Frozen shoulder is a painful condition in which the shoulder loses the ability to move normally. Often, patients’ shoulders can be painful at night and also hurt when reaching overhead, behind their back, or in other extremes of motion such as putting on a jacket. Some therapists do take a “no pain, no gain approach”. However, at the St. Francis Rehabilitation Center, in helping patients with this condition, we prefer the slogan “you don’t get a sore thumb better by hitting it with a hammer”. While you will need to do exercises that gently move the shoulder, we carefully choose exercises that are friendly to your shoulder and teach you to perform them in a very comfortable manner that is NOT painful. This gradually improves the movement in your shoulder while decreasing pain and inflammation. Frozen shoulder can typically get better with exercises done primarily at home – only a few visits to see a therapist are usually necessary. This approach is supported by multiple studies published in medical journals demonstrating that home based comfortable stretching guided by skilled therapists provides superior results compared to highly painful stretching.
Many times, doctors will send a patient to physical therapy if he/she has experienced a fall, been ill, or just felt unsteady while walking. There are several different components to increasing and maintaining balance and mobility.
When you arrive for your appointment, there will be paperwork to complete, most importantly a past medical history form, including a list of your medications. This information is needed to see if you have any conditions or take any medication that could contribute to your symptoms.
During the evaluation, the therapist will test the muscle strength in your legs and assess your balance. These tests are done in an effort to determine which system of balance needs to be addressed. There are three primary systems of balance: vestibular, visual, and proprioceptive. The vestibular system is located in your inner ear and is sensitive to head movements and can create dizziness if there is a dysfunction. The visual system plays a role in your balance by interpreting what you see and making adjustments to obstacles that are ahead, such as a curb. Proprioception is the feedback that you receive from your feet being in contact with a surface. This is important if you are walking on an unstable surface, such as grass or gravel. These three systems help maintain your balance, and your legs have to be strong enough to help hold you up!
The PT will analyze how you walk and determine if you need an assistive device, such as a cane or walker, for safety. Your balance may be tested by your performing tasks such as balancing on one leg and standing with your eyes closed and by performing tasks that involve putting your feet close together or in front of each other. Some of these tests may seem silly, but they give the therapist information about your ability to perform daily activities safely.
Often, your therapist will want to see you once or twice a week to work on increasing strength and balance. One thing to remember with balance is that repetition helps the body re-learn the correct way to perform daily activities. More than likely, the PT will send you home with exercises to perform on your own. Performing these exercises will help maintain your mobility and strength between PT visits. Working on balance is a time-consuming process; you will need to be patient with yourself as your symptoms improve. Most importantly, therapists want patients to remain safe with their mobility and prevent future falls. By improving strength and balance, you will be on the right track to stay injury free!