Disorders of the shoulder joint are among the most common of all peripheral joint complaints. In particular, shoulder impingement syndrome and rotator cuff pathology are the most frequent cause of shoulder pain and disability. Impingement can occur when the muscles of the rotator cuff become irritated and inflamed as they pass through the subacromial arch. Shoulder impingement disorders can be classified as primary or secondary, meaning there could be anatomic variations in your skeletal structure that can predispose you to this condition. Secondary impingement is caused by poor posture or excessive movement in your shoulder due to weakness in the rotator cuff and muscles surrounding the scapular.
Symptoms of shoulder impingement or rotator cuff pathology include pain during active elevation of the arm in the lateral (outside) or anterior (front) of the shoulder, difficulty reaching behind the back, and muscle weakness. Activities performed below shoulder level are typically not painful. Onset of symptoms is usually more gradual rather than sudden due to its degenerative nature.
Commonly prescribed treatment for shoulder impingement or rotator cuff pathology include non-steroidal anti-inflammatory medications, thermal modalities, and subacromial corticosteroid injections. Therapeutic exercise regimes, postural correction and manual therapy techniques are also advocated to restore shoulder mobility and stability, by improving range of motion and enhancing shoulder and scapular muscle function.
Frozen Shoulder or Adhesive Capsulitis is a condition causing stiffness in the shoulder resulting in pain and limited motion. The shoulder is a ball and socket joint giving it a large range of motion. With great mobility comes a need for increased stability. The rotator cuff muscles and a capsule surrounding the shoulder joint provide this stability. Frozen Shoulder occurs when this capsule becomes inflamed and thickens from adhesions and scar tissue resulting in decreased motion and pain.
This condition commonly occurs after periods of immobilization such as surgery or after injury. It is also most common in women, individuals with chronic diseases and over the age of 45. There are three stages in which this condition develops. A freezing stage in which the pain is increasing and motion is becoming limited. A frozen stage in which pain improves but motion decreases. Lastly a thawing stage in which the range of motion begins to improve. Frozen Shoulder can be effectively be treated during these stages with Physical Therapy. A comprehensive program will be individually created to address any deficits and pain and may include joint mobilizations, soft tissue mobilization, postural retraining and a supervised stretching and strengthening program.