Sometimes we are approached by people who believe they have a stiff shoulder however, there seems to be some confusion by what it is and what to do about it.
What is a stiff shoulder?
The term “stiff shoulder” refers to a group of conditions where the shoulder joint loses its normal range of motion, often accompanied by pain and difficulty with daily activities.
This can develop gradually or after an injury, surgery, or prolonged immobility. While “stiff shoulder” is not a specific diagnosis, it describes a symptom commonly seen in conditions like frozen shoulder (adhesive capsulitis), post-traumatic stiffness, and arthritis-related shoulder stiffness.
What Causes a Stiff Shoulder?
The stiffness occurs when the soft tissues around the shoulder joint; such as the capsule, ligaments, and muscles become tight or inflamed. This restricts movement and can lead to pain, weakness, and frustration.
Key contributors include:
Frozen Shoulder: This is still a condition being researched as the cause is not fully known, but it can be affected by several health and lifestyle factors such as aging.
There are two main classifications:
Primary – there is no identifiable reason for the onset or association with other health concerns.
Secondary – there could be other underlying causes such as post shoulder surgery, calcific tendinopathy, or other health factors such as diabetes or thyroid disease.
Injury or Surgery: Trauma or immobilisation following a fracture, dislocation, or surgery can cause stiffness as tissue heals. Stiffness can occur due to capsular or soft tissue adhesions, scarring, or muscle guarding.
Arthritis: Joint inflammation or degenerative changes (e.g. osteoarthritis or rheumatoid arthritis) in the glenohumeral joint leading to pain, swelling and reduced range of movement. It can be common in older adults or secondary to inflammatory conditions.
Common Symptoms of a Stiff Shoulder
Pain that can range from mild to severe, often worsening at night.
Reduced range of motion, especially when reaching overhead, behind your back, or across your body.
A feeling of tightness or resistance when moving the shoulder.
Difficulty with everyday tasks, like dressing, reaching into cupboards, or sleeping comfortably.
What Can Be Done About It?
The good news is that most people with a stiff shoulder can see significant improvement with the right approach. Treatment focuses on reducing pain, restoring movement, and improving function. Early intervention can lead to faster recovery and better long-term outcomes.
What you should look for in a comprehensive rehabilitation plan
Education: Be intentional about understanding your condition, prognosis, and the rationale for treatments.
Active Rehabilitation: Movement and strengthening should be prioritized over passive modalities.
Load Management: Proper progression is essential to avoid exacerbating symptoms or inducing further stiffness.
Multidisciplinary Approach: Collaboration between physiotherapists, surgeons, reconditioning coaches and other healthcare providers ensures optimal outcomes.
Our recommendation with stiff shoulders is that you contact your GP or physiotherapist. These conditions can require an individualised medical approach and face-to-face assessment.
Additional considerations to keep in mind. If you have a stiff shoulder and you have diabetes and/or epilepsy or seizure activity, and/or your shoulder is stiff more than painful and the stiffness lasts longer than 30 minutes in the morning, follow the recommendation above and contact your GP or physiotherapist.
If you're unsure if you are struggling with a painful stiff shoulder, take our free shoulder assessment.
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