Diabetes mellitus is often associated with various musculoskeletal disorders, including chronic conditions affecting the areas of the hand, shoulders, and other major joints.
Frozen shoulder (adhesive capsulitis) and rotator cuff tendinopathy are the two main shoulder disorders associated with diabetic conditions.
These musculoskeletal problems can negatively impact the quality of life; thus, it is important to recognize and treat these conditions early to prevent future chronic disability.
A condition that is characterized by intense pain and stiffness in the shoulder can also be referred to as adhesive capsulitis. Diabetic patients are considered to be at higher risk of developing frozen shoulder. The pathophysiology of frozen shoulder is not fully understood, yet some hypotheses suggest an underlying pathologic process of inflammatory or fibrosing build-up conditions within the shoulder joint.
The preferred and first choice for management and treatment of frozen shoulder is physiotherapy. In the beginning, treatment is focused on a range of motion exercises, and if the pain allows it, stretching and strengthening practices can be added.
Rotator Cuff Tendinopathy
Tendinopathy can be described as a chronic tendon disorder conditions. Rotator cuff tendon disorders are frequent among patients with diabetes. These disorders most commonly affect the supraspinatus tendon, which may result in pain during overhead motions.
Physical therapy and other rehabilitative programs and techniques are used to treat rotator cuff tendinopathy.
A recommended training protocol includes:
- Range of motion exercises
- Stretching and strengthening
- Eccentric exercises
- Manual therapy
- Aerobic training
Home rehabilitative exercises are used for increasing range of motion, flexibility, strength, and endurance: