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Mathias Masem, M.D.
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Shoulder | Elbow | Wrist | Hand

Frozen Shoulder

What is a frozen shoulder?
A frozen shoulder is stiffness and pain in the shoulder.

How does it occur?
A frozen shoulder usually develops after a shoulder injury that causes pain and does not allow you to move your shoulder enough. Sometimes, however, a frozen shoulder may occur for no known reason. If you have limited movement of your shoulder for weeks, months, or years because of the injury, the capsule surrounding the shoulder joint may become very stiff. Your shoulder may develop scar tissue, or adhesions, in the joint.

What are the symptoms?
Your shoulder will lose its normal ability to move in all directions. You may not be able to lift your arm above your head or be able to scratch your back. Movement of the shoulder may be very painful. You may feel grinding when moving your shoulder.

How is it diagnosed?
Your health care provider will examine your shoulder and may take x-rays. In some cases, he or she may want to do an arthrogram (an x-ray of your shoulder after dye is injected into your shoulder joint) or an MRI (magnetic resonance imaging) scan.

How is it treated?
Your health care provider will probably send you to physical therapy for a supervised exercise program. You will also be given exercises to do at home. Your provider may prescribe an anti-inflammatory medicine and may choose to do an injection of a corticosteroid medicine into your shoulder joint. When your shoulder is painful it is important to use ice packs on your shoulder for 20 to 30 minutes 3 or 4 times a day.

In cases that do not respond to therapy, your health care provider may talk to you about doing a "manipulation under anesthesia." In this procedure, you are put to sleep with a general anesthetic and your provider moves your shoulder in various directions to break up the adhesions, bands of scar tissue, in your shoulder capsule. You may need arthroscopic surgery to see if there are other causes for your frozen shoulder.

When can I return to my sport or activity?
The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity will be determined by how soon your shoulder recovers, not by how many days or weeks it has been since your injury occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better.

You may safely return to your sport or activity when:

  • Your injured shoulder has full range of motion without pain.
  • Your injured shoulder has regained normal strength compared to the uninjured shoulder.

In throwing sports, you must gradually rebuild your tolerance to throwing. This means you should start with gentle tossing and gradually throw harder. In contact sports, your shoulder must not be tender to touch and contact should progress from minimal contact to harder contact.

How can I prevent a frozen shoulder?
After you have had an injury to your shoulder it is important that you do not limit your shoulder motion for a prolonged period of time. It is important to do your shoulder rehabilitation exercises as they have been prescribed. If you feel that you are losing range of motion in your shoulder you should see your health care provider.