Frozen Shoulder: Management

- Focus on calming things down and reducing pain

- Modalities: Thermal modalities, TENS? (not overly supported)

- Manual therapy (focus on pain reduction):

- Exercise (focus on movements that ease pain)

- Focus on working within comfortable ROM and do not push it too far

What are the PT management strategies for the pain dominant/freezing stage of frozen shoulder

- focus on pain reduction

- Low grade GH mobilizations in a position of comfort

- Soft tissue mobilization

- Adjacent areas: cervical, thoracic, scapula

What are the manual therapy recommendations for the pain dominant/freezing stage of frozen shoulder

- Lower dosage

- More frequent

- Not pain-provoking

- Arm unweighted

What are the exercise recommendations for the pain dominant/freezing stage of frozen shoulder

- GH mobs in resting position

- Spinal mobs/manip

- Scapular mobilization

What types of mobilizations are used for frozen shoulder

- Patient may require adequate pain-management such as Medication

- Good evidence for corticosteroid injections at this stage

what does the medical management of the pain dominant/freezing stage of frozen shoulder entail

- Education to patient: pushing into pain/discomfort will not cause damage

- Manual therapy

- Exercise (mobility, strength, functional training)

- Will likely reach a plateau with in-clinic treatment

- 'Long-term condition requiring long-term management'

- Often will move to self-management with HEP and intermittent follow-up with PT

what does the PT management of the stiffness dominant/frozen stage of frozen shoulder entail

- Higher grade GH mobs in end range of motion

- Continue with targeting adjacent areas as needed

What is the focus of manual therapy for the stiffness dominant/frozen stage of frozen shoulder

- Higher dosage: longer holding times, progressing into pain/discomfort

- Initiate strengthening: Exercise with the arm unloaded tends to focus on RTC as primary mover

- Functional training: reaching, dressing, grooming etc.

What is the focus of exercise for the stiffness dominant/frozen stage of frozen shoulder

posterior mobs are more effective

For releasing frozen shoulder stiffness are anterior or posterior mobs more effective