Frozen shoulder

1. A BIT OF ANATOMY

The scapulohumeral region is made up of 3 bones: the clavicle, the scapula (or shoulder blade) and the humerus. Its mobility is ensured by a musculotendinous and ligament complex. She depends

so many of the soft tissues that surround it to stabilize it and control movement.
One of these structures is the joint capsule. So that the sliding of the differ

In order for these structures to be effective, optimum lubrication of the surfaces is required.

This improves sliding and limits friction, heating and wear. This liquid of

lubrication, called

synovial fluid, is secreted and contained in the joint by the joint capsule.

2. WHAT IS RETRACTILE CAPSULITIS? WHAT ARE THE LESION MECHANISMS?

By definition, adhesive capsulitis is an inflammation of the joint capsule. The latter shrinks and thickens gradually. Due to its symptoms, it is also called “frozen shoulder”, and is manifested above all by two main symptoms:

Pain
Stiffness, leading to a progressive loss of mobility in the shoulder joint

The mechanisms of appearance of this pathology are still poorly understood. However, several factors seem to favor its appearance:

Gender: women aged 45 to 65 seem more likely to develop capsulitis (prevalence of 70%)
Trauma to the shoulder, which may have caused immobilization of the shoulder
Calcifying tendinopathy
An emotional or psychological shock, or stress could promote the triggering
Depression
Diabetes
A disease affecting the thyroid
Taking medication (barbiturates, etc.)

Finally, it is also possible that in the event of adhesive capsulitis appearing on one side, the opposite side will also be affected afterwards.

 

3. HOW DOES THE PATHOLOGY EVOLVE?

In general, adhesive capsulitis evolves according to three main phases, of variable length, during which the symptoms vary:

 

Phase 1: lasting from 1 to 4 months, this phase is above all characterized by significant pain, spreading in the shoulder region, and which can radiate to the elbow.
It is often present even at rest and during simple movements, particularly in the evening and at night.
Phase 2: lasting from 3 to 12 months, it is characterized by stiffening of the affected shoulder, causing a significant limitation in the mobility of the joint. There is also a decrease the pain decreases, which becomes intermittent.
Phase 3: this last stage corresponds to the recovery phase, and can last from 6 months to 2 years. The pain decreases, and the range of motion returns to normal.

 

 

4. IS IT SERIOUS?

Adhesive capsulitis is a serious pathology, which will require professional follow-up whatever happens.

Although the prognosis is favorable, the healing process and rehabilitation can be long.

The diagnosis is based above all on the clinical examination carried out by the practitioner, which generally makes it possible to determine the seriousness of the situation.

It is essential to determine if it is really a capsulitis, or rather a stiffening of the shoulder following a tendinopathy. This will have a direct influence on treatment and healing times.

It should be noted that medical imaging offers very little information as to the diagnosis of capsulitis, the X-ray appearing normal.

 

5. IS SURGERY AN OPTION?

 

Surgery is mostly refuted and remains exceptional. Indeed, the surgical intervention leads to a new trauma and therefore risks aggravating the situation.
It is nevertheless still proposed in certain cases of sequelae of capsulitis, as arthroscopy may be beneficial to partially release the capsule.

 

6. HOW DOES THE REHABILITATION TAKE PLACE?

Rapid management and early treatment of capsulitis (medical and physiotherapist) can significantly reduce the harmful consequences of this pathology and reduce recovery time. It is therefore important to start your treatment as soon as possible.

The treatment will start by respecting the different phases of evolution of the capsulitis, so as not to aggravate the symptoms.

Respecting the process, the work will then focus on:

Pain management
Education of the patient about his pathology
Gradual recovery of joint amplitudes
Global and specific muscle strengthening (strength, neuromuscular control, stability, etc.)
Gradual rehabilitation of the joint

 

 

7. WHAT CAN I DO TO SPEED UP THE PROCESS?

In order to speed up the healing process, be sure to follow the recommendations of the health professionals with whom you work.
Laziness or, on the contrary, overzealousness, will be your enemies.
Conversely, discipline, rigour, perseverance as well as a positive and voluntary state of mind will help you get back in top shape as soon as possible!

 

We care, u perform