ADHESIVE CAPSULITIS

It’s not uncommon to have clients who come for a massage session as a result of adhesive capsulitis (commonly known as a frozen shoulder). In nearly all cases this is painful and causes restricted movements. This is a condition characterised by stiffness and pain in the shoulder joint. Signs and symptoms usually start gradually, worsen over time, and over time resolve – usually between one and three years.

Dr. Peter Jones presented a workshop at the recent Massage Therapy Association’s (MTA) AGM.

He talked about the risk of developing frozen shoulder increasing if a person is recovering from a medical condition or procedure that prevents them from moving their arm — such as a stroke or a mastectomy.

Symptoms

Frozen shoulder typically develops slowly, and in three stages. Each stage can last a number of months.

Freezing stage includes:

  • Gradual onset of shoulder pain at rest
  • Sharp pain at extremes of motion
  • Pain at night with sleep interruption
  • 2/9 months
  • Aggressive treatment should be avoided
  • Activities that cause pain should be avoided

Frozen stage. Pain may begin to diminish during this stage. However, the shoulder usually becomes stiffer, and using it becomes more difficult.

  • Pain starts to subside
  • Shoulder becomes stiffer/ progressive loss of glenohumeral motion
  • 9/15 months

Thawing stage.

  • Spontaneous, progressive improvement of range of motion
  • 15 to 24 months

It’s important to take a proper case history in order to establish an effective treatment protocol. This includes asking

  • What
  • Where
  • When
  • Why
  • As well as any red flags

Besides regular massage of the affected areas, the therapist might suggest the following:

  • Heat (before/during), packs, shower
  • Freezing – pain free = low intensity +short duration
  • Frozen -> aggressive stretching to improve ROM = load bearing + prolonged stretches
  • Thawing – increase stretch frequency & duration