Home Exercises for Frozen Shoulder

A Lot Of Home Exercises for Frozen Shoulder

Here are doctor and therapists often recommend home exercises for frozen shoulder, don’t do any of these exercise without your doctor’s or therapists appropal. It’s up to you to carry out your prescribed exercise program, keep in mind thet doing the assigned exercises is the only way to full recovery.

frozen shoulder home exercises

1.    Codman’s Pendulum Exercise
Holding the side of a table with your good arm, bend over at the waist, and let your affected arm hang straight down. Swing it back and forth like a pendulum, then in circles that start small and gradually grow larger. Do this for at least 5 minutes, 3 times a day
   
2.    Wall walking
Stand facing a blank wall, with your feet about 12 inches away. “ walk “ the fingers of your affected arm up the wall as high as pain permits. Mark the spot and try to go higher next time. Do at least 10 repetitions, 3 times a day. Do this exercise with your affected side to the wall.

3.    Cane Exercise
Sit in a chair or lie down, hold a cane, stick or broom handle in both hands with your elbow straight. Raise the cane over your head or as high as you can. Do at least 25 repetitions, 3 times a day.

4.    Range of Motion
Move your affected arm in all directions, straight out in front, high up overhead, out to the side, accross your body, around your back, reach as far as you can in all directions. Do each motion 25 times, 3 times a day.

5.    Pulley Exercise
Hang a pulley and run a six foot rope or cord through it. Holding one end in each hand with your arms extended in front of you, pull the ropr toward you with your good arm, this will raise the affected arm, raise it as high as you can ( you can do the same thing using a towel draped over a door or shower curtain rod. Repeat at least 25 times, 3 times a day.

6.    Weight swinging
Holding a weight in hand of your affected side, swing your arm back and forth in larger and larger. Your doctor will tell you what to use for a weight. Do 25 complete swings, 3 times a day.

7.    General Exercise
Any kind of exercise that involves your shoulder will help you regain mobility. Swimming is one of the best forms of exercise for this purpose, but golf, tennis, and jumping rope can also be useful. Ask your doctor or therapists which activities are good for your condition.

Frozen Shoulder Acupuncture

Frozen Shoulder Acupuncture - Effective Treatment Of Frozen Shoulder

The term "frozen shoulder" is used to describe a variety of conditions that cause pain and limit the range of motion of the shoulder joint. Acupuncture has been used for thousands of years by the Chinese. It is a technique that involves manipulating and inserting fine needles into specific ares of the body with the goal of reducing pain and gain range of movement. Acupuncture works by improving energy movement along the meridian pathways. It is especially useful in treating conditions such as shoulder tendinitis and frozen shoulder symptoms.

Acupuncture For Frozen Shoulder

Several studies have reported that acupuncture can successfully treat frozen shoulder, but the majority of these studies have not been of the randomized, controlled trial (RCT) variety. A new study using the RCT format compared the use of acupuncture (along with exercise) to exercise alone in a small group of frozen shoulder patients. The study, published in the Hong Kong Medical Journal, found that patients treated with acupuncture and exercise demonstrated "significantly greater improvement" on shoulder assessment tests than those using just exercise, and suggests that acupuncture could be useful in cases where more conventional therapies have been unsuccessful.

The exercise/acupuncture group followed the same home and group exercise programs as the exercise group, but also received acupuncture twice a week during the trial. A three-inch, 30-gauge needle was inserted perpendicular to zhongping, an extra acupuncture point located on the lower leg along the stomach meridian. Zhongping was chosen based on the belief that stimulating it can "improve the flow of qi across the shoulder."

A contralateral needling technique was used, in which the right-side acupoint was used for left frozen shoulder and vice-versa. The needle was inserted to a depth of 2.5 inches, followed by wide-amplitude needle rotation simultaneously with lifting and thrusting to produce de qi. The needle was retained for 20 minutes, with three one-minute needle manipulations made during the treatment period. While being needled, the patient also performed a series of functional exercises using the affected shoulder.

Subjects in both groups were assessed using a test called the Constant Shoulder Assessment, which combines patient ratings for pain and activities of daily living with range of motion measurements for a maximum score of 100 points. Assessments were taken at three intervals: baseline (just prior to the start of the study); at the completion of treatment; and at 20 weeks.

Despite the relatively deep needling involved in the trial, the researchers reported that no acupuncture-related complications occurred during the course of care. However, one patient in the acupuncture/exercise group discontinued treatment after the second session due to fear of needle pain.

