Frozen Shoulder / Adhesive Capsulities

What Is Frozen Shoulder (Adhesive Capsulitis)?

Frozen shoulder, medically known as Adhesive Capsulitis, is a condition characterized by stiffness and pain in the shoulder joint. It occurs when the strong connective tissue surrounding the shoulder joint (the shoulder capsule) becomes thick, tight, and inflamed.

This causes "adhesions" (bands of scar tissue) to develop, leaving less room for the shoulder bone to move. It typically progresses in three stages—Freezing (painful), Frozen (stiff), and Thawing (recovery)—and can take months or even years to resolve without proper intervention.
 

How Does Therapy Work?

The goal of physiotherapy for a frozen shoulder is to "unstick" the joint and restore its natural movement through a combination of heat, stretching, and specialized techniques.

1. Breaking Adhesions: Using manual therapy to gently stretch the tight capsule and break down scar tissue.

2. Pain Modulation: Using advanced electrotherapy to calm down the highly sensitive nerves in the shoulder.

3. Restoring Joint Play: Applying specific gliding movements to the joint to help the "ball" of the shoulder sit and move correctly in the "socket."

4. Muscle Re-education: Training the surrounding muscles (like the rotator cuff and shoulder blade muscles) to support the joint as it regains its range.
    

What Are The Treatment Techniques?

To achieve the best results, we use a "Combination Protocol":

• Manual Joint Mobilization: The therapist uses skilled hand movements to glide the shoulder joint into directions where it is stuck.

• Mulligan Concept (MWM): The therapist holds the joint in a specific position while the patient moves their arm, providing instant, pain-free improvement in range.

• Shockwave Therapy: Excellent for chronic cases to trigger a healing response in the thickened capsule.

• TECAR / CRET Therapy: Delivers deep internal heat to soften the stiff collagen fibers before stretching.

• Myofascial Release: To relax the tight chest and back muscles that often "compensate" for the frozen shoulder.

• Kinesiology Taping: To provide support and reduce the "heavy" feeling in the arm.
   

What Are The Benefits?

• Pain Reduction: Significant relief from the constant, dull ache (especially the pain that keeps you awake at night).

• Restored Mobility: Regaining the ability to reach behind your back, comb your hair, or reach for overhead shelves.

• Faster Recovery: Shortening the "Frozen" and "Thawing" phases through active intervention.

• Prevention of Muscle Wasting: Keeping the arm and shoulder muscles strong even while the joint is stiff.

• Avoidance of Surgery: Most cases can be fully resolved with consistent, advanced physiotherapy.
   

Typical Treatment Parameters

• Frequency: Usually 2–3 sessions per week.

• Duration: 30–45 minutes per session.

• Timeline: While every case varies, patients typically notice a significant reduction in pain within 4–6 weeks, followed by gradual improvements in movement.

• At-Home Care: A specific "Active Stretching" plan is provided to be done twice daily to maintain the gains made in the clinic.
   

How Does The Patient Feel?

• The Experience: During the "Freezing" stage, treatment focuses on soothing the pain. In the "Frozen" stage, you will feel a firm, deep stretch.

• The Sensation: You might feel a "pulling" or "stretching" discomfort during the mobilization, which is necessary to loosen the capsule, but it should never be an unbearable sharp pain.

• Afterward: You may feel a bit sore for a few hours (similar to a gym workout), followed by a feeling that the shoulder is "looser" or "lighter."
   

The Advanced Plan at Ang Physiotherapy

We don't just "stretch" the shoulder; we use an integrated tech approach:

1. Advance Electrotherapy: To numb the pain before we start the manual stretching.

2. Robotic/Mechanical Decompression: If there is an associated neck or nerve issue contributing to the shoulder stiffness.

3. Laser Therapy: Specifically to target the inflammation inside the joint capsule.

4. Graduated Exercise: Transitioning from passive stretches to "Samarth Batch" style strengthening to ensure the pain never returns.
    

Contraindications & Precautions

• Acute Fractures: If the stiffness is due to a recent broken bone that hasn't healed.

• Severe Osteoporosis: Requires a very gentle, modified manual approach.

• Active Infections: Any infection in the joint must be treated medically first.

• Undiagnosed Tumors: Any unexplained swelling or night pain must be screened by our experts.