By Ashley Brown, DPT
Physical Therapist, Tulsa Bone & Joint Sand Springs
Adhesive capsulitis, commonly known as frozen shoulder, is a condition characterized by shoulder pain and loss of shoulder range of motion. People with adhesive capsulitis often complain of aching shoulder pain at rest, inability to reach overhead or out to the side, difficulty lying on the painful side, and disturbed sleep. Adhesive capsulitis can significantly affect an individual’s ability to get dressed, groom, and perform other activities of daily living.
Are you at risk?
Women and men can both develop adhesive capsulitis; however, women between the ages of 45 and 60 years with a prior history of adhesive capsulitis in the opposite arm are at a higher risk. Adhesive capsulitis is more prevalent in people with diabetes and thyroid disease. Other risk factors include a history of prolonged immobilization, trauma, and autoimmune disease.
The Four Stages of Adhesive Capsulitis
Adhesive capsulitis is classified into four stages. In the first stage, the individual will experience a sharp pain with end ranges of motion, disturbed sleep, aching pain at rest, and loss of external rotation (rotating to the side). The first stage can last up to 3 months. The second stage, lasting 3-9 months, is known as the painful or freezing stage, and is characterized by severe shoulder pain causing gradual gross loss of shoulder range of motion. The third stage can last up to 9-15 months and is known as the frozen stage. The fourth and last stage can last up to 15 to 24 months and is known as the thawing stage. During the last stage, pain improves; however, shoulder stiffness continues.
How is it diagnosed?
A physician diagnoses adhesive capsulitis through physical examination and patient history. Imaging, although not always necessary, can be used to rule out other shoulder problems.
How is it treated?
Treatment typically consists of a combination of physical therapy, nonsteroidal anti-inflammatory drugs, and intra-articular corticosteroid injections. Combination of intra-articular corticosteroid injections and shoulder mobility and stretching have shown to be more effective in improving shoulder range of motion and decreasing pain in the short term compared to exercise alone. If treated conservatively, individuals have been shown to have improved shoulder range of motion and decreased pain.
Treatment typically consists of a combination of physical therapy, nonsteroidal anti-inflammatory drugs, and intra-articular corticosteroid injections. Combination of intra-articular corticosteroid injections and shoulder mobility and stretching have shown to be more effective in improving shoulder range of motion and decreasing pain in the short term compared to exercise alone. If treated conservatively, individuals have been shown to have improved shoulder range of motion and decreased pain. If left untreated, individuals may experience decreased pain and return to performing activities of daily living within 3 years.
How can physical therapy help?
A physical therapist will perform a thorough examination and evaluation to create a personalized plan to help you meet your goals and restore function. A physical therapist will use a combination of manual therapy, exercises, stretches, and modalities to help restore shoulder range of motion and manage pain to get you back to dressing, grooming, sleeping, and performing activities of daily living. Physical therapists are great at teaching you exercises as part of a personalized home exercise program catered to your specific needs to help with your recovery. As movement specialists, physical therapists can effectively help you throughout your recovery process to meet your goals.
To make a physical therapy appointment, click here or call 918-392-1400.
By Dan Skierski, PT, DPT, Clinic Lead, Tulsa Bone & Joint Sand Springs
October is National Physical Therapy month, so I decided to address one of the top issues therapists face in the daily lives of our patients: the risk of falling. Many of our patients fit into one of two categories.
One, they are at high risk to fall and are unaware of the risk; or two, they have suffered one or more falls resulting in injury.
According to the CDC, 30% of adults over the age of 65 suffer a fall each year. Twenty percent of these falls result in serious injuries that require emergency care. Each year, 40% of hospital admissions by elderly people are a result of injuries from falling.
Unfortunately, less than half of the people who fall will tell their primary care provider if they have been seriously injured. Once someone falls, they are at high risk for falling again. Falls are the leading cause of death in the elderly, and nearly $50 billion in medical costs are spent annually treating resulting complications.
Here is a quick assessment to see if you are at risk for falling:
- Can you rise from a chair without using your hands?
- Can you stand on one leg without quickly losing balance?
- Can you stand with your feet in tandem (one foot in front of the other) without losing balance?
Who is at risk to fall? Anyone over the age of 65, small children or individuals with a history of low back or lower body injuries. This includes individuals who have had hip, knee and ankle replacements, low back surgeries or osteoarthritis of the low back, hip, knee or ankle. Another major cause is osteoporosis due to osteoporotic hip fractures.
How can you prevent future falls?
1. Home Modification. According to the CDC, the number one way to reduce costs associated with falls is home modification. This includes eliminating obvious trip hazards such as rugs and small items on the floor, clearing large walkways in your home and outdoor area, and enhancing lighting in dimly lit areas.
2. Physical Therapy. Seeking Physical Therapy can be very beneficial for assessment of the need for an assistive device, as well as gait and balance training. Therapists can also work on lower body strengthening and the prescription of a long-term exercise regimen to maintain functional strength. Physical therapists also screen for other risk factors and address each individual’s safety needs.
3. Consider Using Safety Devices. Other means that can be used for safety are: carrying a cell phone, purchasing a life alert button or wearing a smartwatch with a 911 function.
4. Get a Bone Density Scan. Bone density testing can be done as an early detection method to treat or prevent osteoporosis and falls associated with osteoporotic hip fractures. Tulsa Bone and Joint offers DEXA Bone Scans at our Healthy Bones Center.
Falling is NOT a normal part of the aging process, and there are many measures that can be taken for prevention.
Dan Skierski, DPT, oversees physical therapy at Tulsa Bone & Joint Sand Springs. Dan has a Doctorate of Physical Therapy from the University of Saint Augustine and has been a member of the physical therapy team at Tulsa Bone & Joint since 2014. Dan is ASTYM and dry needling certified, and has taken multiple spine manipulation courses.
Dan treats patients Monday-Friday at our newest location in Sand Springs at 3917 OK 97 in the Springs Village Shopping Center. He and his staff not only help their patients recover from injuries and pain, but they have a good time while doing so. Madison, one of his patients, had this to say about her physical therapy treatment with Dan: “I didn’t ever dread coming here. It was a fun experience.”
In his free time, Dan enjoys fishing. Thanks for all you do, Dan!