Frozen Shoulder – Symptoms, Causes, Diagnosis, Treatment

Frozen shoulder is a typical condition in which the shoulder hardens, which reduces mobility.

There has been ambiguity about frozen shoulder and arthritis. Frozen shoulder refers categorically to the shoulder joint, while arthritis may apply to multiple joints. Frozen shoulder can affect one or both shoulders.

With visible conditions, you may need physiotherapy.

In this article, we will talk about everything that you need to know about frozen shoulder:

What are the symptoms?

A person with a frozen shoulder will have a consistent pain followed by the shoulder joints getting stiff.

There are three stages for Frozen Shoulder:

  • Freezing, or painful stage 

In this initial stage, the pain increases gradually, making shoulder motion harder and harder. Pain tends to be worse at night. This stage can last from 9 weeks to 9 months.

  • Frozen stage

In the second stage, the shoulder remains stiff. It can last from 12 months, and movement may be restricted.

  • Thawing stage

In this stage, shoulder movement may become flexible again. Pain may fade but occasionally recur. That takes between 20 to 24 months.

What causes Frozen Shoulder

Below are the common causes of frozen shoulder: 

  • Stroke
  • Hyperthyroidism, or overactive thyroid
  • Hypothyroidism, or underactive thyroid
  • Cardiovascular disease
  • Parkinson’s disease

The risk factors for frozen shoulder are:

  • Age: Being over 40 years of age.
  • Gender: Women are some susceptible to frozen shoulder
  • Recent trauma: Surgery or an arm fracture often leads to immobility during recovery, and this results in the thickening of the shoulder capsule.
  • Diabetes: About 15 to 20 percent of people with diabetes develop a frozen shoulder.

What are the various Frozen Shoulder treatments?

  There are four main treatment methods: 

  1. Anti-inflammatory medications 

Medications play an immense role, and these include analgesics, anti-inflammatories, and sometimes medicines to assist with sleeping.

  1. Physical Therapy

Physiotherapy is powerful, but the impact depends on the phase of the frozen shoulder.

In the initial stages, the physiotherapy exercises focus on maintaining movement, flexibility, and strength to avoid further stiffness. 

  1. Corticosteroid  injections

 These injections are usually given using a sterile technique.

  1. Shoulder manipulations and Surgery

A manipulation under anesthesia (MUA) is the common Frozen Shoulder treatment technique for a simple frozen shoulder. The shoulder is moved through a range of motion, which causes the capsule and scar tissue to stretch.  

During the treatment procedure, 2 to 3 holes are made in the shoulder. 

The thickened capsule tissue is cut and removed. Thus the tight capsule releases, which allows the increase in range of motion. 

 It is an effective treatment for stiff shoulder after injury, trauma, or fracture, and diabetes.

The benefits of Frozen Shoulder Physiotherapy

The benefits of frozen shoulder physiotherapy vary according to the stage of the frozen shoulder you experience. 

For the first phase, assisted range-of-motion exercises can help prevent loss of movement, and various pain-reducing methods can sometimes help. 

In the second phase, treatment may become more efficient. Although the shoulder is still very stiff, physical therapy can become more active as the pain recedes.

The goal for physiotherapists is to retain and regain as much motion as possible.

Therapy can be more aggressive and is better tolerated for the final phase, which can last up to 24 months. 


If you experience a frozen shoulder, schedule an appointment with us. 

We can assess the stage of the condition and create a particular physiotherapy to get you back to full range of motion as quickly and thoroughly as possible.

What are the various stages of Hip Osteoarthritis (OA)?

About more than 10 % of Canadians are currently living with osteoarthritis, the most common form of arthritis. There’s a prominent connection between osteoarthritis and aging factor.

Therefore, as the baby-boomer generation ages, the number of people with osteoarthritis in Canada is expected to surge. 

Pain and stiffness are indications for worsening disease. By the time the initial symptoms of stiffness and pain occur, changes in the joint may have already reached an advanced stage.

Osteoarthritis Treatment and outcome can depend on the joints’ effects. For the records, osteoarthritis can affect any joint in the body.

It is beneficial to have brief knowledge about your condition before you go for treatment.

How do you know you need physiotherapy for Osteoarthritis

The commonly affected areas are the knees, hips, hands, fingers, and spine. Osteoarthritis rarely affects the elbows, wrists, and ankles.

In most cases, people with osteoarthritis are middle-aged or older because the condition appears over time. There is the gradual development of cracks on the joints due to wear and tear.

