What is a Frozen Shoulder?

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

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How does it occur?
A frozen shoulder develops after a shoulder injury that causes pain and does not allow you to move your shoulder enough. If you have limited movement of your shoulder for weeks, months, or years because of the injury, the capsule surrounding the shoulder joint ma become very stiff. Your shoulder may develop scar tissue, or adhesions, in the joint.

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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.

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How is it diagnosed?
Your doctor 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).

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How is it treated?
Your doctor will probably send you to physical therapy for a supervised exercise program. You will also be given exercises to do at home. Your doctor may prescribe an anti- inflammatory medication and may choose to do an injection of corticosteroid medication 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 to 4 times a day. In cases that do not respond to therapy, your doctor may talk to you about doing a manipulation under anesthesia. In this procedure, you are put to sleep with general anesthetic and your doctor moves your shoulder in various directions to break up the adhesion, bands of scar tissue, in your shoulder capsule.

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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 have 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 radually 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.

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How can I prevent a frozen shoulder?
After you have had an injury to your shoulder it is important that your 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
doctor.

Pierre Rouzier, M.D. THE SPORTS MEDICINE PATIENT ADVISOR