Some limitations were noted by the investigators -- for instance, the number of exercise minutes between groups. The exercise-only group performed supervised shoulder exercises for a total of 360 minutes over the treatment period, whereas the acupuncture/exercise group performed supervised exercises for 600 minutes (360 in a group setting, 240 while being treated with acupuncture). Because acupuncture is known to relieve pain, the researchers speculated that patients who had acupuncture before exercise may have shown greater improvements because they experienced less pain during exercise. Similar concerns were raised about the size discrepancies between groups (the acupuncture/exercise group had 13 patients, while the exercise-only group had 22) and the lack of a control group to disprove the placebo effect.

Despite the limits, the researchers saw promise for the use of acupuncture in conjunction with exercise to treat frozen shoulder. "The combination of acupuncture and physical exercise may be an effective option in the treatment of frozen shoulder," they wrote. "This study provides additional data on the potential role of acupuncture in the treatment of frozen shoulder, particularly for those patients not responding well to conventional therapy." They recommended that larger, placebo-controlled trials be designed to measure short- and long-term outcomes, and that a more uniform method of defining frozen shoulder be established, which would result in valid and more reliable treatments.

Frozen Shoulder After Surgery

Prevent Future Shoulder Pain After Frozen Shoulder Surgery

Whether you've gone in to have a torn rotator cuff repaired or you needed invasive help to fix a frozen shoulder, you are likely interested in finding out how to prevent future shoulder pain after surgery. While it's true you can expect a reasonable amount of pain in the days immediately following the procedure, repeat injuries should not plague your life if you take the right steps.

Protect your shoulder - Wearing a sling after surgery is no fun, but reinjuring the area and causing more pain isn't either. Slings are recommended for six to 12 weeks following shoulder surgery. You won't have to wear one 24 hours a day, but do listen to advice here.

Exercise as directed - Physical therapy is a key component in the recovery process following shoulder surgery. Therapy, in fact, often begins almost immediately following shoulder surgery. If you don't follow the right procedures and stick with therapy - no matter how painful it is - you could end up with even more shoulder pain after surgery. When a shoulder is not properly worked after surgery, scar tissue can become a problem and so can a major loss in range of motion. These two things could have you heading back to the surgical suite so fast, your head just might spin.

The operation can be carried out as a day case procedure with no need to stay overnight in hospital. There is no need to wear a sling afterwards and there is no restriction on activity. Physiotherapy can start as soon as possible, doctors are likely to recommend such things as ice packs and anti-inflammatory medications in the days following shoulder surgery. Do make certain to use all the tools and medications you are given to help prevent swelling and further damage in the shoulder. Shoulder pain after surgery can be lessened when the right combination of treatment is followed.

If you just recovered from frozen shoulder and want to jump right back in playing golf, pay attention to this article carefully. A frozen shoulder condition can take more than a year to get better and requires the person to do exercises everyday. If the shoulder is not used for a long period of time, you will lose approximately five percent of your strength everyday. For example, you may notice in body builders, if they miss out with their gym routine for more than two weeks, you may notice their muscle atrophy (waste away) very quickly. The same thing applies to people who are suffering with frozen shoulder. It is important, you always do your shoulder exercises.

Before doing any specific strengthening exercises, always warm up. Your muscles are like steel wires. If you perform your stretches straightaway, the risk of damaging your muscles are very high because there are not enough blood circulation to your shoulder muscles and the stiffness of the muscle fibers can leads to greater forces of stretch.

Warm up by applying a heat pack or having a hot shower on the affected shoulder. This will help blood circulate around the area. Then stretch your shoulder muscles and don't forget to do your neck muscles as well. If you have enough time, do a quick five-ten minute jog outside so that you get more blood circulation and enhance cellular metabolic chemical reactions in your body. Doing all this will get you back to playing golf in no time!

Frozen Shoulder Surgery

The Simple Patient Guide For Frozen Shoulder Surgery

Most of the time, frozen shoulder can be handled without doing frozen shoulder surgery. Forms of treatment include exercises for frozen shoulder, anti-inflammatory drugs such as ibuprofen and steroids are occasionally given to ease pain.

