The condition commonly referred to as “frozen shoulder” is actually called adhesive capsulitis. This is a condition where the muscles of the rotator cuff become inflamed and resisted to motion, so severely, that the joint capsule around the shoulder actually becomes increasingly stiff. This condition starts with very minimal weakness or stiffness in a one shoulder joint (left or right), which slowly progresses to a very serious level.
(Which muscles aid shoulder movement? Basically, everything pictured!)
When I say it starts slowly, I mean the initial symptoms might be as simple as weakness or quickly feeling tiredness when reaching or doing work overhead. The rotator cuff is primarily comprised of 4 muscles (Supra/Infraspinatus, Subscapularis and Teres Major) but muscles that also contribute and aid to the function of the shoulder are the biceps brachii, coracobrachialis, triceps brachii, latissimus dorsi, rhomboid major/minor, trapezius, pectoralis major/minor, and serratus anterior/posterior. The primary muscles that directly move the shoulder (Supra/Infraspinatus, Subscapularis and Teres Major) tend to start the problem with weakening and losing range of motion (ROM), which requires the accessory muscles to try harder to compensate for the lost strength and control. This may not be noticed initially, but with continued neglect and/or usage of the shoulder, the muscles will continue to weaken. Compound this weakening with the sudden need to use the shoulder, let’s say, sporadic yard work or home repair, the muscles can easily become damaged. The scaring of the muscles that takes place would only further reduce the ROM of the joint, thus causing the accessory muscles to again compensate more. This snowball effect will continue until the barely noticed injuries result in a remarkably reduced ability to move the shoulder with consistent pain with movement.
How is it treated?
There are many ways to treat adhesive capsulitis, the most frequently used is cortisone injections from a primary care physician. This type of treatment works remarkably well in the short term, but should not be relied upon in the long term. The cortisone will reduce inflammation, as is its purpose, but repeated injections in to the joint over long periods of time (years) will cause the bones to deteriorate. This will lead to arthritis and potentially joint replacement. This obviously is not ideal.
The best option is myofascial release coupled with physical therapy. Not everyone is a candidate for this treatment. If you are able to move your arm with mild to moderate discomfort, this treatment might be an excellent option. If you can barely move your arm at all and it’s exquisitely painful, this treatment might not be ideal. What this treatment involves is a practitioner physically massaging and stretching the muscles of the shoulder a little by little to restore proper motion. This treatment coupled with specific at home exercises should be able to restore proper motion and strength to the joint. The benefit of this treatment is once it is complete, there should be 100% function restored to the shoulder. The downside is that the treatment can be uncomfortable. The discomfort is due to the doctor having to massage and stretch the area that hurts. This is typical of virtually all manual therapy, thought.
The last option is arthroscopic surgery. Once this condition gets to the point where you can no longer move the joint, the only option is for a surgeon to physically cut away the parts that aren’t functioning. This obviously changes the physical structure of the joint, and requires lengthy healing time and physical therapy after the fact.
Here at Herrington Family Chiropractic, I can not only manipulate the spine to ensure associated joints pertaining to the shoulder are functioning properly, but also administer a multitude of muscular treatments to break the adhesive scarring of the joint. Treatment can vary from MRT, Graston, US, to cold laser therapy, and couple that with the specialized at home rehab exercises you need to ensure you get the best recovery possible, and get back on your way to being happy and healthy. Many patients become disheartened with the slow recovery from adhesive capsulitis, but the condition took multiple years to obtain, so the recovery can’t happen in within a visit or two. Normal treatment plans for this condition are usually 6-8 weeks depending on how well the patient recovers between visits, and how well they adhere to the recommended home exercises.
If you or anyone you know suffers from sore stiff joints, send them this information and have them schedule an appointment. The sooner you treat yourself, the sooner you can get back to treating yourself!