However, you may not need rehabilitation [1] physiotherapy for the condition if you are below the age of 40. By contrast, at least 80 percent of people over age 55 have X-ray [2] evidence of the disorder, even if they show no prominent symptoms.

There are specific cases when people need to take the help of different physiotherapy treatments to help recover.  These situations are the most probable cause in younger adults who show osteoarthritis symptoms due to sports injuries, obesity, and other types of arthritis, which encompass various inflammatory joint conditions.

However, in this article, we would introduce to you some of the fundamental aspects of hip osteoarthritis to help you understand your symptoms well.

The specific case of Hip Osteoarthritis

First thing first, let’s walk you through what is the hip joint and how that works.

The hip joint consists of a ball-shaped end of the thigh bone (femoral head), which fits into the hip socket (acetabular socket). Generally speaking, that’s the area around your groin, thigh, buttocks, or knee.

The inner part of this ball-and-socket joint is lined with smooth cartilage to help with the flexible joint movement. If this smooth cartilage wears away, the remaining rough surfaces of the ball-and-socket grinds against each other, which causes pain.

Over time, this condition deteriorates causing permanent damage to the joint. 

Let’s know how Osteoarthritis develops in the hip joint, and when you should opt for physiotherapy.

We will also discuss different physiotherapy treatments that we include in the physiotherapy home service. 

Osteoarthritis: The PrimaryStage

The various causes of the Hip OA are the structural problems with the hip joint (hip dysplasia, femoroacetabular impingement), age, obesity, and accidental or chronic injury.
The first changes that osteoarthritis typically bring is when the cartilage that coats the ends of your bones and cushions your joints starts to thin out.

Even though cartilages don’t have nerves when the damaged cartilages rub against each other, they affect the bone underneath,  this is the initial symptom of osteoarthritis.

However, in this initial stage of the disorder, we recommend staying active while avoiding overuse of any particular joint. As a means of physiotherapy, we suggest getting exercise therapy for core stability.

Osteoarthritis: The secondary Stage

As osteoarthritis progresses, you may notice pain tends to worsen as the day goes on, rather than easing off.  Now it becomes difficult to carry the daily activities due to the wear and tear of the hip joints.

At this stage, it is very important to receive physiotherapy to help with your joints pain, stiffness and other symptoms. This will help you delay the further deterioration of the joint disease and also to get back to your normal routine with minimum pain.


At PhysioExperts, our physiotherapists are very experienced to help you with the same using the latest machines and most helpful exercises and manual therapy. We also use electrotherapy, evidenced-based manual therapy, acupuncture, etc to help you get back to your normal activities.

Acupuncture and the Use of Dry Needling Techniques in Physiotherapy treatment

Acupuncture and dry needling techniques are used with other modalities to help you advance in your treatment. The technique requires an intensive clinical reasoning process for proper application. 

Physiotherapists use acupuncture/dry needling techniques for the management of both acute and chronic conditions.

For example, acupuncture is a useful intervention in a range of conditions including, but not limited to, the treatment of headaches, shoulder pain, osteoarthritis, stroke rehabilitation, and other chronic respiratory conditions.

Dry needling is a newer practice that attempts to release tension from knots and pressure points in muscles. However, dry needling and acupuncture have similar application procedures.

In this article, we will learn more about how the physiotherapists use acupuncture and dry needling treatment:

What are acupuncture and dry needling treatment?

Acupuncture Treatment improves pain modulation by stimulating the brain and spinal cord to release hormones, which promotes sleep and wellbeing.

These chemicals assist the body’s healing process.

What are acupuncture and dry needling techniques?

The acupuncture and dry needling technique use needles to help the muscle knots relax or release myofascial trigger points. It is a clean and safe technique that can reduce myofascial pain, muscle tightness, and headaches.

During the procedure, the physiotherapist inserts a needle into a tight band of muscle, which can cause brief localized discomfort, but is effective immediately.

The most common practice is to leave the needle in the muscle for 10–30 minutes. However, there are other types of dry needling techniques:

  • The in and out technique, during which the physiotherapist inserts the needle into a trigger point and removes it right away
  • The non-trigger points technique, during which the physiotherapist inserts needles into the surrounding muscle, instead of a knot or pressure point.

What to expect For Acupuncture and Dry needling Treatment?

