Living with a frozen shoulder: ‘It was like someone hit my arm with a baseball bat’
IIt started with shoulder pain, sharp and burning as if the muscles had been set on fire. Breathing became uncomfortable. I had to steel myself to cough. The damage may have occurred from holding up the heavy telephoto lens while photographing birds in a nearby wetland, or from sitting at a desk with my left arm (the affected arm) almost motionless for hours. Or it could come from something more insidious that developed unnoticed until it crossed a threshold.
I was sure the pain would go away on its own in a few days – then a few more days, and then a few more. My mistake.
My shoulder stopped working. When I struggled to lift my arm, it felt like it was tearing apart. I had a frozen shoulder.
Frozen shoulder affects 3 – 5% of the populationand is reported slightly more often in women than in men. It usually develops between the ages of 35 and 70, with a peak incidence in people in their mid-50s. Despite its common occurrence, it is one of those conditions that often goes under the radar unless – or until – you suffer from it.
“It is an unpleasant condition,” says radiologist Philippa Taplin from Hobart.
To understand frozen shoulder, it helps to know the structure of the joint. The round head of the upper arm bone (humerus) fits into a small, shallow socket on the shoulder blade (scapula), allowing a greater range of motion than any other joint. The connection of the two bones is cushioned by cartilage and enclosed in a fluid-filled tissue capsule. Normally the capsule is baggy – Taplin describes it as “like a deflated balloon” – to allow free movement, but when inflamed it tightens, effectively clamping the joint. The condition is medically known as adhesive capsulitis. Adhesions are scars that stick to other tissues; capsulitis is an inflammation of the capsule.
“If the capsule is inflamed, the shoulder is frozen and cannot move in any direction. It hurts because of the inflammation and because the scars stick together. Once the scarring starts, it only gets worse.”
The shoulder is the most flexible joint in the body. It allows you to make a windmill with your arm to hit a power cord (I don’t), lift weights above your head in a power lift (I don’t either), and reach back to adjust the pillows for a power nap ( I).
It is also the most complex joint. The ball joint arrangement of the upper arm and shoulder blade is just one element. Shoulder movement involves the collarbone and rib cage, as well as a variety of muscles, tendons, and ligaments. When the capsule becomes inflamed, the effects extend outward. They also extend inward. Frozen shoulder also has an impact on mental well-being.
What exactly causes a frozen shoulder remains relatively poorly understood. Diabetes can be a factor in its development; as many as 20% of people with diabetes experience the condition. Sometimes it is caused by an injury.
When Louise Zedda-Sampson broke her arm, part of her rehabilitation program was to try to minimize the risk of frozen shoulder.
“Because you don’t want to,” medical professionals told her.
But often frozen shoulder is idiopathic: it happens without an identifiable precursor.
Younger women I spoke to said they had never heard of it. But when I spoke to women closer to my age—the peak age for frozen shoulder—there were plenty of stories to share.
Patti Miller suffered a frozen shoulder during her dream trip to Paris. Shortly after arriving, her shoulder began to hurt.
“It felt like someone hit the top of my arm with a baseball bat.”
For Cate McKeown it started with a painful shoulder that gradually worsened.
“Then it suddenly became very bad. I could no longer raise my arm when hanging out the laundry,” she says.
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Shoulder pain is the first stage. The second phase, reduced mobility, often lasts a year or more. The mild-sounding term “frozen shoulder” downplays its profound effect on daily activities. Washing, dressing, cooking, driving and even signing a form becomes painful and difficult. Something as simple as walking the dog turns into an exercise in planning.
“You can step on a leash, but you still need two hands to open a dog poop bag,” says Tamara Playne. “I couldn’t get over how much you use a shoulder.”
Unable to lift the camera, I left photography. Doing this made my world shrink. I had lost the joy and energy that came from capturing fleeting moments in nature. Playne gave up the bass guitar as the condition continued. McKeown put the netball on hold. Frozen shoulder leads to lower activity. It affects every aspect of life.
a Qualitative research from 2022 of ten frozen shoulder patients by a team of researchers from Flinders Medical Center found that the pain, lack of sleep and loss of independence had profound psychological consequences. This is often compounded by the feeling that what they are going through is not understood by their friends and family, and sometimes even by their doctors, who may be unfamiliar with the condition and unsure of how to manage it.
The FMC investigation and others have suggested that frozen shoulder can sometimes lead to an altered sense of self. In addition to the impact on daily life, it also prevents patients from spending time with their loved ones and participating in favorite hobbies and sports.
The third and final phase is ‘thawing’, during which the stiffness and contracture slowly disappear and the shoulder becomes mobile again. This is happening at a slow pace and can take anywhere from 12 to 42 months to resolve. One shoulder may never regain full range of motion – both Playne and I are still limited in how much we can lift our arms – but it’s a relief to be able to do all those activities without assistance again. (Including bagging dog poop.)
Maria Kallas, a physiotherapist with a special interest in shoulders, says prompt treatment is the key to dealing with this.
“People can’t move, can’t sleep, can’t manage work or family. They are in pain and looking for an answer.”
In its early stages, frozen shoulder can sometimes be mistaken for rotator cuff injuries, so it is important to find a doctor with knowledge of shoulder problems.
“Get advice quickly within the first few weeks. There are good, strong treatment programs and good management methods.”
It turns out I did the wrong thing by stretching when the pain first started. Pain relief in combination with treatment to reduce inflammation is more effective.
“Keep things organized in the development phase,” Kallas said. “Movement is for later.”
Physiotherapy and customized exercises are useful in the second phase.
I still don’t know what caused my frozen shoulder. Some suggest that stress may cause the inflammation associated with frozen shoulder, or that the condition is uncommon correlates with people suffering from depression or anxiety. Patti Miller suspects that dragging a heavy suitcase over cobblestones played a role in her situation. Tamara Playne wonders whether a birthday surprise for her husband, which saw her send him across Brisbane to the Gabba while blindfolded, could have hastened hers.
When Cate McKeown developed the condition, she was told that things would eventually work out. But, she warned, it could occur in the other shoulder (recurrence in the other shoulder can occur in 6 to 17% of patients, usually within five years). It did.
But the second time, patients know what to expect and that helps them cope. With experience comes an understanding of the condition, the limitations it brings and, crucially, that it will end.
“I was more patient with it the second time,” McKeown says. “I knew what was happening and what to expect.”