If physical therapy and anti-inflammatory drugs don't handle the condition, then frozen shoulder surgery may need to be done. Frozen shoulder surgery begins with an anesthetic and is followed by manipulation of the shoulder area. Then two to three incisions are made around the shoulder.

frozen shoulder surgery arthroscopic

Instruments that give the physician magnified vision are inserted into the incisions and the scar tissue is divided. Occasionally, a rotator cuff tear will have to be repaired during this surgery. Frozen shoulder surgery is done as an outpatient and no sling is required. After surgery, physical therapy can begin very soon.
Surgery involves a gentle manipulation under anaesthetic, followed by key hole surgery in which two to three little stab incisions (about 0.5 to 1cm each in size) are made around the shoulder. Through these arthroscopic portals, the camera as well as a variety of surgical instruments is inserted into the shoulder and the layers of thickened scar tissue inside the shoulder are divided under direct magnified vision.

Most people would agree that if you have tried and not responded to anti-inflammatory drugs, corticosteroid injections as well as physiotherapy, then surgery can be considered. It must be noted that surgery is not a 'quick fix' but it can reduce the intensity of the pain and expedite the recovery process.
Frozen shoulder surgery is a painful condition of the shoulder triggering shoulder immobility. Medically it is termed as adhesive capsulitis. The condition worsens during sleep impairing the movement and is always associated with severe pain. No obvious causes have been isolated for this condition except the possibility of the trauma in the shoulder.

Treatment to Frozen shoulder follows three steps. The patient may require one or two or all of them depending on the severity of the case. The first step is medication where the patient is treated with steroids and anti inflammatory drugs. Introduction of frozen shoulder therapy along with medication usually cures this condition.

Frozen shoulder therapy is a set of exercises aimed to increase the mobility of the shoulder. Therapy is painful but is the most effective way to treat a frozen shoulder. Frozen shoulder surgery is resorted only if all the possible treatment options fail to cure the condition.

No admission is required for this surgery. Pain in the shoulder and Mobility of the shoulder is affected because of the adhesions that restrict the movement of the shoulder. Adhesions can be removed by arm movements without any incision or manipulation. There is no actual surgery performed on the patient. Another procedure is adopted that involves a couple of incisions and manipulation of the shoulder. This procedure is called as arthroscopic capsular release. The scar is divided and the tendon is snipped and resown that reduces the size of the tendon.

Movement of the shoulder is reduced on Frozen shoulder surgery. Normal movement is restored after prolonged physical therapy. Discontinuation of physical therapy has a high incidence of relapse of frozen shoulder. Occasionally, Frozen shoulder surgery might be performed to rectify the rotator cuff tears.

Frozen Shoulder Exercises

How to STRETCHING EXERCISES For Frozen Shoulder ?

Frozen shoulder is the term used to describe a stiff shoulder joint that has temporarily lost the ability to move freely; most people with frozen shoulder have difficulty reaching overhead and reaching to the low back. The stiffening is the body's natural response to inflammation that develops in or near the shoulder. Stiffening is a protective reflex that protects the shoulder from further injury.

In 95 percent of cases, frozen shoulder is totally reversible, although full recovery may take several months. Stretching exercises are the treatments of choice for frozen shoulder.

Heat — Heat helps prepare the tissues for stretching and should be performed prior to exercise sessions. The preferable method of heating is in a warm shower or bath for 10 to 15 minutes. Local heat (for example with a moist heating pad or a towel warmed in a microwave) is an alternative, but generally is not as effective.

The best exercise for frozen shoulder includes range of motion and shoulder stretching exercises to help alleviate and prevent frozen shoulder. It is important to stretch both the posterior and anterior muscles of the shoulder.

A good posterior shoulder stretch is: Place one arm across your body under your chin just parallel to the ground. Using the other hand gently press it towards your body. Hold for about 10 seconds for 3 to 4 repetitions.

A good anterior shoulder and chest stretch is: Standing upright, clasp your hands behind your back and gently pull away from your body while lifting them up. Keep good posture and hold for about 10 seconds for 3 repetitions.

A good exercise for frozen shoulder and to improve range of motion is: Sitting in a chair with arms at your side circle your torso a full range for 5 rotations each direction. Just let the arms dangle doing no work.

Once your range of motion has returned you can begin to strengthen the area with this exercise.

Flexion: Stand upright and hold a stick in both hands, palms down. Stretch your arms by lifting them over your head, keeping your elbows straight. Hold for 5 seconds and return to the starting position. Repeat 10 times.

Extension: Stand upright and hold a stick in both hands behind your back. Move the stick away from your back. Hold the end position for 5 seconds. Relax and return to the starting position. Repeat 10 times.

