Frozen Shoulder/Adhesive Capsulitis

Although the name of this condition suggests a complete lack of mobility and motion, the modern idea of this shoulder issue is a little different than the classical name. Decades ago, shoulder slings were used for just about all shoulder pain. The lack of movement, especially for this condition led to complete immobility and hence the name: FROZEN SHOULDER.

We’ve come a long way on treatment options in modern sports medicine and the sling has gone the way of the dinosaur for most shoulder injuries. More importantly, the introduction of movement and focus on Range of Motion immediately upon diagnosis and presentation made a huge difference in stopping the complete lack of motion. This in turn has led to a better prognosis and shorter recovery time. That’s the good news.

The bad news is this condition still takes a long time for recovery and despite all the best intentions, wishes and prayers, there is still no magic fix for this.

Although there is debate over what causes the condition (hint: lots of things could be the cause), by the time you are in a clinical setting, you’re typically past “the cause” and are working toward results.  Let’s get this shoulder back to normal.

​First off, I want you to be ready for the progression of this issue. Here’s what to expect:

​Classically, in the beginning, there is pain with movement most of the time. Sleeping hurts, getting things out of the fridge hurts, reaching in the back seat hurts. It just hurts! Over the course of weeks and sometimes months the movement becomes notably decreased. Untreated, the condition gets to a “critical point” or the point where it doesn’t get any worse. It’s at the tipping point. Over time this condition is almost always self-limiting, meaning IT WILL GO AWAY on its own. Waiting, however, is a poor choice. Get movement back!

  1. Stop the pain
  2. Stop or limit the negative progression (loss of ROM)
  3. Begin and continue the recovery process
  4. Do this all- WAY FASTER than the natural progression

From my research, PT, Chiropractic, Laser, Surgery, ortho intervention all seem to work. As stated earlier, the condition is self-limiting so over a long enough timetable, everything works. Personally, I would be very hesitant to try surgery on anything that is going to get better on its own. The twist is, there doesn’t seem to be anything that works better than the other. I’ll correct that, everything works better than, “just rest” and doing nothing. Your treatment options depend on your personal life.

Work toward SPEED and RECOVERY.

If you’re willing to do some basic rehab on your own and have the ability to move the joints, work the muscles and actively pursue increasing your ROM you can beat this. If you just don’t have the time to get the work done yourself or just are more comfortable with repeat visits then look towards a modern style therapist.

Cortisone injections are popular for this issue and over half of my clients that present with Frozen Shoulder have had them. Clinically, I haven’t seen a lot of results with the injection both in the research and in our clinic, most likely because the issue is past the inflammatory phase by the time we see you.

Exercises MUST BE PERFORMED DAILY! Basic moves such as active motion with weighted distraction and manual ROM as well as releases especially along the pec and post shoulder speed recovery. 

Chiropractic Adjustments to the shoulder and surrounding area instantly create motion. But muscle work is key for this condition and has to be the main focus, working towards making the stiff tight muscles, more supple and pliable and trying to force more blood and oxygen into the area speeding recovery.

​At my clinic, we’re known for quick results and we pride ourselves on applications that fix injuries in 3-4 visits. This condition doesn’t respond like that, it takes time, it takes repetitive treatments and homework. We’re always looking for that “missing link” and because there are many different factors causing in essence, different versions of “frozen shoulder” different approaches and trials are needed.

I do feel comfortable telling you that recently, the cupping methods, not the leave a cup on for a giant hickey but more the techniques that slide the cups along the muscle and superficial fascia have been having a much bigger impact than other therapies we use. This is especially true if there are scars through the shoulder, chest or upper back. At home rehab, just getting a client to take the arm and shoulder into New Found Range of Motion is a key component.

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