Understanding shoulder pain: Frozen shoulder vs. rotator cuff injuries

The shoulder is the most mobile joint in the human body. As we use our shoulders for many movements and activities, any shoulder pain can cause much disruption and discomfort in our daily lives.

Unfortunately, people may wait to receive a medical diagnosis if they are feeling pain, stiffness or a decrease in their shoulder’s range of movement. In some cases, rest may alleviate any discomfort, but these symptoms could also be the sign of something more serious, a condition called “frozen shoulder.”

Frozen shoulder vs. rotator cuff tears

Frozen shoulder is a common term for adhesive capsulitis. It occurs when the lining of the shoulder joint contracts and scars, limiting movement. This excess lining can lead to inflammation, pain and limited motion (known as capsular fibrosis).

But unfortunately, individuals who frequently experience reduced motion may be diagnosed incorrectly as having a rotator cuff injury, leading to a delay in proper treatment for the frozen shoulder.

The rotator cuff is made up of four main muscles and tendons that enable us to move our shoulder joints in various directions. A rotator cuff tear is a structural injury to one of the muscles or tendons in the shoulder. It’s important to diagnose frozen shoulder early on to begin treatment and avoid some of the more severe symptoms associated with the condition. An imaging procedure such as an MRI can help rule out structural injuries and occasionally show the capsular fibrosis that causes a frozen shoulder.

Who gets frozen shoulder and what can I do to avoid it?

Frozen shoulder can affect anyone at any age and impacts between 2% to 5% of the US population. People living with several conditions have been found to have a higher prevalence of experiencing frozen shoulder:

• Diabetes (Type 1 and Type 2)
• Thyroid disease
• Atherosclerotic disease
• Dupuytren’s disease
• Cervical disc disease
• Hyperlipidemia

While it won’t protect you completely from developing frozen shoulder, improved control of underlying diabetes blood sugars and thyroid disease levels have been shown to help decrease the severity of symptoms. Speaking to a doctor and getting an early diagnosis is critical to help establish either an at-home rehab or physical therapy plan, which will avoid prolonged shoulder immobilization and stiffness.

How are frozen shoulder and rotator cuff tears treated?

Rotator cuff tears may require a surgical intervention to repair a torn tendon to the bone, whereas frozen shoulder is overwhelmingly treated without surgery. Following a correct diagnosis, your healthcare provider may recommend a combination of physical therapy and steroid injections that can help decrease discomfort and improve your shoulder. In the rare case that surgery is required, it will aim to decompress, release or break up any scarring.

Once fully recovered, you can maintain optimal shoulder health with daily stretches and mobility exercises.

• Shoulder rolls: Roll your shoulders backward in a circular motion about 10 times. Then, reverse the direction and roll them forward.
• Doorway stretch: Stand in a doorway and place your hands on the doorframe at shoulder height. Lean forward gently until you feel a stretch in your chest and shoulders. Hold for around 30 seconds.
• Shoulder blade squeezes: Sit or stand with your arms relaxed at your sides. Squeeze your shoulder blades together as if you're trying to hold a pencil between them. Hold for a few seconds, then release. Repeat 10 times.
• Yoga cat-cow stretch: Start on your hands and knees, inhale deeply as you arch your back and lift your chest (this is called “cow pose”), then exhale as you round your back and drop your head (the “cat pose”). Repeat this several times.

Next steps for your shoulder recovery

If you’re living with shoulder pain, it’s crucial to seek a proper diagnosis from a medical professional. Whether it’s a rotator cuff injury or a frozen shoulder, it’s important to have a tailored treatment plan for your road to recovery.

How’s your shoulder health? Take our shoulder assessment and find a shoulder specialist near you.