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Frozen Shoulder and Physiotherapy

Frozen shoulder is the condition of pain and stiffness in the shoulder joint accompanied by loss of motion. An inflammation in or around the shoulder may trigger the body’s normal defensive response of stiffness. When the shoulder becomes stiff, it becomes too painful too move. Someone with frozen shoulder may not be able to reach above and over the head or touch the back.

While there is no definite cause of frozen shoulder, over 90 percent of patients experience full recovery. Doctors recommend physical therapy for frozen shoulder as the best treatment.

Physical therapy for frozen shoulder starts with reducing the pain and stiffness of the shoulder and increasing blood circulation through heat. One effective way of the heating method is taking a 10-minute hot shower or bath. Alternatively, the physical therapist may apply heat to your shoulder locally with the use of heating pads, wraps or towels. Hot water bottles and heat creams and ointments may also be used.

Shoulder massage is also a good way to start physical therapy for frozen shoulder as it increases the flow of blood and oxygen into the area. Once pain is reduced either through heating or through massage, the therapist proceeds with a series of physical therapy exercises.

In physical therapy for frozen shoulder, you will first perform weight and non-weight stretching exercises to improve the flexibility of your shoulder joint. The common exercises include arm swing with weights, arm raise, overhead stretch, stretching your arms across your body, and towel stretch.

It is important to note that during these stretching exercises, you should feel tension but you should not overstretch your shoulder to the point where you feel pain or severe discomfort. These exercises are done once or twice daily until the shoulder restores its normal range of movement.

Your doctor will advise you should you need to perform other exercises to tone and strengthen your shoulder muscles such as rotation exercises. Remember not to force movement in your shoulder. This does not mean you should not move it at all but instead to limit activities that may further injure your shoulder.

If physical therapy for frozen shoulder does not work for you, your doctor may recommend surgical treatment. The good news is physical therapy for frozen shoulder is usually enough for patients to get effective results that improve with time. If you have frozen shoulder, consult a physical therapist and get the treatment that you need.

Muscle Strain

Muscle strain or muscle pull or even a muscle tear implies damage to a muscle or its attaching tendons. You can put undue pressure on muscles during the course of normal daily activities, with sudden, quick heavy lifting, during sports, or while performing work tasks.

Muscle damage can be in the form of tearing (part or all) of the muscle fibers and the tendons attached to the muscle. The tearing of the muscle can also damage small blood vessels, causing local bleeding (bruising) and pain (caused by irritation of the nerve endings in the area).

Muscle Strain Symptoms

  • Swelling, bruising or redness, or open cuts as a consequence of the injury
  • Pain at rest
  • Pain when the specific muscle or the joint in relation to that muscle is used
  • Weakness of the muscle or tendons (A sprain, in contrast, is an injury to a joint and its ligaments.)
  • Inability to use the muscle at all

Muscle Strain Treatment Self-Care at Home

The amount of swelling or local bleeding into the muscle (from torn blood vessels) can best be managed early by applying ice packs and maintaining the strained muscle in a stretched position. Heat can be applied when the swelling has lessened. However, the early application of heat can increase swelling and pain.

Note: Ice or heat should not be applied to bare skin. Always use a protective covering such as a towel between the ice or heat and the skin.

  • Take nonsteroidal anti-inflammatory agents such as aspirin and ibuprofen to reduce the pain and to improve your ability to move around.
  • Protection, rest, ice, compression, and elevation (known as the PRICE formula) can help the affected muscle. Here’s how: First, remove all constrictive clothing, including jewelry, in the area of muscle strain.
    • Protect the strained muscle from further injury.
    • Rest the strained muscle. Avoid the activities that caused the strain and other activities that are painful.
    • Ice the muscle area (20 minutes every hour while awake). Ice is a very effective anti-inflammatory and pain-relieving agent. Small ice packs, such as packages of frozen vegetables or water frozen in foam coffee cups, applied to the area may help decrease inflammation.
    • Compression can be a gently applied with an Ace or other elastic bandage, which can provide both support and decrease swelling. Do not wrap tightly.
    • Elevate the injured area to decrease swelling. Prop up a strained leg muscle while sitting, for example.
  • Activities that increase muscle pain or work the affected body part are not recommended until the pain has significantly gone away.

Medical Treatment

Treatment is similar to the treatment at home. The doctor, however, also can determine the extent of muscle and tendon injury and if crutches or a brace is necessary for healing. The doctor can also determine if you need to restrict your activity, take days off work, and if rehabilitation exercises are required to help you recover.

Next Steps Prevention

  • Avoid injury by daily stretching.
  • Stretch every time before you exercise.
  • Establish a warm-up routine prior to engaging in strenuous exercise.
  • Start an exercise program in consultation with your doctor.