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A frozen shoulder is generally very uncomfortable and
makes life very awkward with the stiffness in the shoulder. The correct name is
adhesive capsulitis of the shoulder.
The onset is normally gradual and there are a variety of possible causes. Prior
problems with the neck or elbow are common as is a fall perhaps forgotten in
the previous few weeks or months.
The nature of a frozen shoulder is that it progressively
worsens and it is this very gradual deterioration that prevents many from
realizing there is a problem until at least 3 months has passed. Often the
affected arm will become painful making it difficult to sleep on that side at
night time. There will also be pain in the surrounding muscle bulk commonly.
The condition affects women more so than men and most frequently aged 40’s,
50’s and 60’s.
Unfortunately, the progressive nature of the condition
means that it is often not seen in clinic until it is very advanced, by which
time there is severe immobility of the shoulder.
On the upside, it is rare for there to be more serious
complications. Treatment osteopathically is normally sufficient for the
condition to improve substantially if a treatment program is completed.
For
competitive sports players, a structured rehabilitation program is essential
to restore mobility as well as for continued improvements in the shoulder.
At Osteoklinika we have had very good success with Frozen Shoulder patients!
Shoulder Anatomy
Of all the major joints in the human body the shoulder
joint has the greatest range of movement.This is facilitated by a very shallow
ball and socket which is held in place by the rotator cuff muscles – a group of
4 muscles and tendons surrounding the shoulder joint that also control the
complex motion of the joint.The process leading to a frozen shoulder is not
fully understood, although it is likely that damage or impingement of the
rotator cuff causes inflammation and stiffness. Because the joint is likely to
then be protected, the stiffness worsens gradually leading to a frozen
shoulder.
Unlike the back or the knee which are weight bearing, the
shoulder joints are such that you can protect them by reducing their usage. It
is likely that this becomes part of a compensation pattern subconsciously
meaning that the joint becomes further immobilized and the stiffness develops
still further.
Osteopathic Treatment
Once a frozen shoulder is suspected, osteopathic
treatment should be started as soon as possible, if the recovery time is to be
shortened as much as possible.
Medical opinion is that frozen shoulders
typically take 18 – 24 months to recover if untreated. The majority of patients presented to me at Osteoklniika are not frozen solid as they are seen earlier enough to
prevent that. These are then treated and recover normally within 2 to 3 months or even less!
It should be remembered that frozen shoulders are often
caused by or result in problems in other areas such as the neck, back or elbow.
It is therefore highly important that the cause and underlying factors are
properly investigated. An osteopath will help you by looking into any
underlying factors as well as posture and lifestyle. This is vital to ensure a
rapid recovery as well as ensuring that the injury is not allowed to recur.
Your osteopath will
use a variety of techniques in your treatment. These range from the very gentle
to the rather more forceful depending upon your situation and your preference.
They are likely to include treatment to the shoulder as well as to the neck and
back coupled with posture and lifestyle advice. Treatment will continue over a
period of weeks or months. However, we believe in Bio-Structural Integration™ at Osteoklinika and Low Intensity Laser Treatment for Frozen Shoulder.
Low
Light Laser Therapy and Bio-Structural Integration™ for Frozen Shoulder
Every cell in our body works synergistically together to maintain
homeostasis. When one system is disturbed the other cannot function properly.
In my method of Bio-Structural Integration™, I address the dysfunction at every
level. Within one treatment I use Cranial Osteopathy to release central nervous
system lesions. After that I use an Osteopathic Muscle Energy Technique to
correct the joints, followed by Myofascial Release of connective tissue.
Neuromuscular Massage is implemented to reduce muscular tension, and Electrotherapy helps to interrupt the pain cycle. All of the above is done
within a 1 hour treatment.
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| Laser Therapy for Frozen Shoulder |
After the structure is realigned I recommend Low Light Laser Therapy
(LLLT) to deal with inflammation as a result of the Frozen Shoulder. Healing is
now stimulated at the cellular level. This session may take 30 minutes to 1
hour depending on the condition being treated and the protocol selected. In an
acute situation we recommend a minimum of 12 laser therapy sessions. Elimination
of inflammatory process assists in structural stabilization of the joints. As a
result, muscles and ligaments relax; fascia releases its tension, flexibility
increases helping to bring back normal range of motion and reduction of pain
for the shoulder.
The program of rehabilitation could be up to 5 weeks long and provides
more than 90% of success in bringing back a pain free should and life! If you
have tried every possible known therapy and still have pain, you should not
give up. Surgery should be the last resort. During many years
of practice I developed protocols for numerous difficult-to-treat conditions
such as LLLT.
Shoulder
Advice
Keep using your shoulder joint as ‘normally’ as possible. Seek out a better pillow to ensure your sleep posture is allowing for minimal pain during the night. Seek advice sooner rather than later. Take professional advice and make sure
you follow it – there is no quick fix to treating frozen shoulder, it is a
gradual process. Make sure that you carry out any prescribed exercises
regularly. Avoid making the shoulder too painful as this will increase the
inflammation and stiffness, slowing down the healing process.
What
Do You Do If Osteopathy Does Not Work?
There are a small minority of cases where manual
therapies are insufficient and surgical options need to be considered. In this
situation a shoulder arthroscopy may be suggested to investigate, repair or
free up the frozen shoulder. Rarely, where there is extensive damage to the
joint, a replacement joint may be considered. However, it should be remembered
that this is a complex joint and surgical replacement is more difficult and
less common than hip or knee replacement.
Important
to Note
The purpose of this
article is to educate. While every effort has been made to ensure its accuracy,
its content should not be construed as definitive medical advice or health
advice. It is not a substitute for professional examination and advice. Because each individual’s health care needs
are unique and because medical knowledge is always evolving, please consult a
qualified health care professional to obtain the most current recommendations
appropriate to your needs. Neither the author nor the publisher shall be liable
for any outcome or damages resulting from reliance upon the content of this
publication.
For more information about inflammation and
pain, Andrew Subieta can be reached at Osteoklinika Pain Management & Rehabilitation
905.660.8810. Also, please check our website at www.osteoklinika.com for more information about Bio-Structural
Integration™. You can also find us on
Google +, Facebook, LinkedIn or Twitter pages.
