Frozen Shoulder, or adhesive capsulitis, is a very stubborn, debilitating, and restrictive condition that can affect all the activities of daily living. It may present its ugly head shortly following that first tennis practice of the season that exhausted you to the point of “becoming one” with your recliner for three hours before bed. Or, maybe you decided to save a few bucks and wash and wax your cars over the weekend and found it nearly impossible to get a fork of linguine up to your mouth on Monday evening. The common symptoms of this condition include: severe pain, progressive stiffness and loss of motion in the shoulder joint. The shoulder’s range-of-motion is often so limited that many patients have difficulties in raising their arm above the head, moving the arm across the body, and especially behind the back. What is most disturbing about this condition is that the loss of movement that can last from months to years.
Fortunately, we can show our patients ways to control the pain and regain full range of motion and full function in a lot less time. Often, the actual cause of this condition is unknown. The medical community is still debating over possible causes. However, Frozen Shoulder usually occurs in three distinct phases:
Freezing Stage
This stage is characterized by pain in and around the shoulder and progressive loss of range of motion.
Frozen Stage
Pain is actually reduced in this stage. The range of motion of your shoulder seems to be stuck, not decreasing or increasing.
Thawing Stage
This stage is characterized by a slow increase in range of-motion of the shoulder. It is also a stage of increased weakness due to the disuse atrophy of the shoulder.
Examination and Diagnosis
The diagnosis of Frozen Shoulder is usually made after an examination. X-rays or an MRI are usually not prescribed, unless the doctor needs to rule out other conditions such as osteoarthritis or significant tear(s). Patients with Frozen Shoulder have a very limited range-of-motion in both active and passive ranges of motion. Active range-of-motion is when you move yourself; passive range of motion is when someone moves your arm for you. In addition to the decreased active range-of-motion in the shoulder joint itself, it is common to find significant trigger points in several of the rotator cuff muscles. This is especially true of a muscle called the subscapularis,as pointed out by Janet Travell, author of “Myofascial Pain and Dysfunction”. Trigger points in the subscapularis muscle refer pain to the back of the shoulder (deltoid muscle), shoulder blade (scapulae), and even the wrist.
Treating Frozen Shoulder
There is no doubt that Frozen Shoulder is one of the tougher conditions to treat. The good news is that 80 – 90% of patients suffering from Frozen Shoulder will eventually experience a complete recovery. The bad news, recovery that is based on conventional therapy (muscle relaxants, corticosteroid injections) can take a very long time (twelve to forty-two weeks).
Exercise
Fortunately there are alternatives to these traditional therapies, which with the right therapy and exercises can reduce treatment time to between 4 to 10 weeks in most cases. I have consistently seen positive results in over 80% of Frozen Shoulder cases that we treated with a combination of specifically designed soft-tissue protocols along with rehabilitative exercise routines.At our office, we often use a treatment protocol that involves:
- Using Cold Laser (LLLT) to the involved shoulder prior to treatment in order to increase blood circulation, reducing swelling and to make the tissue more malleable.
- Administering appropriate hands-on soft-tissue and joint adjusting protocols directly to the shoulder and surrounding areas. (Active Release Technique, Graston, Fascial Distortion Model, and Chiropractic Manipulation to the shoulder and possibly other joint areas).
- Acupuncture (using pin-point laser and Piezo electric stimulation) for not only trigger points directly on the muscle, but also for sites away from the shoulder along meridians that affect shoulder function.
- A gentle shoulder exercise routine that mobilizes both the joint and the soft-tissues involved in this condition, following-up with more advanced exercise routines that address range-of-motion, strength, and flexibility as the patient improves.
So, remember to stay active by incorporating toning as well as stretching exercises to compliment your cardio routine. Your body will thank you with fewer ailments!If you would like more information about treating this or other conditions, or would like to schedule an appointment, just give us a call at the clinic.
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