FROZEN SHOULDER aka ADHESIVE CAPUSILITIS
Although the name of this condition suggests 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 the 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 and in most cases it just never gets to this point. 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 intention, 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 this clinic we’re past the cause, we’re working for the result. Let’s get your shoulder back to normal.
First off, we 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.
What we’re trying to accomplish in our clinic is a few different things:
Stop the pain
Stop or limit the negative progression (loss of ROM)
Begin and continue the recovery process
Do this all WAY FASTER than the natural progression
We have a good track record in this clinic with the treatment of this issue and typically the problem is resolved over the course of a few months. We are always working on ways to get even faster results but realize this just isn’t the classic injury we see clinically. The recovery for most of the ‘acute care’ issues we see is quick. This one takes time.
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 time table 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.
What we’re working towards is SPEED and RECOVERY.
If you’re willing to do some basic rehab on your own, I feel our office is a great fit for you as we have the ability to move the joints, work the muscles and actively pursue increasing your ROM and I feel we do a great job. We set it up and you do the hard work and rehab on your own. If you just don’t have the time to get the work done yourself or just aren’t comfortable with repeat visits in our clinic, then I suggest PT and we have some great ones in town I can recommend.
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. You do these at home. I’m not going to have you pay me for things you can do on your own.
Adjustments to the shoulder and surrounding area instantly create motion. The muscle work we do here is our 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.
Results are good and major pain reduction is usually within the first few visits where we can then really work towards deeper muscle release and moving the joints.
We’re a clinic 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. This handout is an effort to explain what is happening so you know the “why’s” of your condition and our approach.