Frozen shoulder is a condition many people have heard of, but is very misunderstood. The literature and overall medical opinion of its management has changed frequently over the years.
What is frozen shoulder?
Frozen shoulder refers to an idiopathic (out of the blue) problem where the shoulder randomly starts becoming painful and progressively becoming stiffer, losing its flexibility. There is lots of disagreement as to what the specific anatomical process involves. One popular theory is that
the shoulder becomes inflamed, stimulating new tissue formation, stiffening the shoulder as the capsule becomes thicker and less malleable.
How is it diagnosed?
Frozen shoulder has a very clear pattern. No trigger. Progressive in nature, slowly the shoulder becomes stiffer in a predictable pattern. Typically we lose our ability to turn the arm away from our body, and behind our back, first. Often there is pain initially, though this does vary. This is
known as the ‘stiffening’ phase, which can last for 6-12 months. This is when clients usually present. Is is important to recognise that early on before the stiffening is very noticable, frozen shoulder can often mimic other shoulder problems, so sometimes it will be a diagnosis of
How do we fix it?
Management is very controversial among the medical professions. The general consensus these days is that there is a general time frame for recovery, irrespective of management. That is, the condition will usually progress on its own to a ‘thawing’ phase where mobility progressively returns, usually 1-2 years after initial onset. This does not mean there is no place for physio and other treatments though. There is evidence that suggests the severity of the freezing phase (pain and stiffness) can be eased through physio intervention and exercise. In addition, full recovery can be limited without a proper exercise program to facilitate return to function. There is also emerging evidence for minimally invasive surgeries and injections that can improve symptoms during the freezing phase.
So what is the bottom line on this confusing condition?
- Accurate diagnosis is essential.
- Have confidence the problem is ‘time limited’ where it will mostly recover on its own.
- Establishing a management program early on will help streamline recovery
- if your symptoms are very severe, there may be a role in physio to help control the situation
through massage, manual therapy, exercise, and other modalities
- once things start resolving, exercise is a critical component to ensure full recovery
Having worked as a physio for many years, Simone has had a wide variety of experience in both public and private physiotherapy settings, working the last 7 years in private practice. Simone has developed a special interest in treating foot and ankle injuries, running injuries, jaw pain (TMJ) and posture- related back and neck pain.
Simone has vast experience working with elite sporting teams and athletes including Premier League football, rugby, track and field, Australian baseball, and swimming.
Simone is passionate about helping people move well and stay active. She has a plenty of experience in running video analysis, and hands on manual therapy as well as dry needling / acupuncture, and helping develop and retrain ideal movement.
When not in the clinic, you will find her out running, at the beach or spending time with family and friends.
Darren has worked as a physiotherapist for over 25 years and has a passion for helping people to move at their best.
He believes in taking a whole-person approach to assessment and injury management, taking into consideration the various factors that contribute to a person’s recovery or ability to improve their performance. He utilises specific advice, education, hands-on therapy and tailored exercises to help people achieve their goals. He is trained in dry needling (Western acupuncture) and teaches Physio Pilates.
Darren has extensive experience and training in treating all types of musculoskeletal problems, neck headaches, postural issues, chronic pain, orthopaedic and sports injury rehabilitation and athletic performance improvement.
On the weekend you will find Darren out playing on the football field, spending time with his family and friends, outside enjoying God’s creation or trying to catch that perfect wave.
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Jackie trained as a physiotherapist in Birmingham, UK qualifying in 1987. She worked in London before immigrating to Australia in 1995. After working for another private practice for 7 years Jackie decided to start Berowra Physiotherapy in 2003. This was also the year she took the exam to become a credentialed McKenzie therapist.
Jackie has also completed level 2 sports course and regularly attends post graduate seminars and courses. Jackie takes a very functional approach to treatment seeing it as a partnership between therapist and patient and keeping exercises simple and manageable.
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Jane is a physiotherapist who is dedicated to providing high quality, individualised assessment and treatment of patients presenting with pain and movement dysfunction. This requires a thorough initial assessment which provides a reliable diagnosis. Appropriate treatment strategies can then be applied and reassessed at subsequent visits.
The aim Jane’s treatment is to provide patients with effective self-management strategies based on education and personalised exercises and/or management advise. This facilitates optimum results and prevention of further injuries. Year of experience and commitment to continuing education enables Jane to provide reliable and accurate assessments and effective treatment strategies.
Extensive experience in neurological rehabilitation at Royal Prince Albert Hospital and Prince of Wales Hospital has given Jane a holistic approach to movement disorders. One of her special interests is chronic pain. She has completed her post-graudate education through the University of Sydney (Graduate Certificate in Pain Medicine) and have attended David Butler’s Explain Pain course. This training has enabled me to give chronic pain sufferers evidenced based and up to date assessment and treatment. Jane is also quiet passionate about minimising the risk of transition from acute pain to a chronic pain. Early assessment of people who have soft tissue injuries can help identify those at risk of developing a chronic pain problem (neck and low back being the most common). Education, management advise and appropriate exercise can help prevent pain becoming chronic.