External rotation: Lie on your back and hold a stick in both hands, palms up. Your upper arms should be resting on the floor, your elbows at your sides and bent 90°. Using your good arm, push your injured arm out away from your body while keeping the elbow of the injured arm at your side. Hold the stretch for 5 seconds. Repeat 10 times.

Internal rotation: Stand upright holding a stick with both hands behind your back. Place the hand on your uninjured side behind your head grasping the stick, and the hand on your injured side behind your back at your waist. Move the stick up and down your back by bending your elbows. Hold the bent position for 5 seconds and then return to the starting position. Repeat 10 times.

Shoulder abduction and adduction: Stand upright and hold a stick with both hands, palms down. Rest the stick against the front of your thighs. While keeping your elbows straight, use your good arm to push your injured arm out to the side and up as high as possible. Hold for 5 seconds. Repeat 10 times.

Scapular range of motion: Stand and shrug your shoulders up and hold for 5 seconds. Then squeeze your shoulder blades back and together and hold 5 seconds. Next, pull your shoulder blades downward as if putting them in your back pocket. Relax. Repeat this sequence 10 times.

Pectoralis stretch: Stand in a doorway or corner with both arms on the wall slightly above your head. Slowly lean forward until you feel a stretch in the front of your shoulders. Hold 15 to 30 seconds. Repeat 3 times.

Biceps stretch: Stand facing a wall (about 6 inches away from the wall). Raise your arm out to your side and place the thumb side of your hand against the wall (palm down). Keep your elbow straight. Rotate your body in the opposite direction of the raised arm until you feel a stretch in your biceps. Hold 15 seconds, repeat 3 times.

Weighted pendulum stretch — Range of motion exercises are recommended early in the recovery period. These exercises are intended to help maintain joint mobility and flexibility of the muscles and tendons in the shoulder. Pain should not exceed mild levels with any range of motion/flexibility exercise. Anyone who feels sharp or tearing pain while stretching should stop exercising immediately and consult with a healthcare provider.

The weighted pendulum stretching exercise performs two functions:

•    Gently stretches the space in which the tendons pass to relieve pressure on the tendons

•    Prevents the development of a frozen (stiff) shoulder

This exercise can be started almost immediately after a shoulder injury, or after receiving a steroid injection into the shoulder joint. This exercise should be performed after heating for five minutes once or twice per day. The exercise is performed as follows :

•    Relax your shoulder muscles

•    While standing or sitting, keep your arm vertical and close to your body (bending over too far may pinch the rotator cuff tendons)

•    Allow your arm to swing forward to back, then side to side, then in small circles in each direction (no greater than 1 foot in any direction). Only minimal pain should be felt.

•    Stretch the arm only (without added weight) for three to seven days. Progress this exercise by adding 1 to 2 pounds (0.5 to 1 kg) each week and gradually increasing the diameter of the movements (not to exceed 18 to 24 inches or 45 to 60 cm )

•    After a few weeks this exercise should be supplemented or replaced by other exercises to target specific areas of tightness/restriction. The pendulum stretch may be recommended as a warm up for more localized flexibility exercises and/or strengthening exercises.

When performed correctly the pendulum exercise should not result in more than mild discomfort. If more pain is felt, consult a healthcare provider for instructions.

Passive stretching exercises — Passive stretches should be performed after the pendulum stretch exercise. 

These exercises should further loosen the tightened shoulder lining and restore normal range of motion. These exercises should be peformed in sets of 10 to 20 once or twice a day for several months. The goal of these exercises is to stretch the shoulder to the point of tension but not pain. Severe discomfort is unusual and suggests overstretching.

Armpit stretch — Use your good arm to lift the affected arm onto a shelf, dresser, or any object that is chest high Gently bend at the knees, opening up the arm pit. Try to push the affected arm up a little farther with each stretch.

Finger walk — Face a wall about three quarters of an arm length away Using only your fingers (not your shoulder muscles) raise your arm up to shoulder level.

Towel stretch — Take a three foot long towel, grasp it with both hands, and hold it at a 45 degree angle Use the upper, good arm to pull the arm toward the lower back. This can be repeated with the towel in the horizontal position.