Generally, the physiotherapists conduct the acupuncture treatment with the use of single-use, pre-sterilized, disposable needles of varying sizes that pierce the skin at specific acupuncture points. These needles are typically left in position for about 20-30 minutes before being removed.

At the starting point, the physiotherapist will run through a detailed history and examination to assess your suitability to acupuncture.  You also need to alert the physiotherapist of any medical conditions you may suffer from, such as diabetes, heart problems, and low blood pressure.`

To begin with the real procedure, the physiotherapist will determine the acupuncture points, after a thorough examination.  The Acupuncture Treatment plan may combine the traditional technique of finding out the acupuncture points only, trigger points, or a combination of both.

Clients will generally require about three sessions before the physiotherapist can access any cause and effect reasoning, though some people may show immediate effects after treatment.

How safe are acupuncture and dry needling?

As compared to other modalities used in medicine, Acupuncture and Dry Needling Treatment is considered to be very safe.

At Physio experts, we use sterile, single needles so that there is no risk of infection, and our physiotherapists are highly trained and implement the strictest hygiene standards.

The whole dry needling and acupuncture Treatment has minimal side effects, which is less than 1 in 10,000 treatments.

Acupuncture and Dry Needling Treatment at PhysioExperts

At PhysioExperts, we’ve been giving care for over 10 years. Our personalized physiotherapy services have helped our clients to receive quality treatment.

We have a team of Licensed Physiotherapists certified in acupuncture who are involved in on-going post-graduate courses, ensuring current and research-based treatment approaches.


Dry needling and acupuncture Treatment is one of the many services that we offer to our clients. We apply these techniques as a part of our overall physiotherapy plan to manage symptoms.

Besides, our physiotherapy packages come integrated with other treatment techniques, education, and exercises to help with your condition. Get In touch to know more.

How to Stop Muscle Cramps in their Tracks through rehabilitation physiotherapy

You may find this interesting to know that you have over 600 muscles in your body. From a functional perspective, these muscles control everything you do, from breathing to putting food in your mouth to swallowing.

Medically, a cramp is a spontaneous surge of electrical activity over a large number of skeletal muscle fibers, which quickly develops into a painful, sustained contraction (muscle spasm). 

This article will help you understand:

  • what causes muscle cramps are in details
  • how the problem develops
  • what the different physiotherapy treatments

The Anatomy:

What parts of the body are involved?

The muscles consist of many fibers that are bundled together to form a structure. You have the bigger, more frequently used muscles that have more fibers, and then the smaller, lesser-used ones. From the functional aspect, some muscles are voluntary, and some are involuntary muscles.  

Voluntary muscles are the one group that we move by choice (for example, the muscles in your arms and legs).

 These muscles are connected to bones by tendons. Involuntary muscles, or smooth muscles, are the ones that move on their own (for example, the muscles that control your diaphragm, heart).

When it comes to muscle spasm treatment, the most commonly affected muscles are the calf muscles (gastrocnemius), the muscles in your upper arms (triceps), the muscles behind your thighs (the hamstrings ), and the muscles in front of your thighs (the quadriceps).


What causes muscle cramps?

Typically, there are two kinds of cramps— Exercise-Associated Muscle Cramps (EAMC) and the Nocturnal Cramps. EAMC occurs during/post-exercise, and nocturnal cramps occur at nighttime sleep.

Potential causes of EAMC and nocturnal are:

  • Overuse of the muscles that reduces fiber lengthening between contractions.
  • Change in neuromuscular control.
  • When recovery time is less than expected 
  • Electrolyte loss through sweating during exercise.
  • Pregnancy.

Apart from that, some of the medical conditions could be responsible for muscles cramps all over the body :

  • Peripheral vascular disease.
  • Uremia – raised levels of urea and other nitrogenous waste in the blood.
  • Diabetes.
  • Thyroid dysfunction.
  • Alpha motor neuron disorders. 


How do you know it’s a muscle cramp?

As you may already know, muscle cramps are painful.  However, you know you need rehabilitation physiotherapy when the symptoms of muscle cramps show up quickly and intensely. They can be so strong that you may have to stop what you’re doing. As it turns out, the occurrence of muscle soreness makes you quit daily activities.

However, the most obvious sign is the sudden,  acute pain in the affected muscle or muscles.

If it’s a large muscle that is involved, like the one in the calf of your leg, you may be able to feel a knot like a thing, or a hard lump in the muscle, just under the skin.

The situation often happens when you are just getting started with your exercise therapy, and you are obese to start rehabilitation physiotherapy then.

