By Mike Dixon RMT
Frozen shoulder is a lay term used for a condition called Adhesive Capsulitis. Adhesive Capsulitis is a more accurate term to describe the condition. This means the shoulder capsule becomes inflamed and adhered. The suffix “itis” means inflammation. When the capsule gets inflamed the body lays down fibrin to heal the area. This fibrin (scar tissue) causes the capsule to become adhered. The result of laying down of fibrin causes the shoulder to become “frozen”. What this really means is that the range of motion becomes very limited. Thus simple tasks like combing your hair or reaching to the upper shelf becomes very difficult.
The first stage of the condition is called the Freezing stage; this is the inflammation stage where the tissue around the shoulder is inflamed. With inflammation you get the five cardinals signs and symptoms. They are Pain, Swelling, Heat, Redness and loss of function. This is the painful stage. Often awaking the person at night which results in lack of sleep.
The second stage is the “Frozen Stage” this is when the inflammation has subsided and the shoulder becomes severely limited in its’ range of motion. This is due to all the scar tissue that the body has laid down due to the inflammation.
The third stage is the “Thawing Stage” This is when the shoulder starts to become mobile again as it unfreezes. One explanation of why this occurs is because the condition is no longer painful; the person can now start to move the shoulder again with little to no pain. With movement the joint produces a lubricant called synovial fluid. The fluid works its way into the capsule which is like grease for the joint. As the joint becomes more and more lubricated the adhesions (scar tissue) starts to break up and is reabsorbed by the body. Mobility and function returns. The cycle is complete.
The answer to this question is not clear. There is no known or exact cause but there are some pointers or tendencies towards this condition. The number one pointer is being female and fifty. In Japan it is so common they called it the fifty year old shoulder. It may to related to menopause and hormonal changes another related cause is a fall or traumatic event such as a motor vehicle accident or a FOOSH injury (falling on a outstretch hand).
In the freezing stage (painful stage) the treatment is primarily pain management. Gentle massage and passive range of motion techniques help to maintain mobility and reduce pain. Ice applications can help reduce the inflammation thus reducing pain. Care must be taken not to over cool this skin thus causing an ice burn.
In the Frozen stage, massage and the introduction of stretching and joint mobilizations help to restore mobility. Specific exercises can also help prevent muscular wasting (atrophy) and maintain joint biomechanics and integrity.
In the thawing stage it is helpful to ensure that proper exercise techniques are performed as range of motion increases. Joint mobilizations help to expedite the recovery process. Massage helps with muscular tension and soreness from the immobility. There is help available for this condition. See some pictures of some exercises below
To be assessed or treated with this condition please make an appointment with Mike Dixon RMT at the link below.
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