Physical Therapy Benefits Frozen Shoulder

Much more common in women than men, frozen shoulder typically affects those in the 40- to 60-year age range. About 3% of the general population and 20% of those with diabetes suffer from this puzzling condition. Its technical name, adhesive capsulitis, comes from the area affected (the shoulder's joint capsule), and the fact that shrinkage and/or inflammation lead to scarring, which causes a “sticking” or adhesion of the tissue within.

The benefits of physical therapy vary according to the stage of frozen shoulder you experience. Stage 1, the “freezing phase,” during which the shoulder becomes increasingly painful and stiff, typically lasts from a few weeks to eight months. The shoulder is resistant to aggressive physical therapy or pain reduction and is very difficult to treat. When possible, passive or assisted

range-of-motion exercises can help prevent loss of movement, and various

pain-reducing methods can sometimes help. Some research indicates that anything beyond minimal treatment during the “freezing phase” could impede long-term success.

In Stage 2, the “frozen or stiffening phase,” treatment may become more effective. This phase usually lasts up to 12 months. Although the shoulder is still very stiff, physical therapy can become more active as pain recedes. To achieve this, a nerve block administered by an anesthesiologist can be effective, as can more conservative medications. The goal is to retain and regain as much motion as possible.

Therapy can be more aggressive and is better tolerated for Stage 3, the “thawing or recovery phase,” which can last up to 24 months. Sometimes, arthroscopic surgery, in which specific tight sections of the shoulder capsule are cut to “release” them, is recommended and helpful, but often frozen shoulder resolves fairly well without it.

If you experience frozen shoulder, schedule an appointment with us. We can assess the stage of the condition and devise a specific treatment program to get you back to full range of motion as quickly and completely as possible.
Pain After Falling on an Outstretched Hand

After a fall on an outstretched hand, you should have an x-ray to check for a bone fracture, which could certainly account for lingering pain. Often, the bone affected is the navicular bone, also known as the scaphoid, located between the base of the thumb and the radius (one of the two long bones of the forearm). Because a navicular fracture often causes pain and swelling on the thumb side of the wrist, gripping motions can be particularly painful.

A fall on the hand can cause a fracture in the radius itself, especially in older people. Immediate pain, swelling and visible evidence, such as the wrist's angle, indicate that something is very wrong. The usual treatment for a small navicular fracture includes casting, splinting and a rehabilitation program that includes range-of-motion and strengthening exercises.

Because the blood supply, which carries oxygen and nutrients to the scaphoid bone, is poor, hand and wrist pain after a fall commonly lasts weeks, even several months. A rehabilitation program for a sprain may include

• splinting during the day and/or night
• icing
• exercises to promote strength, flexibility and function
• nonsteroidal anti-inflammatory pain medication (NSAIDs) or cortisone injections if your doctor approves

Rehabilitation is an important part of healing because of the long immobilization time needed to treat most scaphoid fractures. If you have fallen on an outstretched hand, we can design an individualized program to achieve the best chance of alleviating that nagging, lingering pain and help you regain full range of motion and strength in your hand and wrist.