by Sarah Apple Kingsley, pt, dpt
Frozen shoulder, also known as adhesive capsulitis is a disease or disorder in which you begin to lose the function and range of motion of your shoulder. It is associated with a thickening, scarring, or contracture of the capsule that surrounds the shoulder joint. Pain is often associated with this condition, however, the hallmark is loss of range of motion and stiffness of the shoulder.
Typically there are three phases associated with Adhesive Capsulitis and now more formally and appropriately referred to as Rigid Shoulder.
- Stage 1 – Freezing – A gradual onset of pain that lasts anywhere from 6 weeks to 9 months. As the pain progresses, a loss of motion slowly begins.
- Stage 2 – Frozen – The pain subsides, however stiffness and loss of motion remains or worsens. This phase can last anywhere from 4 to 9 months.
- Stage 3 – Thawing – Range of motion and function slowly begins to return to normal over a period of 5 months to 2 years.
This dysfunction can be caused by a variety of factors, including Diabetes (especially Type I), injury or surgery to a shoulder, Parkinson’s Disease, and Cardiac Disease. In the past Diabetes was regarded as the highest association and risk factor for this condition. However, now confirmed, one of the main risk factors stands to be thyroid disease including both hyper and hypothyroidism.
A 2020 study evaluated the association between thyroid disorders and frozen shoulder in those having experienced a rotator cuff tear in a population of 166 individuals. The study concluded that the relative risk of developing frozen shoulder following a rotator cuff tear was 2.69 times greater in those with thyroid disorders. The study also showed this risk was significantly greater in females with poor thyroid health as opposed to males. Results also revealed the risk of developing frozen shoulder was higher in individuals with hypothyroidism and those with the presence of benign thyroid nodules. This study was the first of its kind to specifically assess the association between frozen shoulder and rotator cuff tears, however, it did not analyze the association between frozen shoulder and shoulder injuries in general. My guess is that the risk would be similar, if not even greater with a broader diagnosis.
The shoulder joint is one of the most complex in the body, consisting of multiple bones, ligaments, and tendons that are surrounded by a capsule of connective tissue. Frozen shoulder occurs when there is an irritation of the structures within, leading to inflammation of the capsule. This inflammation causes the capsule to contract or constrict causing scar tissue formation. INFLAMMATION is one of the most common and classic symptoms of thyroid disease, thus likely contributing to the cause of a frozen shoulder. Endocrine disorders in general, including thyroid diseases, lead to hormone imbalances in the body, making it poorly able to respond in appropriate manners to internal and external stressors. This typically leads to a build-up of inflammation in the body with needs for highly functioning detoxification mechanisms in place in order to combat, which are also typically lacking in those with autoimmune or endocrine diseases.
WHAT SHOULD I DO??!!
If you know or suspect thyroid disease or dysfunction, take matters in order to boost your thyroid health. Speak with your doctor if prescriptive or naturopathic thyroid support supplements are appropriate for you. You can also support your thyroid with food! Some thyroid-boosting foods include sea vegetables, brazil nuts, wild salmon, eggs, sesame seeds, pumpkin seeds, grass-fed beef, spinach, shrimp and scallops, cashews, and fermented foods such as greek yogurt, kombucha, or sauerkraut.
Lastly, PREVENT SHOULDER INJURY! Keep your shoulders healthy by performing consistent and effective range of motion and shoulder strengthening exercises, especially targeting the scapular muscles. Exercises and stretches to open the chest and prevent impingement or irritation are especially helpful. Our bodies LOVE TO MOVE. It helps to encourage the detoxification process of flushing out the tissues. Find a physical therapist or skilled personal trainer to help guide you in appropriate shoulder mobility and strengthening exercises to prevent your risk for shoulder injury, and then it won’t get locked up! And check out all of our shoulder-focused classes on LYT Daily to help you keep your shoulders healthy and mobile.