Frozen shoulder which is also known as adhesive capsulitis, is characterized by shoulder stiffness and pain, leading to limited range of motion. It develops gradually and can be treated with nonsteroidal anti-inflammatory drugs, glucocorticoids, injections and physical therapy. 

Stages: 

• Sharp pain stage: Painful and limits movement.
• Freezing Stage: Increased pain and restricted movement.
• Frozen Stage: Pain may lessen, but stiffness remains.
• Thawing Stage: Gradual improvement in motion. 

Symptoms:

• Severe shoulder pain, especially at night. 
• Stiffness affecting daily activities, particularly overhead movements. 
• Significant loss of external rotation. 

Causes:  Often unclear but can be linked to injuries, prolonged immobility or conditions like diabetes and thyroid disorders. 

Types: 

• Primary Frozen Shoulder (Idiopathic): No identifiable cause, also more common in women aged 40-60.
• Secondary Frozen Shoulder: Related to specific conditions or events, developing more rapidly post-injury or surgery. 

Physiotherapy Rehabilitation Phases: 

• Sharp Pain Phase (0-3 months): Pain management and range of motion exercises.
• Initial Phase (3-9 months): pain management and gentle exercises.
• Middle Phase (9-15 months): Emphasis on increasing range of motion and strength.
• Late Phase: Emphasis on functional training and return to activities. 

Treatment Options: 

• Functional Movement Screening for personalized rehabilitation.
• Advanced manual therapy techniques, including joint mobilization and myofascial release.
• Integrative modalities like dry needling, ultrasound and electrical stimulation for pain management and healing.
• Telehealth for guidance and follow-ups. 

Move Beyond Frozen Shoulder! 

Aqua therapy or aquatic therapy can be an effective treatment for frozen shoulder (adhesive capsulitis), which is characterized by stiffness and pain in the shoulder joint. Here’s how aqua therapy is beneficial for Frozen Shoulder: 

• Buoyancy: Water reduces the weight of the shoulder joint, allowing for greater range of motion and less pain during exercises.
• Resistance: Water provides natural resistance, helping to strengthen the muscles around the shoulder without the strain that might occur on land.
• Pain Relief: The warmth of the water can help relax muscles and alleviate pain, making it easier to perform stretches and exercises.
• Gentle Range of Motion: Patients can engage in gentle range-of-motion activities in the water, promoting flexibility and reducing stiffness.
• Improved Blood Flow: Aquatic therapy can enhance circulation, which may aid in the healing process. 

Considerations: 

• Supervision: It’s often recommended to perform aqua therapy under the guidance of a physical therapist.
• Temperature Control: The water temperature should be comfortable, either too hot can increase inflammation or too cold may cause discomfort. 

Hence, Aqua therapy can be a valuable component of a comprehensive rehabilitation program for frozen shoulder, helping to enhance mobility and reduce pain in a supportive environment. Always consult with a healthcare professional before starting any new treatment regimen. 

Consistency in exercises and therapy is essential for optimal recovery.