This may be a new one to some of you. For those who have dealt with it, they know it all too well. Frozen shoulder or adhesive capsulitis is not a fun problem to have. It is incredibly painful and burdensome. As it progresses your ability to move your shoulder becomes limited, hence frozen. In this article I will break it down for you. I will also lay out what we do differently with treating frozen shoulder and why that is so effective. It is not my intention to get into the nitty-gritty details of the condition, don’t want to bore you too much 😉 but just give a good overview.
What is it?
Adhesive capsulitis is an inflammatory condition of the shoulder joint capsule that causes fibrosis. Just think of fibrosis as scar tissue. As this tissue builds up the joint becomes stiffer and your ability to move it decreases. External or lateral rotation is among the movements most effected. It is also quite painful. It is even more frustrating if it is your dominant arm.
There are generally three phases:
- Freezing or painful phase: This phase is characterized by gradually increasing pain and decreasing range of motion. It is often painful at night causing sleep disturbance.
- Frozen or adhesive phase: During this phase, the joint is freezing up and tends to be painful only at the end range of motion.
- Thawing or resolution phase: The last phase ends with spontaneous recovery. Gradually, movement starts to return to the arm.
How long does it last?
It is considered a self-limiting condition. But do not think that means it is quickly resolved. It can take anywhere from 1 to 3 years, sometimes even up to 5 years! Many patients continue to have symptoms past 3 years. A small percentage may have symptoms for a very long time.
This is why it is very important to get effective treatment sooner than later. Though sadly, the typical treatment can be long and painful, lasting up to a year or more.
This is an important area to consider. Think of having your dominant arm start to become painful to use. Over a period of months the pain gets worse. But something else happens, you are unable to move it as well. You cannot raise your arm easily and when you do it is painful. You cannot reach behind you. It soon becomes stiff and almost useless.
Now imagine your daily routine. Maybe you work as a farmer, or in construction, or just think of your daily habits. Think of putting on clothes, shaving, brushing your hair, carrying your child, etc. Now think of not being able to use your dominant arm for those activities. Or at least is completely limited and painful. That is what we are talking about. It is a terrible condition. Not meant to scare you, but to put it in perspective.
It makes me think of times when I hurt my back or I wake up with dreaded “crick” in my neck. I cannot turn, lift, or move the way I would like. It is painful too. I cannot even fathom what that would be like for years rather than the typical few days it lasts. If you have dealt with frozen shoulder, you may be nodding your head right now. But that is why we are here to help!
Who is in the line of sight?
Women above 35 years of age account for the majority of cases. And that correlates with the cases I have seen with it. There are quite a few risk factors but to name a few, a history of diabetes, stroke, thyroid disorder, or a previous shoulder injury puts you at a higher risk. Thyroid disorders are also more common in men than women. There are many other risks, but I wanted to at least put down a few. If you would like to see the full list check out the link in the sources at the bottom. There is a lot more information there too, but just search for risk factors.
A Bit on Diagnosing
As you have come to see, we are not your typical chiros. Like many other conditions, I take big picture view. I want to see how my patients are moving. So I will often put them through different movements and test their muscles to see how they are holding up. I also want to understand their overall health, so I ask detailed questions about diet, nutrition, and other aspects of their health.
All of these are very important in the treatment process. And as I have said before I am not that much concerned with the diagnostic process as much I am about applying the appropriate treatments. That may sound counterintuitive, but we get really bogged down in the diagnosing. This wouldn’t be a problem if it effected the treatment much. But often times the time spent diagnosing with various tests doesn’t change the treatment very much. And my motto is “if the test doesn’t change the treatment, why do it?”
That being said, I do utilize manual muscle testing and other diagnostic tools in helping me determine what is going on and how to treat it. I don’t want to be too controversial. 😉
The number one tool I use for treatment is myofascial release. Fascia is such an important and overlooked structure in our body. It is the connective tissue that covers our muscles, joints, and organs. It is throughout our entire body and it is so important in managing this type of issue. Check out my other blog on fascia to learn more.
Utilizing manual muscle testing, I can effectively identify which areas need myofascial release or reconfiguration which is a more accurate term for it. It is essentially a circular rubbing of a particular area of tissue. Those areas are found in a pattern, similar to like peeling back an onion a layer at a time. Each area needing the treatment at a particular time. These areas are inflamed and angry. So it can be quite uncomfortable. But in my time in practice, I have found no suitable alternative. And the results are often amazing.
I for one love getting myofascial release because I know I will feel like a million bucks when I am done.
I will also give some exercises that will help speed up recovery but mainly the focus is on treating with myofascial therapy.
So I wanted to share with you two cases of people with frozen shoulder I have treated. One was a young female who was in the beginning stages of it. The arm was starting freeze up and it was very painful. She could not bring it up to shoulder level. The interesting thing with this case was I didn’t work on the shoulder at all. It was the opposite hip. We have fascial connections between our shoulders and the opposite hips. By doing a few areas on that hip for 30 min, her shoulder loosened up and the pain went away.
The other case was middle-aged female who was 6 months into her physical therapy treatment. She still had very limited use of her arm. Barely could lift it chest high. The exercises they were having her do were not effective so she came to see me. This is not to denigrate physical therapists, there many good ones, just this treatment wasn’t working for her case.
She came in for 2 treatments, that is right just two. The first visit within 1 hour, she was able to move her arm almost completely through its entire range. By the end of the next visit, it was completely restored and pain free. This is not toot my horn at all. But through applied kinesiology and appropriate treatment we are able to get at the crux of a problem rapidly and address it. Those are two of many stories of people we have helped with various issues. I hope it helps to hear their stories.
Frozen shoulder can be scary, but it doesn’t have to be. There is hope. We pride ourselves on being to help people with many ailments, but our satisfaction is watching people being able to do what they love best. If you have frozen shoulder or any shoulder pain or you know someone who does feel free to reach out, ask us questions. We would love to be of service.
1. Physiopedia contributors, “Adhesive Capsulitis,” Physiopedia, , https://www.physio-pedia.com/index.php?title=Adhesive_Capsulitis&oldid=237129 (accessed August 18, 2020).
2. Featured photo: Africa Studio/Shutterstock.com