Restoring normal movement requires a keen, experienced eye and ear to detect the source of the problem or the link. Pain and movement dysfunction can often have abnormal contribution from the central nervous system. Jane’s background in neurology and pain medicine give her the edge on being able to include neuromuscular facilitation with exercise and functional movement programmes.Book Now – Wahroonga
Jennie has managed the Physiotherapy Department for Nepean and Hornsby Hospitals for 12 years, has been a member and chairperson for the OH&S; Committees of Nepean and Hornsby Hospitals and has been a member of the APA council. She is delighted to be working at Berowra Physiotherapy on Monday, Wednesday and Thursday afternoons.
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Denise has been practising for more than 20 years, since graduating from her Physiotherapy degree at Sydney University, in both hospital and private practice settings. She has developed a special interest in treating postural neck and back pain, shoulder injuries and foot and ankle pain, as well as rehabilitation following hip and knee surgery.
Denise experienced first-hand the benefits of improving core muscle strength and stability after having her first child, and this led to her undertaking Clinical Pilates courses.. She has since applied this knowledge widely in the clinic for the treatment and prevention of pain and poor posture, utilising the principles learned from from 15 years of practising and teaching physiotherapy- based Pilates. Denise has vast experience as an educator, teaching everything from Get Fit to Ski classes, to Physio Pilates and Prenatal Education classes. She feels great satisfaction in seeing her clients learn more about their bodies and how they can move better.
Rob became interested in anatomy, exercise, and the human body when he began going to the gym in high school. He began researching and managing his own injuries with exercise and from that point, physiotherapy stood out as a career for him.
Rob developed his skills and gained experience in private practice, musculoskeletal, sports physiotherapy and post-surgical rehabilitation at the Australian Catholic University where he completed his Bachelor of Physiotherapy. Rob believes in managing patients with a combination of hands-on techniques and exercise. He aims to involve the patient in the decision-making process to optimise results such as reducing pain and increasing function in work, sport, or day-to-day living.
Outside of physiotherapy, Rob enjoys living an active life including cycling and regularly going to the gym and outdoors with friends and family.
Betty’s passion to become a physiotherapist began in her early teens, when she visited the physio tent at netball for advice after having injured herself skateboarding. Now her passion has evolved into helping people find ways to move better and stay active.
Having graduated from the University of Sydney with a Bachelor of Exercise and Sport Science and Masters of Physiotherapy, Betty has developed a great understanding of how the body moves and how to use exercise to help others improve their health and wellbeing. Betty’s passion for exercise and sports injury rehabilitation is reflected in her experiences working as a physiotherapist with National Premier League football teams, as well as AFL and rugby teams. Betty enjoys working with people of all ages and abilities to find the right treatments to help them achieve their healthiest selves.
In her spare time, Betty likes eating, going to the gym, and lives and breathes all things netball. She also plays football/soccer and enjoys watching the English Premier League (come on you Spurs!). During the holidays, you may find Betty going camping or hitting the beach with friends and family.
Steph has always loved sport and exercise and was heavily involved in athletics for over a decade. She also played hockey and touch football for many years. This love of physical activity and sport combined with a deep care for people turned into a career as a physiotherapist, helping restore people from injury or pain to ensure they continue doing what they enjoy.
Steph graduated from a Bachelor of Applied Science (Exercise and Sports Science) in 2011, and a Doctor of Physiotherapy degree at Macquarie University in 2015. While studying, Steph conducted research with physiotherapists at the Australian Institute of Sport looking at predicting and preventing injuries in elite athletes. For the past 7 years Steph has worked with a range of sporting, musculoskeletal and women’s health conditions and has trained extensively in the treatment of chronic lower back pain.
Steph loves being outdoors, anything from hiking up a mountain to relaxing at the beach. She loves a hard CrossFit workout, going for a run or working out in the home gym. Most of all she loves spending quality time with her husband and two little boysBook Now – Asquith
Carlita has been a physiotherapist since 2011, where she graduated from The University of Sydney. She is passionate about life, health and fitness and loves teaching people move better and understand how their bodies work.
She has helped many people to reduce aches and pains for a range of different conditions. She has a particular interest in headaches, migraines, neck and back pain, and also enjoys helping people with post-operation rehab, sports injuries, shoulder pain, knee and hip joint pain.
Carlita uses a range of treatment techniques and likes to do a combination of hands on therapy, dry needling and exercise to achieve the best results. Pilates and other specific strengthening and rehab programs are regularly used in her treatment programs.
When she’s not working she loves spending time with her husband and kids, catching up with friends at church, running and mountain biking.
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