Pendulum by night:
Many a time patients with frozen shoulder, complain of pain in the night. we as therapists, run out of ideas after a while when nothing works!!
The challenging part with adhesive capsulitis stage 1 and 2 (the inflammation & freezing stages ) the patients feels so uncomfortable in the night.,whatever the position they adopt is uncomfortable. They resort to painkillers, hot packs and end up sleeping in sitting the whole night.
I have advised them not to sleep on the affected shoulder and to lie flat.,but to no avail. So what helps??
If anyone says i can get frozen shoulder alright in two sittings please don’t believe it. I tell all my patients it will take time.,i give them atleast 3-4 months..I will discuss this in detail in another post.
Even when you sleep on the painfree shoulder, the weight of the top hand itself will increase the tension in the shoulder. I have found relief in my patients by asking them to support it on a pillow while sleeping on tummy up and on their pain free sides. kind of a distraction effect.
Recently i understood.,that the pain in the night could be because of the migration of the humeral head towards the acromion and reducing the subacromial space and causing compression of the inflammed tissues and thereby pain.
in the day , the gravity does a wonderful job of distracting the shoulder.,so i have started recommending pendulam exercise in the night.,roll on to the tummy leave your hand out of the cot, pick up the waterbottle next to you and swing 30 reps * 2 sets and trust me it helps. ( just make sure the bed is high enough to swing without hurting your hand, if not get next to the bed, take support, bend your knees slightly and swing)
It gives a traction effect and thereby relieves pain and the patients appreciate this simple tip. Managing pain is very important to get patient satisfaction and we have to do so using our physiotherapy skills , technique and most importantly common sense in most cases!!!