Frozen shoulder is an aseptic inflammation of the soft tissues surrounding the shoulder joint. It is characterized by pain and motor dysfunction, mostly in middle-aged and elderly people, and is referred to as “fifty shoulder” or “frozen shoulder”. It is a degenerative disease, most of which can heal on its own, but it has a long course and affects the patient’s daily life. The normal range of motion of the shoulder joint is 90 degrees of forward flexion, 150-180 degrees of supination, 90 degrees of abduction, 180 degrees of adduction, 40-50 degrees of posterior extension, and 40-50 degrees of posterior extension of the elbow (back touch test) to the lower edge of the opposite scapula. The shoulder joint consists of four joints: glenohumeral (shoulder-humeral), shoulder lock, sternoclavicular and scapulothoracic wall (shoulder-thoracic), which is the most mobile joint in the human body, and the space between its joint surfaces is also the largest. The shoulder joint movement is powered by the contraction of the muscles that make up the rotator cuff. Shoulder capsule: located in many ligaments and muscle attachments, the main ones are: the long head tendon of the biceps, the capsular crypt of the joint cavity, and the subacromial mucus capsule. Muscles that make up the rotator cuff: from the back: supraspinatus, infraspinatus, and small garden muscles; from the front: subscapularis and large garden muscles; from the outside: deltoid, pectoralis major, trapezius, and triceps. Etiology: The exact etiology is unclear. It is generally thought to be degenerative (wear and tear, aging), followed by trauma, strain, or inflammation and adhesions caused by low and improper shoulder joint activity. Most of them are related to wind and cold. Pathology: The main cause is aging of the rotator cuff muscles and the connective tissue of the long head of the biceps tendon. In addition to its role in shoulder flexion, the biceps long head tendon also plays a role in stabilizing the shoulder joint, and studies have found that hypertrophy of the long head tendon occurs in patients with rotator cuff injuries. Acute and chronic aseptic inflammation of the soft tissues around the shoulder causes local pain, reflex muscle spasm, followed by local fibrosis, shoulder joint contracture and shoulder joint motion dysfunction. Course of the disease: 4 to 5 months in the acute phase (pre-freezing phase), 4 to 5 months in the adhesive phase (freezing phase), and 4 to 5 months in the remission phase (thawing phase). The disease can heal spontaneously for up to 2 to 3 years. Early diagnosis and treatment can shorten the course of the disease. Symptoms and signs: pain: especially at night, affecting sleep; movement disorders; pressure points: biceps long head tendon attachment in the inter-nodal groove, rostral process, deltoid shoulder (where the bursa is located); muscle atrophy: disuse muscle atrophy, especially deltoid and triceps. Rehabilitation 1. Principles: acute phase: pain relief and appropriate exercise; freezing phase and remission phase: both focus on functional exercise. 2. Methods: (1) Physiotherapy: mainly thermal therapy: mainly ultra-short wave, low and medium frequency electrotherapy; hot water bags, moist hot towels, field effect therapy instruments, etc. are available at home; ice therapy is also available for 5 to 10 minutes to relieve pain. (2) Exercise therapy: Promote blood circulation, loosen adhesions, slowly move away, activities at the same time promote muscle training, increase muscle strength and overcome atrophy. For patients with biceps long head tendonitis, strengthen the rotator cuff muscle group strength training during the rehabilitation process, thus reducing the burden on the long head tendon. Exercise is mainly patient-initiated exercise, generally two times a day for 15-30 minutes each time. The specific methods are as follows: ① Swinging exercise: upper body is flexed forward and the healthy hand holds the table. In this position, the shoulder joint can be easily relaxed, and gravity can be used to do back and forth, internal and external and rotational activities. You can also stand straight and do shoulder rotation activities. ②Shoulder internal and external rotation exercise: Lie on the bed, bend the elbow joint 90 degrees, and do the back and forth movement with palms up and palms down. ③Stick exercise: 1.2m long stick, or you can use a long towel instead. Standing position, feet shoulder-width apart, healthy limbs drive the affected limbs to do. Including: forward and upward lifting, above lifting neck posterior, to the side and upward lifting, posterior extension, posterior lifting, left around the ring, right around the ring, twisting arm movement, etc. ④Wall climbing exercise: frontal wall climbing, practice shoulder joint forward flexion and supination; side wall climbing: practice shoulder joint abduction. ⑤ Dumbbell exercises: including supination, side planks, front planks, internal and external rotation activities. (6) Others: Combing and combing the hair and waist activities. (3) massage: there are two types of techniques: Western and Chinese. Western style (Maitland’s technique) is mainly a joint relaxation technique, including long axis traction, joint surface separation, joint surface sliding and other 4 degrees of manipulation treatment for each functional position of the shoulder joint, which is very effective. The Chinese style mainly introduces home self-massage, which includes holding and kneading with the healthy hand, pressure and pain point pressing and plucking. Shoulder and back are mainly massage with holding and pressure pain points. Acupuncture point massage includes: Hegu, Quchi, shoulder beak and other point massage, and finally the whole shoulder joint stroking massage. (4) Other methods: closed treatment, acupuncture treatment, medication treatment, etc. Closed treatment has obvious effect on acute frozen shoulder. The treatment drugs are generally adrenocorticotropic hormone suspensions, with the aim of maximizing the local effect and minimizing the systemic effect. It is divided into long-acting, medium-acting and short-acting preparations. V. Prevention 1. Avoid straining the shoulder and remember not to carry heavy things. 2.Avoid wind, cold and dampness in the shoulder, especially shoulder protection during sleep. 3.Avoid trauma to the shoulder. Common traumas include rotator cuff muscle strains and ligament tears. 4.Appropriate exercise. Shoulder exercises for middle-aged and elderly people: promote blood circulation, joint ligament slippage and prevent frozen shoulder. (1) head hand confrontation: cross your fingers at the back of your neck, stretch your head and neck backwards, pull your arms forward, cross each other for 2-3 seconds, repeat 5-10 times; (2) back hand confrontation: cross your fingers at the back of your back, lift your palms upwards, maintain for 3 seconds, repeat 5-10 times; (3) turn your hands upwards: cross your fingers at the front of your body, turn your palms upwards and turn your palms to the top of your head with your palms upwards, maintain for 3 seconds, repeat 5-10 times (4) Rotate the shoulders forward and backward, 5~10 times; (5) Shrug the shoulders and raise the elbows, maintain for 3 seconds, repeat 5~10 times.