1. Community
  2. Bones, joints and muscles
  3. Frozen Shoulder

Physiotherapy - gentle vs agressive

Posted , 4 users are following.

maria58274
maria58274

As I've come to find out, there seems to a lot of different opinions on the best way to treat frozen shoulders and this seems to apply equally to physiotherapy.  Some seem to suggest the more agressive "no pain, no gain approach" while other say you must stop when it hurts - and some actually doubt it's usefulness at all until the final stages, saying it can do more harm than good.

I was wondering if this was a US vs UK difference of treatment opinions -  or just difference between the specific therapist?  I don't know the origins of all the posters on here but a couple I came across that were given more agressive physio were from the US.  I'm in the UK and have generally been told to stop when it hurts, which makes sense to me.  What is the consensus out there of the different approaches and their effectiveness, from personal experience?  Where do you come from?

In my limited experience I've found if I overdo anything - carrying anything heavy or too much hoovering, etc, I suffer for it afterwards (housework is overrated!).  Same goes for physio.  I think I'm in the frozen stage, pain levels subsiding a bit but much stiffness.  The last physio session cranked the pain levels up again and they've taken a couple of weeks to subside.  Others have reported similar.  I think my physio must have realised he'd gone far enough as he stopped before the end of the session and said he didn't want to go any further that day,

Also, anyone who had had hydrodilation, how much physio is needed afterwards?

Looking forward to seeing your opinions on this.

1 like, 7 replies

7 Replies

  • pollmadoll64
    pollmadoll64 maria58274

    Posted

    Well I am from the UK and my physio stops when I say I am in pain. I am 8 weeks post surgery and the physio is suggesting another injection as I am finding it hard moving my arm to the side.My GP would prefer to talk to my surgeon beforehand
  • alison44235
    alison44235 maria58274

    Posted

    Hydrodilation was good for me. The pain went for 5 weeks and in that time I got 95% of movement back with 2 sessions of physio each week and of course exercises to do 4 times a day at home. The pain did come back but not nearly as bad and I just got used to it and acepted it. I think it might take a few months before it is completely better. It started 11 months ago after a fall.

    Good luck

    • pollmadoll64
      pollmadoll64 alison44235

      Posted

      Could you let me know which country you are from as I am from the UK and I am very interested in having this treatment as I have had frozen shoulder for four years and have just had shoulder surgery 8 weeks ago. I am still stiff from.it and my physio is suggesting a third steroidal injection?
    • alison44235
      alison44235 pollmadoll64

      Posted

      I live in the U.K. near York. I had tO go privately in the end as was getting no where at the nhs. I did not want an operation or steroid injections, luckily hydrodilaion worked for me, Good luck.
    • terry74787
      terry74787 pollmadoll64

      Posted

      Are you doing at least two hours over a 24 hour period every day even on the days you don't go to PT.  I came home from the hospital with a machine that moved my arm up and down12 hours a day for the first week or so then I had aggressive as in cry on the table stretching twice a week at PT plus a series of exercises to do at home all designed to keep me from freezing up again..  Hard work but better than surgery with no benefit. 
  • terry74787
    terry74787 maria58274

    Posted

    Personally I throw down scar tissue that locks my joints down very quickly. If you can't move the joint because of the scar tissue, you are going to have to be aggressive.i have a therapeutic massage therapist. Painful but does the trick. 

     

  • frozen_stiff
    frozen_stiff maria58274

    Posted

    Hi Maria, I only hope the rest of the frozen shoulder patients not on this forum are being better diagnosed and treated. I am in the no pain camp. No use tearing at the taught capsule. Here is what I think. If you have shoulder trauma you should have the arm moved or move it yourself and have some pain but not too much. In the injured shoulder or an overuse or a immobi;ized shoulder early movement seems to be the best route. If early intervention is not done a very stiff shoulder can result. It may be restricted the same as a frozen shoulder an every bit as painful it would seem, The difference in FS from an injury is in the histology and pathology of the capsular cells. This is why it lasts so much longer.

    Having had shoulder injuries I have made sure I know what needs be done. Firstly there are movements you can see being done eg hand above your head, Then movements you may feel but can't see, eg the head of the humerus spinning  and or gliding. These movements in some way happen in all joints. These movements are necessary for a full pain free range of motion. It would seem sensible for therapists to replicate these small and important movements before any thing else. Exercises for a FS before these joint movements are resolved must be counter productive.  In another forum here  I asked the FS followers to try one thing but had no takers. So one more time, sit on your hand palm up, arm is now fixed. Place the other hand on the shoulder so the fingers can feel the bones of the outer shoulder and the head of the humers. Let the arm relax and feel a glide between the tip of the shoulder and the humeral head when you raise the shoulder as far as pain will permit with the arm relaxed. Try both sides and compare. Better still have a partner to compare, It took me some time to master this but I shure noticed the discrepancy.   Let us know if you fell the mior loss of joint play.

Back to top

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.