Special physiotherapy is used to promote the mobility of the shoulder. The shrunken capsule is stretched and the muscles are retrained.
In this way, the humeral head is re-centered in the shoulder area and the joint becomes increasingly mobile.
We recommend twice-weekly physiotherapy in combination with a home exercise program. Even if this is often unpleasant for patients and involves a certain amount of pain, it is essential to avoid increasing stiffness in the shoulder. Physiotherapy is the decisive and most important aspect of frozen shoulder.
We have also seen very good treatment success with ACP therapy for frozen shoulder in our practice in Freiburg. ACP can improve and significantly reduce inflammatory processes in the body in a natural way, similar to the body's own cortisone. In the case of frozen shoulder, patients often report a significant reduction in pain and an improvement in mobility when treated in our practice.
For degenerative changes in the tendon, we recommend 3-6 ACP injections, each at one-week intervals.
Themode of action of AC P
Many injuries to the human body heal by themselves. Behind this complex healing process are growth factors from the blood.
During treatment with ACP, blood is taken from the patient with a small special syringe, similar to the way you would have a small blood count at your GP.
This blood is then specially processed so that only the growth factors responsible for healing remain in a highly concentrated form.
The body's own active ingredient obtained in this way is then injected into the affected tendon. The body's healing mechanisms begin at the site of the injection. The inflammation and the associated swelling recede. This creates more space under the acromion.
The muscles can then glide better again, the joint runs more smoothly and the tendon can recover. In professional sport in particular, the treatment of irritated tendons with ACP has now become standard practice - ACP can often even replace harmful cortisone treatments in the long term.
Medication is used to combat inflammatory changes in the bursa. If the inflamed bursa swells again in this way, more space is created under the acromion. The muscles can then glide better again, the joint runs more smoothly and the tendon can recover.
Inflammatory changes to the capsule are also reduced very effectively. As taking cortisone medication can also lead to certain side effects, this is discussed with you individually and is only carried out in our practice in exceptional cases. However, a single cortisone infiltration (targeted into the joint) can significantly reduce inflammation and quickly improve pain and mobility, which is always amazing for all patients.
Cortisone infiltration is covered by all health insurance companies.
Acupuncture can be used very well as supportive pain therapy and to reduce the tendency to swell in osteoarthritis.
1x - 2x per week for 10 weeks
In frozen shoulder surgery, the inflamed capsule of the shoulder joint is stretched in a minimally invasive procedure (using the keyhole principle) in order to restore mobility in the shoulder joint.
The shoulder is often much more mobile immediately after the operation, but intensive physiotherapy must be carried out daily to prevent the shoulder from becoming stiff again after the operation.
If necessary, bony changes, the roughened tendon or inflammation of the bursa are corrected at the same time so that there is more space in the acromion and the muscles can glide again without irritation.
We perform this operation exclusively arthroscopically (using the keyhole principle). Thanks to particularly gentle techniques, there is usually no major bleeding. The muscles are not injured, which means that in almost all cases there is no need to insert a drain.
The patient can move their arm again on the first postoperative day. In addition, a motorized chair is often used for 4 weeks at home, which then passively moves the operated shoulder several times a day.
The operation usually takes 30 to 60 minutes and is performed under general anesthesia.
In most cases, we recommend having this frozen shoulder operation performed on an inpatient basis, as a pain block (anesthesia of the nerves) is also used in our procedure. As a result, the patient usually has no discomfort on the first postoperative day. It is also very important that the shoulder can be moved passively and actively again immediately.
You will be able to move your arm again on the first day after the operation.
Depending on the work activity, 1-3 weeks after the operation, but intensive physiotherapy must still be carried out at least twice a week, as well as a daily program at home.
Occasionally, outpatient rehabilitation is also necessary, during which the patient must be on sick leave for this period. This usually lasts between 3 and 6 weeks.
Sports that do not put a lot of strain on the shoulder, such as jogging, can be performed from the 6th week onwards.
For sports that put strain on the shoulder, breaks of up to 12 weeks may be necessary. We will be happy to advise you and create an individual plan for you to build up the load.
In extreme forms, especially in connection with concomitant diseases such as diabetes mellitus, frozen shoulder can often persist for months, sometimes even years, and lead to pronounced frozen shoulder with possible subsequent osteoarthritis.
Even if surgery is only necessary in very rare cases, it should be used if the condition cannot be managed conservatively in order to avoid permanent damage to the joint. However, we will advise you very thoroughly on an individual basis.
With today's special minimally invasive techniques, complications are extremely rare. The worst and extremely rare complication would be a joint infection.
As our arthroscopic surgery involves a great deal of fluid irrigation, infection practically never occurs. However, should this occur, an antibiotic would have to be administered. It may be necessary to irrigate the joint again.
There is normally no risk of major injury to the tendon, bone or nerves.
One of the main risks is that the shoulder will revert to a certain degree of stiffness after the operation and intensive physiotherapy will be necessary.