Frozen Shoulder Ultrasound

Frozen Shoulder treatment Using Ultrasound

frozen shoulder treatment using ultrasound

Ultrasound is a therapeutic modality that has been used by physical therapists since the 1940s. Ultrasound is applied using a round-headed wand or probe that is put in direct contact with the patient's skin. Ultrasound gel is used on all surfaces of the head in order to reduce friction and assist in the transmission of the ultrasonic waves. Therapeutic ultrasound is in the frequency range of about 0.8-1.0 MHz.

Ultrasound can produce many effects other than just the potential heating effect. It has been shown to cause increases in tissue relaxation, local blood flow, and scar tissue breakdown. The effect of the increase in local blood flow can be used to help reduce local swelling and chronic inflammation, and, according to some studies, promote bone fracture healing. The intensity or power density of the ultrasound can be adjusted depending on the desired effect. A greater power density (measured in watt/cm2 is often used in cases where scar tissue breakdown is the goal.

Ultrasound can also be used to achieve phonophoresis. This is a non-invasive way of administering medications to tissues below the skin; perfect for patients who are uncomfortable with injections. With this technique, the ultrasonic energy forces the medication through the skin. Cortisone, used to reduce inflammation, is one of the more commonly used substances delivered in this way.

A typical ultrasound treatment will take from 3-5 minutes. In cases where scar tissue breakdown is the goal, this treatment time can be much longer. During the treatment the head of the ultrasound probe is kept in constant motion. If kept in constant motion, the patient should feel no discomfort at all. If the probe is held in one place for more than just a few seconds, a build up of the sound energy can result which can become uncomfortable. Interestingly, if there is even a very minor break in a bone in the area that is close to the surface, a sharp pain may be felt. This occurs as the sound waves get trapped between the two parts of the break and build up until becoming painful. In this way ultrasound can often be used as a fairly accurate tool for diagnosing minor fractures that may not be obvious on x-ray.

Ultrasound therapy is also a helpful tool for pain prevention of frozen shoulder, and having a portable ultrasound device at home can be a powerful and convenient treatment tool. If you have symptoms or are recovering from frozen shoulder, using ultrasound on a regular basis before your activity or throughout the day will help relax your muscles, tendons and tissues, diminish pain and inflammation, soften scar tissue and contribute greatly to the healing of your injury.

Physical Therapy For Frozen Shoulder

The physical Therapist’s Role for Frozen Shoulder

physical therapy for frozen shoulder

Physical therapy may be prescribed by your doctor to help relieve pain, regain mobility, and strengthen your shoulder muscle. It is particularly valuable in freeing up or preventing a frozen shoulder.

Physical therapist may use a combination of the following treatments :

Exercise, exercises for frozen shoulder serves two functions ; first, to increase the motion in the shoulder joint, second, tominimize the loss of muscle on the affected arm ( muscle atrophy ), a physical therapist can supervise your exercise program, assisting you in doing the appropriate exercises correctly, and showing you to avoid motions that will hinder your progress.

The physical therapist also has special exercise equipment available for your use. One is a “ wall ladder “ for your fingers to helf you in doing the wall walking exercise. Another is a shoulder wheel with a knob that you grasp as you swing your arm around. Pulleys and weightlifting machines are also on hand. A goniometer, which measures the shoulder’s range of motion, is used to monitor your progress. Special isokinetic exercise equipment may also be used to provide evaluation as well as strengthening.

Heat, Hot packs may be applied to help relax shoulder muscle spasme. Applications of heat to the shoulder can help to loosen the joint and provide relief of pain. Patients can apply to the shoulder, then perform their stretching exercises–this should be done at least three times daily on the joint for 10 minutes before stretching. To heat slightly deeper tissues, diathermy can be done with a special electrical machine.

Ultrasound, uses high frequency sound waves (not within the range we can hear) to stimulate the deep tissues within the body and to heat specific area all the way to the bone. By passing an ultrasound probe over your body, deep tissues are stimulated by the vibration of the sound wave may. This leads to warming and increased blood flow to these tissues and to break up adhesions and calcium deposits.

Electrical Stimulation ( TENS ), is a therapy that passes an electrical current to an affected area. Nerve conduction within the region is altered, which can in turn alter muscle contractility. Blood flow to these tissues is also increased with electrical stimulation. Patients often experience diminished pain after this electrical stimulation of treatment

Ice, useful in cooling off muscles. In addition, these methods can stimulate blood flow and decrease swelling and spsme. These can be important aspects of the therapeutic process. Your physical therapist may apply an ice pack or massage you with an ice cup.