Stiffening in the shoulder can be caused by a variety of painful syndromes, collectively referred to as secondary frozen shoulder. However, the majority of shoulder stiffness cases arise from a separate syndrome in its own right (primary frozen shoulder). Idiopathic (unknown cause) Adhesive Capsulitis is a condition that is hard to understand.Woman between the ages of 40 to 65 are more prone to this condition. This condition has been referred as an "ENIGMA" in medical literature. Ernest Codman coined the phrase "frozen shoulder" in 1934. He found the condition difficult to define, treat and explain. After all these years and despite of all the research, confusion still exists and all that has been defined are theories.
The shoulder is a fascinating joint and is also the most difficult joint to treat. The shoulder is a joint complex which is made up of four joints, glenohumeral joint, acromioclavicular joint, sternoclavicular joint and the scapulothoracic joint. Aside from these joints, there are other anatomical structures that play a large role in normal shoulder function. These include the cervical spine (neck), thoracic spine (upper back), clavicle and ribs. The shoulder has heavy reliance on the muscles around the shoulder to act as dynamic stabilizers during movement of the arm. Dysfunction of the stabilizing mechanism, either at the shoulder joint itself or around the shoulder blade, combined with or without abnormalities in the anatomical arrangement of the structures around the joint, or biomechanical faults make the shoulder particularly prone to pain and injury. If any one of these structures is not functioning properly, they will have a direct negative impact on the shoulder complex. It is very important to keep this anatomy in mind because treating the body as a whole gives better predictable outcome
Frozen shoulder typically develops slowly and in three stages. Each of these stages can last a number of months:
Painful stage:During this stage, pain occurs with any movement of your shoulder and your shoulder's range of motion starts to become limited.
Frozen stage:Pain may begin to diminish during this stage. However, your shoulder becomes stiffer and your range of motion decreases notably. Avoid extreme movements that cause pain during this stage. But, you can, and should continue normal use of your shoulder.
Thawing stage:During the thawing stage, the range of motion in your shoulder begins to improve.
For some people, the pain worsens at night, sometimes disrupting normal sleep patterns.
This is a self limiting disease (it will get better on its own), may take three years or more. To know the truth ask somebody who has or is suffering from the condition. The condition never resolves on its own, the body only adapts to the debilitation.
- Traditionally, people who suffered from a frozen shoulder where told to "wait it out".
- Treat the inflammation with anti-inflammatory medication or corticosteroid injection.
- Refer to physical therapy where the therapist tries to control pain, heat and stretch and some strengthening exercises.
- Treatment is expected to be painful.
- Treatment is expected to take months.
Why traditional physical therapy is so painful and does not work?
- Heat packs applies to an already an inflamed joint causes more inflammation thus more pain
- Normal generalized strengthening programs are not appropriate, especially in true adhesive Capsulitis because strengthening muscles in shorter range worsens final outcome.
- True adhesive Capsulitis obtains very little benefit from aggressive (so called) long term physical therapy.
- These poor outcomes in physical therapy are probably due to severe impingement (without correcting biomechanical fault).
- For the same reason manipulation under anesthesia is so controversial.
- Traditional therapies are ineffective with unpredictable outcomes because the main focus is the shoulder joint only.
At Synergy Therapeutic Group We Treat you Differently
- Correcting the biomechanical problems in a systematic manner .
- Stabilizing the new position temporarily using specialized taping techniques .
- Stretching tight structures strengthening the weak muscles so that biomechanical correction can be permanent.
- Biomechanical correction using manual techniques (which causes minimal or no pain) and stabilization give immediate and dramatic results
- It is so dramatic that patients unable to sleep in the night usually sleeps in the night after first visit & may gain over all shoulder range up to 30 degree.