During physical therapy for a frozen shoulder, you can expect to undergo a series of stretching and strengthening exercises. These are important for maintaining the shoulder’s range of motion and preventing loss of strength. Physical therapy for a frozen shoulder also sometimes includes ice packs, heat treatment, and transcutaneous electrical nerve stimulation (TENS) therapy. Massage to break down muscle adhesions can be effective at reducing discomfort, while severe pain may be treated with a cortisone injection.
Physical therapy for a frozen shoulder usually involves an exercise program. A major issue with frozen shoulder is that a joint immobilized for a long period of time can stiffen up further. This results in a reduction in range of motion and additional problems including loss of muscle strength. Exercises can prevent this to a certain extent, although it’s important that you perform the correct progression at the proper times.
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Stretches are often essential if you want to fully recover from the condition; physical therapy for a frozen shoulder will nearly always include a set of flexibility exercises. These can include static stretches, in which you hold a position of increased muscle length for a period of time, and active stretches where movement is involved. An example of an active stretch is the pendulum swing, which is simply swinging one arm in controlled circles. It’s important that you perform stretching exercises everyday and not just during physical therapy sessions.
Once range of motion begins to increase, strengthening exercises often become part of physical therapy for a frozen shoulder. A list of exercises, including frequency and repetition, is often provided by the therapist. Isometric exercises, where no movement is involved, are usually recommended first. When these can be performed pain free, you will probably progress to more demanding techniques.
A physiotherapist may decide to utilize treatments such as temperature packs or TENS on a frozen shoulder. These are generally considered to be pain relief techniques, but might help to speed up the healing process. Temperature packs can either be hot or cold depending on which the therapist thinks will have the most effect. Massage is also useful for relaxing muscles around the shoulder.
If pain is severe, physical therapy for a frozen shoulder may involve a cortisone shot. This is a type of strong anti-inflammatory that can be injected directly into the injured area. It is not a permanent fix, but can allow rehabilitation to begin sooner and provide some pain relief.