What’s frozen shoulder, and how can Liz’s toddler and cat cause it?
Posted by Liz Sims, PT, DPT - Redpoint Physical Therapy, Plymouth, Massachusetts
The above diagram depicts a real event that happens in my life, and the lives of many parents, on a regular occasion. If you don't know the story first hand, I'm sure you've heard it... mom and dad, desperate for a night's sleep, let the crying baby into their bed. As my dear friend Craig put it, “toddlers enter a quantum physics wormhole and become six times their normal size when taking over a bed. Add a cat (or two) to the mix, and there's a real shortage of real estate for quality sleep.
Liz, you ask, Why didn't you move the cats?
Well, you don't know how purry-furry and snuggly Mr. Pigg is (look at that face!)... And the Bloocat is not moved, lest she gains her revenge by waking us at awful o'clock using such horrid methods as scratching the metal radiator.
So I, as many parents would, gracefully stuffed myself between cat #1 and baby, being careful not to kick cat#2 or husband. I found a relatively comfortable position. Or perhaps I was just too sleep deprived to notice it wasn’t comfortable. Because when I woke up, my left shoulder hurt.
Now, this is not uncommon. People wake up all the time with pain that wasn't there the night before. Sometimes it disappears just as spontaneously. Sometimes it takes a few days and since ibuprofen. Because of the tendency for it to heal without any action on my part, I (and many others) will use the wait-and see approach.
Here's the problem. I know I irritated my rotator cuff. Most people in this situation will avoid using the injured shoulder. Maybe that helps the irritation go away in a day or two. Or, maybe that pain hangs on, so you continue to rest it.
What is Frozen Shoulder?
Frozen shoulder - or adhesive capsulitis - is idiopathic in nature, meaning we don't know the cause. However, when taking the history of a patient with this diagnosis, there will often be a common theme such as a prior injury followed by a period of disuse.
So, say my shoulder doesn't improve with rest over a few days. With my continued rest, the tissue surrounding my shoulder joint could potentially stick together (called adhesions), significantly limiting my range of motion. Instinctively, I might then further limit my use of that arm due to pain, but that only worsens the symptoms, leading to more adhesions, less range of motion, and more pain.
Frozen shoulder has 3 set stages: the freezing stage, where you have increasing pain and loss of range of motion; the frozen stage, where you are “stuck” and painful; and the thawing phase, where you have less pain and range of motion slowly returns.
Some people never get frozen shoulder - just because you wake up wedged between a cat and a baby doesn’t mean you have to rush to the doctor. Some people get it and recover without much effort. Other people will recover with the help of a doctor and a physical therapist, and others still might struggle to recover over a 2 year period with medical management.
What do you do if you get frozen shoulder, and how can you help to avoid it?
If your shoulder pain persists for more than a few days and is not steadily improving, then you need to address it. If rest and ice don’t help, a physical therapist can help you to restore normal function and relieve pain, thus minimizing the potential for frozen shoulder.
If you are unlucky enough to have your shoulder freeze up, it will progress at its own rate. However, physical therapy will help you maximize your recovery and might also speed it up. But please be aware that physical therapy for this problem - while necessary - is a little unpleasant… we are sorry, in advance.
If you are experiencing shoulder pain and would like some advice, please feel free to contact me :)
Feel free to share ridiculous ways you’ve injured yourself in the comments below. If it’s more outlandish than sleeping between an infant and a feline, you’ll win a free Redpoint PT cap!