Frozen Shoulder
Frozen shoulder (Acute frozen shoulder in this article, we’ll discuss ‘chronic’ [non-injury caused] frozen shoulder elsewhere) is the colloquial term for a condition that can happen after an injury or a significant shock to the shoulder joint (Like falling on an outstretched arm, possibly tearing ligaments or other capsular components, or just ‘shocking’ it). In the days to weeks after such an incident, the joint can start to ‘freeze,’ where it starts having severely limited range of motion, and increasing amounts of pain. It’s quite common to not be able to lift your arm up to or past parallel with the ground, and being able to reach bra clasps behind your back is typically an impossibility. Severity varies, but some people end up having very minimal use of the arm at all. This is a condition which is remarkably common, and can be significantly disabling. Even though it is ‘temporary,’ in that it’s typical length of effect is 9-18 months, sometimes up to three years before it ‘thaws’, most of the medical community has very little help to offer to improve and more quickly resolve this condition. We can do better.
Frozen shoulder is a perfect example of one of the most primary strategies the body uses to protect itself from injury: it limits range of motion and compresses joints. Frozen shoulder is not something ‘gone wrong,’ as a reaction, but a protective mechanism meant to allow your shoulder to heal. The shoulder joint as the greatest range of motion of any joint in your body, and the arm is quite long for the joint it’s attached to so has a lot of leverage. Mix that with the complexity of the shoulder joint itself and the brain is easily able to realize that a perceived injury to the shoulder is a good reason to lock it down until it can heal. So the brain actively does just that, increasing the ‘resting muscle tone’ (the pre-set tightness/tension of the muscle, if you want to think of it that way) to keep the joint in a more restricted range of motion while it has a chance to heal, minimizing further injury.
The problem comes in by the fact that the brain doesn’t just shut off this mechanism once the injury has healed and so if it took 5 months to heal…it may still take another year to ‘thaw’ and return to normal. At the same time, frozen shoulder is functionally like you are flexing your shoulder 30% nonstop. To say it gets painful is speaking very lightly! A range of secondary symptoms come out of this like an inability to sleep due to not being able to find a non-painful position, neck pain, and pain in other areas that have to compensate for the weird positions and demands put on the body while it’s unable to use the shoulder. And this is of course on top of the limited range of motion which can make it hard to even dress yourself and shower, let alone enjoy each day.
Most of physical medicine offers stretches at best, with minimal or at least incredibly slow outcomes, and medications for the pain. Many insist that there is little that we can do for it at all, but this is simply not true. So what do we actually do? The first step is lowering the hyper-sensitivity of the area itself. The muscles in the area that stabilize the shoulder joint have been severely over worked for a long time and the weight of a nickle is enough to cause a lot of pain on contact, and so we start with typically a single session of very very veeery gentle manual work on these stabilizer muscles (and a few ligaments of note in the area). This alone often brings back most of the range of motion, though not always ‘full control’ by itself. We follow this with more complicated neurological techniques, where simply put we stimulate different kinds of nerves around the shoulder, showing the brain that different vectors of movement, especially those that mimic the original injury, are not in fact a threat to the shoulder anymore. The result is the brain is able to realize that it doesn’t have to hold this protective guarding pattern anymore, and can return to normal use of the shoulder.
Most of this approach can be done in two sessions, though for those who have previous injuries to the shoulder, neck, and other areas which are ‘adding load,’ to their frozen shoulder, it may vary. Similarly, where we catch someone in their frozen shoulder process can make a significant difference in either direction. For those who have just been injured, if we catch them before the ‘freeze,’ we may be able to stop it from happening entirely if it’s a minor injury or just a shock, or at least lower the intensity of the freeze while it goes through it’s healing in more significant injury cases. During healing we’re still able to improve range of motion and have a significant impact on pain (While also most commonly referring to local practitioners which use cold laser [which literally improves healing speeds of injuries], acupuncture [which can help remove some barriers to healing speeds, and help pain], or other modalities), and speed up the overall process. If we get to you when the shoulder is still frozen, but any injury is fully healed, it’s a relatively quick process.
If you have a frozen shoulder, or have someone in your life who does, let us help take care of it.
So a year ago I had a little fall at work. I landed face first with hands down to brace me on the carpet after falling over a couch. It took a couple of weeks before it started to hurt, but when it started my shoulders ached all the time, and I soon lost range of motion. I let this continue for 5 months before I went to the doctor. she told me without extensive PT it would go away in @ 18 months. Corey found out, and he said " I can fix that for you!" He worked on pin pointing the problem and worked on my shoulders. in one 45 min session I had 100% use of my right shoulder by the next day. My left shoulder was worse that took another half hour a week later, but I also had 100% use after the session. There was no pain involved in the treatment, it actually felt good, like a really deep massage. I am so glad I listened to him, and would recommend this for anyone with frozen shoulder or deep muscle issues. Thanks Corey you saved me a year of pain.
-Barbara Grider