Avid followers, family, friends and anyone who has come into contact with my since early December last year (2017), will know that I have been struggling with a phenomenon known as ‘frozen shoulder’, or ‘adhesive capsulitis’.
Let me start with a little pathophysiology (one of my FAVOURITE pastimes).
The current definition of a [frozen shoulder] is:
“a condition of uncertain aetiology characterised by significant restriction of both active and passive shoulder motion that occurs in the absence of a known intrinsic shoulder disorder” (American Shoulder and Elbow Surgeons, 2017).
Additionally, The American Academy of Orthopedic Surgeons defines the condition as “ a condition of carrying severity, characterised by the gradual development of global limitation of active and passive shoulder motion where radiographic findings other than osteopenia are absent”.
It must be note that FS may be idiopathic (ie – no particular cause), but is often common in LADIES OF A CERTAIN AGE. (insert eyeroll)
The symptoms of frozen shoulder (FS) have been divided into three phases:
1. FREEZING (painful) – up to 9 months, gradual onset of diffuse shoulder pain
2. FROZEN (stiffening) – 4 months – 20 months, progressive loss of ROM (glenohumeral external rotation, internal rotation and abduction)
3. THAWING – 5 months – 26 months (gradual motion improvement – may take up to 9 months to retain full ROM)
CHEAK OUT those time frames. I mean – really?!
I think I am currently somewhere in 1-2. I have lost my ROM, AND I am in tremendous pain.
I cannot actively move my arm above shoulder height – passively, I can nearly get my arm upright. External rotation is a no no.
Treatment – I have had a cortisone injection (by my GP), and a hydrodilatation (pain akin to childbirth from my shoulder joint – but without the happy ending). I have regular physio and chiro. Both of these work together to keep the muscles and joints surrounding my shoulder, mobile and happy. They are also excellent for my mental health.
The freezing stage of my FS started back in November 2017. i felt a twinge when I was doing my normal daily activities, (including crossfit, running, housework etc), so I gradually avoided them all. This resulted in a freezing up of my shoulder – less ROM and LOTS OF PAIN.
It turns out the FS stops one from doing ones hair, or taking off t-shirt/singlets/bras etc.
I spent much of December and January on the couch, with a heat pack. Dozing through the day. I couldn’t sleep at night (a tell tale sign of FS), due to the intense pain. I was uncomfortable. I was miserable. I cried. A lot.
I had my cortisone injection in the third week of January – it provided some relief. Not enough. 9-10/10 pain all day, EVERy day, was not conducive to happiness. Hydrodilatation was the next option, whereby a local anaesthetic, then cortisone, then 20ml saline is injected into the shoulder joint under x-ray. Only 10ml of saline went in – the pain was too much, and the Dr took pity on my crying, sobbing state. Thankfully, the hyrdodilatation provided some relief, and now I am at 3-5/10 constant pain, with spikes to 100/10 when I jar my arm, or move it incorrectly.
I still have minimal movement, but less constant pain.
I cannot swim. Or crossfit. Or yoga. Or bike ride. Or walk (for exercise). I can now run – but must be careful not to jerk my arm.
It has been truly debilitating, not just for me – but for the rest of my family. It’s hard work seeing Mum/wife miserable and in tears constantly.
I have put on weight, and am the heaviest I have ever been. It turns out eating and sitting on your backside in pain, is not conducive to being fit, healthy and happy. Who knew!
So – there you have it.
Frozen shoulder in a nutshell.
I leave you with a photograph of quite possible the cutest Molly there ever was – stay tuned for her story…..