule with a trained physical therapist will ensure the safest, fastest recovery. The patient will experience complete recovery usually within four months from the start of this phase. While a frozen shoulder may last for up to two years, working with a physical therapist and treating within the shoulder rehab protocol is best. This way healing is accelerated and the physical discomfort is reduced from this ailment.