Stiffening of the Shoulder - CENTRE FOR ORTHOPAEDICS, SPORTS MEDICINE AND REHABILITATION - Dr. Erich H. Rembeck

Stiffening of the Shoulder

General points

There are two types of frozen shoulder. A primary and a secondary type. The primary type of shoulder stiffness begins with an unspecific inflammation of the joint mucous membrane (which may be triggered by hormonal disorders or disorders of the blood glucose or lipid metabolism). It predominantly affects women in their fourth to sixth decade of life. At first, the disease is characterised by shoulder pain which leads to an increased disuse of the affected arm. In combination with the inflammation, this leads to a shrinking of the capsule which further restricts the movability of the shoulder joint. The disease progresses in phases and can spontaneously resolve itself.

The secondary type of shoulder stiffness may occur as a consequence of a long period of joint immobilisation, an operation, an inflammation or injury. This type also leads to reduced movability of the joint due to shrinking of the joint capsule.

Therapy

The objective of the treatment is to restore painless movability of the shoulder joint. At first, medicinal treatment using an "incremental cortisone regime" takes place. After completing this incremental regime after 3 weeks, we recommend the commencement of passive physiotherapy within the pain-free range. If the treatment objective cannot be reached using conservative measures, the shrunken joint capsule can be separated arthroscopically.

Aftercare

The inpatient stay lasts approx. three to four days in order to allow an early mobilisation of the shoulder joint, in order to prevent a further repeated shrinking of the capsule. On the day of the operation, the arm must already be moved under local anaesthesia and on the instructions of a physiotherapist.

Ability to work

A return to work is possible after approx. 3 - 4 weeks; in the case of patients performing heavy physical work, the rehabilitation phase is extended to approx. 6 - 12 weeks.

Ability to do sport

With the resumption of work, sport activity may also be resumed. Here, the individual type of sport and the specific strain on the shoulder region should be taken into account and discussed.