The mainstay of treatment for a frozen shoulder is shoulder capsular stretching exercises. Treatment duration is about 2 years.
Our experience at ROC is that 90% of patients with idiopathic frozen shoulders can obtain 85% of normal movement in about three months if they engage in a good supervised exercise program continued daily with a supplemental home exercise routine 95% of patients presenting with idiopathic frozen shoulder are treated by non-operative means. Non-Operative Means:
- Use of a subacromial steroid injection
- Pain medication taken 30 minutes prior to therapy
- Heat used prior to stretching
- Anti-inflammatory medication
Shoulder Six Pack Exercise Program
ROC follows very specific therapy focusing on an assisted passive stretching program. This is very hands-on with a trained therapist. Due to the significant amount of pain experienced during capsular stretching, a patient cannot be expected to do the exercises alone. This is why we advise patients to take prescribed pain medication 30 minutes prior to beginning therapy and also to warm up prior to stretching.
The sequence of stretching is extremely important and involves stretching the shoulder capsule one plane at a time. Two such exercises include forward flexion stretching and cross body adduction stretching. Once these two planes of motion have been achieved, the anterior capsule and rotator interval is stretched by external rotation at the side and in abduction. The final stretch is internal rotation stretching behind the back.
Surgery for Frozen Shoulder is considered if:
- Therapy fails because the pain is intolerable
- The frozen shoulder has shown no improvement in spite of a good supervised therapy protocol over a 3-6 month period
Surgery is a combined closed manipulation and arthroscopic release of the shoulder capsule. A closed manipulation performed alone risks injury to the shoulder. Post-traumatic frozen shoulder is the condition most likely resulting in surgery and simple manipulation alone does not release all layers of adhesions present in the subacromial space. This is why an arthroscopic decompression must accompany the capsular release to achieve success.