frozenContracted shoulder, more commonly known as frozen shoulder, is a common pathology seen in men and women over the age of fifty.

It is characterized by a gradual onset of pain and then stiffness in one or both of the shoulders. On arthroscopic investigation the most striking feature is the thickened, tough capsule that surrounds the shoulder joint.  The formation of new blood vessels in the synovial
membrane, usually around the rotator interval area (between the subscapularis and suprapinatus) is another common feature.

Signs and symptoms

1. a gradual onset of arm pain;

2. unable to lie on the affected side;

3. restriction of movements: elevation and external rotation. Although this is seen in other shoulder pathologies loss of external rotation is a strong predictor.

4. negative X-rays.

It runs a distinct course, divided into different phases: ‘pain-predominant’ or ‘stiffness-predominant’ . Most people will experience pain first. There is then a phase of increasing pain and increasing stiffness, during which pain is the predominant complaint: at its height, pain is present even at rest. The pain abates leaving  stiffness as the predominant complaint; then the condition ends—more or less—in resolution.

It is commonly thought to persist for about 2 years but some studies have shown ongoing issues for up to four years.

Physiotherapy can help with with pain management and range of motion.  Pain is reduced with manual therapies to the shoulder and neck.  Range of motion comes back slowly but can be aided with regular movement of the shoulder and improved thoracic and cervical range of motion.

I hope this short summary helps!

Thanks for reading,

Dave Carter

most of this information was from: Evidence-based clinical guidelines for the diagnosis, assessment and physiotherapy management of contracted (frozen) shoulder. Version 1.7, ‘Standard’ physiotherapy