How does rehabilitation physiotherapy help relieve the pain from muscle cramps?

Generally speaking,  people understand that they are experiencing a muscle cramp, so they don’t seek immediate medical help to find out what is that and what caused that. However, sometimes muscle cramps are more critical when they are frequent, lengthy, and painful. If an illness is a cause, rather than overexertion, it’s crucial to find out the driving force. The hypothesis helps apply different physiotherapy treatments.

At PhysioExperts, we work closely with our dietitians, and we would often refer our clients to them if we believe the cause of your cramps is a diet/lifestyle origin. 

It is always helpful to seek the advice of an expert regarding repeated episodes of cramps. During rehabilitation physiotherapy, they may organize further assessment, treatment plans, blood tests.


If you are experiencing muscle cramps due to illness, or due to any other reason, our physiotherapy and rehabilitation centre is here to help you get rid of that. You may request an appointment with us to know more.

Core Stability: What is it and Why is it important in rehabilitation physiotherapy

What Is “Core”?

There are many misconceptions among people about specifics of Core. They are of the notion that the core is simply the abdominal muscles or the “6-pack” abs. However, the concept of the core is much more than what they think, and it’s very crucial to have an accurate idea. This helps in fruitful rehabilitation physiotherapy.

Technically, the core area of the body is your midsection, and it involves all of the muscles in that area that makes up the torso. Commonly, these are on the front, the sides, and the back of the body. More specifically, the core includes the muscles that stabilize the hips and shoulders.

Do you need more clarity about the concept of “Core stability”?

In this article, we are going to clarify the same thing and guide you about how our physiotherapy and rehabilitation centre could help you achieve core stability.

 What’s the importance of Core stability for health?

In a more generalized term, the core is at the center of your body, and it encompasses your abs, hips, back, and chest.  The underneath muscles work as stabilizers for the entire body.  Consequently, rehabilitation physiotherapy in the form of core training is all about doing specific exercises to develop and strengthen these stabilizer muscles.

Let’s walk you through the benefits of having a strong core.

The following are the takeaways with a strong core:

  • Improve the balance and stability

 Core training exercise helps the muscles in your pelvis, lower back, hips, and abdomen to work together.

  • Eliminate back pain

Having a strong core eliminates the recurring occurrence of back pain. 

  • Upright Posture

An upright posture can help you sit and stand for long periods.

What are the conditions for rehabilitation physiotherapy and Core Training?

Improving core stability could be part of the rehabilitation physiotherapy, where people are under the following health conditions.

  • If you are suffering from chronic conditions such as back pain, you may require core training for recovery
  • If you had a ligament or muscle sprain
  • Recovery from an injury
  • Optimal spinal stabilization
  • Patients who have undergone a recent joint surgery

Apart from that,  as we grow older, we tend to lose a significant amount of muscle mass. Things get worse when most of the individuals spend their day seated in the office doing little or no physical activity at all. With that said, it is beneficial to adopt a stringent workout routine that focuses on these highly useful muscles.

Additionally, if you are someone who is on the way to recover from a recent injury, and in dire need for exercise prescription and rehabilitation physiotherapy home service, you may need to take the step. Consider visiting us at our physiotherapy and rehabilitation centre in Ottawa.

The special case of how osteoarthritis (OA) can affect the core stability

There has been various research about how lower extremity injuries may diminish core stability measures. In fact, osteoarthritis is a degenerative joint disease where the knee is the most common site for OA.

As per the international journal of Therapies and Rehabilitation research, there have been correlations of hip activity and core stability.

The outcome was that the core stability measures the hip abductor and external rotator strength along with the functional activity level in knee osteoarthritis Treatment.

Now that you know the chronic osteoarthritis could be prevented, we would want to give some of the glimpses about how Physio Experts can help you build Core Stability as a part of osteoarthritis Treatment in Ottawa.

How does rehabilitation physiotherapy help with osteoarthritis and Core stability?

Different rehabilitation physiotherapy treatments for OA include cardio and water-based exercise (swimming). The different physiotherapy treatments are strength training, weight management, self-management, and maintaining a physically active lifestyle. 

To be more specific, we would introduce exercise therapy in your osteoarthritis Treatment in Ottawa to manage the knee, hips, and hand OA. 


For more information about osteoarthritis Treatment in Ottawa, you need to get in touch with us at Physio Expert’s physiotherapy and rehabilitation centre.