Normal Shoulder: The shoulder joint is a shallow ball(upper end of humerus bone) and socket joint (shallow pit in the scapula) that has a smooth capsule with ligaments around it that make way for a wide range of movement. Majority of the strength and stability of the shoulder is provided by the rotator cuff.
Frozen shoulder: Presence of a stiff, painful shoulder with varying degrees of movement restriction. Over an average period of two years, the frozen shoulder progresses from pain to stiffness and then resolution.
Diabetics and Shoulder disease: Two of the most common disorders of the shoulder include Frozen shoulder and Rotator cuff disease. Both occur in diabetic individuals. Frozen shoulder is far higher (disease prevalence) in Diabetic patients(27.5%) when compared to non-diabetic patients (5%).
Why does Frozen shoulder happen in Diabetic patients? Although the exact mechanism is not known, it is attritube to a. sub-optimal micro-circulation in diabetic patients, b.high levels of advanced glycosylation end products that increase the stickness of the tendons and ligaments, making them less pliable and less stronger.
What to be to done to reduce Frozen Shoulder?
Many links have been explored, although not proven statistically, shoulder problems are higher in patients with longer duration of diabetes, poorer control and co-existence of hyperlipidemia. It can occur in one or both shoulders. After assessment by an expert,a combination of oral anti-inflammatory medications and physiotherapy help to ease the symptoms. Prior to physiotherapy, it is better to do warm-up exercises to ease the stiffness.