Lack of exercise and sedentary lifestyle can increase risk of frozen shoulder, warns Dr Rajeev K Sharma.

When was the last time you stretched your hands generously and took a pain to exercise your shoulder joint, rotating it both inward and outward? Perhaps you don’t even remember distinctly.

In the middle of extended working hours and excessively hectic routines, many of us often skip one very important component of our lives: making sure that all our body joints and parts are kept moving and sufficiently exercised. This oversight can cause trouble for your body in the longer run. On the other hand keeping a few minutes of your time daily dedicated to stretching and warm up exercises can go a long way ensuring robust health.

Frozen shoulder is a painful condition that can render a person’s shoulder joint immovable. It causes pain and stiffness around shoulder. Patients are presented with a decreased range of motion around the shoulder which affects their daily activity. It may be caused by a number of factors which includes trauma to the shoulder, old manumitted fracture, co-morbid conditions like diabetes mellitus, hypothyroidism.

Frozen shoulder develops when there develops inflammation in the capsule of the shoulder joint, which has ligaments to hold the shoulder bones to each other. This renders the shoulder bones incapable to move freely in the joint. Frozen shoulder or adhesive capsulitis, starts rather gradually, finally making stiffness to swathe the entire shoulder.

In some people, frozen shoulder can be manifested in the form of lack of use of shoulder complex, which, put simply, means a lack of movement of the shoulder joint and the ligaments around it.

The shoulder joint is surrounded by several ligaments and tendons that provide it support and stability and also render flexibility of movement to it. If you don't put your shoulder and its surrounding complex to a range of motion on a regular basis, the ligaments and tendons may tighten up over a period of time.

In many cases, preventing a frozen shoulder can be possible by performing regular motion and exercises and stretches that promote flexibility and mobility of the joint.
Sedentary lifestyle, working several hours on computers and driving long distances -- modern life already offers plenty of opportunities to put our shoulder under aberrant exertion -- when this gets coupled with our inactivity, the circumstances often become a breeding ground of such conditions. Like a machine, if our body or any of its part falls short of natural mobility over a long period of time, it can cause problems.   

The treatment of the condition called frozen shoulder includes physiotherapy, intra-articular injection of steroids, manipulation under anaesthesia and arthroscopic release and decompression.

Who are at risk

People around 40 and older are more likely to experience frozen shoulder.
Systemic diseases - People who have certain medical problems, like diabetes, overactive thyroid (hyperthyroidism), underactive thyroid (hypothyroidism), cardiovascular disease, tuberculosis and Parkinson’s disease are apparently more predisposed to develop frozen shoulder.

Immobility or reduced mobility - Those people who have to undergo prolonged immobility or have fewer mobility of their shoulder are at higher risk of developing frozen shoulder.

Immobility may be the result of some medical conditions like rotator cuff injury, broken arm, stroke and recovery from surgery, or due to inappropriate work postures, inactive lifestyle and lack of exercise. 

Off all these risk factors, lack of physical activity and sedentary lifestyle are the ones that can be avoided if you imbibe a little of exercise in your schedule.

If you do not keep your shoulder involved in a range of motion regularly through everyday activities and exercise, the optimal supply of blood for nourishment and removal of waste products would be restricted and over a period of time can cause them to tighten up.

Similarly, a shift in the alignment of shoulder blades and upper arm bone due to prolonged erroneous posture, like hunching over in front of a computer for several hours, can put significant stress on the ligament and tendons, which could gradually lead to a mild to severe degree of inflammation in the region, and further to scar tissue formation and shoulder stiffening.

Women generally figure it out comparatively sooner than men, while combing their hair or fastening bra. Men notice it usually when it taking out stuffs from their hip pocket starts becoming painfully difficult and while combing hair.

The worst part is that people often keep ignoring the symptom, considering it some sort postural pain or sprain, until they find it impossible to move their shoulder even an inch. Frozen shoulder could be treated almost entirely, and many a times only with non-steroidal anti-inflammatory medications (NSAIDs) and steroid injections. While, steroid injections along with physiotherapy can improve motion in advanced stages of frozen shoulder, with severely restricted movements.

Keeping your shoulder joint flexible is important. So is seeking immediate medical help to prevent progression of the disease.

(The writer is a senior consultant orthopedics and joint replacement surgeon)