Frozen Shoulder - 3 Ways to help you heal

“The shoulders are the busiest parts of the body we have… Reading a person’s mind is watching how they position them.”

Two weeks ago we mentioned all the common injuries that could appear from midlife on and make daily life more complicated. Now we are breaking them down and will post videos in our library with prehab and rehab exercises as well as how to adjust your workouts when one part of your body is “compromised”.

Frozen Shoulder

Adhesive capsulitis, more commonly referred to as frozen shoulder, is a condition involving pain and stiffness in the shoulder joint that often develops from long periods of inactivity, usually the result of surgery or a broken arm. According to the Mayo Clinic, signs and symptoms typically begin slowly and then gradually worsen over time, eventually improving within a period of one to three years.  For some people, the pain worsens at night, sometimes disrupting sleep.  

Symptoms

There is typically a three-stage period of development for the specific symptoms of frozen shoulder:

• Freezing stage (usually lasts from 2 to 9 months) is when the shoulder's ability to move becomes severely limited to the point where any movement of the shoulder causes pain. 

• Frozen stage (usually lasts from 4 to 12 months) is when there might be some lessening of the pain, although the shoulder becomes stiffer and more difficult to use.

• Thawing stage (usually lasts anywhere from 5 to 24 months) is when there is marked improvement in the shoulder's ability to move. 

The Joint and its Instability

The shoulder joint is considered to be one of the most mobile joints in the body, which allows for a wide range of motion, but this increased mobility also makes it inherently less stable than other joints, such as the hip or knee.

One reason for the shoulder's instability is its unique anatomical structure. The ball-and-socket joint of the shoulder is made up of the head of the humerus (the upper arm bone) and the glenoid cavity of the scapula (the shoulder blade). The glenoid cavity is relatively shallow and small, which means that the humeral head has less surface area in contact with the glenoid, which makes it more prone to dislocation.

Another reason for the shoulder's instability is that the rotator cuff muscles, which provide stability to the shoulder joint, are relatively small in comparison to the large muscles that surround it, such as the deltoids and pectorals. This means that the rotator cuff muscles may not be able to keep the humeral head centered in the glenoid cavity during certain movements, which can lead to instability.

Additionally, the shoulder joint relies heavily on the stability provided by the surrounding ligaments, tendons, and muscles, and injuries to these structures can also contribute to shoulder instability.

Overall, the shoulder joint is less stable than other joints in the body due to its unique anatomical structure, the size and location of the muscles that provide stability to the joint, and the reliance on the surrounding ligaments, tendons, and muscles.

Diagnosis

During a physical exam, a health care provider might ask you to move your arm in certain ways. This is to check for pain and see how far you can move your arm (active range of motion). Then you might be asked to relax your muscles while the provider moves your arm (passive range of motion). Frozen shoulder affects both active and passive range of motion.  Although it can usually be diagnosed from signs and symptoms alone, imaging tests (X-rays, ultrasound, MRI) can rule out other problems.

Treatment

The ultimate goal for most frozen shoulder treatment focuses on controlling shoulder pain and preserving as much range of motion in the shoulder as possible. Treatment typically involves physical therapy that utilizes range-of-motion exercises.  A physical therapist can teach these exercises to help patients recover but a patient’s commitment to continuing these exercises is necessary to regain as much movement as possible.  In some cases, other treatment options include the use of corticosteroids and numbing medications injected into the joint. One of the most helpful treatments would be acupuncture, to move the shoulder from a frozen state, improve range of motion and lessen the pain. Ultimately prevention is key (see below), especially to avoid a reoccurrence.

Causes

The shoulder joint is enclosed in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement.  Although research has found no specific reason why frozen shoulder only affects some people, medical experts agree that the likely cause is inactivity of the shoulder for a prolonged period of time.  This restricted movement can be the result of numerous factors, including: rotator cuff injury, broken arm, stroke, or recovery from surgery.

Risk Factors

Certain factors may increase the risk of developing frozen shoulder, such as:

• Age and sex (people 40 and older, particularly women, are more likely to have frozen shoulder).

• Systemic diseases (people who have certain diseases appear more likely to develop frozen shoulder). Diseases that might increase risk include:

• Diabetes

• Overactive thyroid (hyperthyroidism)

• Underactive thyroid (hypothyroidism)

• Cardiovascular disease

• Parkinson's disease

Prevention

One of the most common causes of frozen shoulder is not moving a shoulder while recovering from a shoulder injury, broken arm or stroke. If your frozen shoulder symptom is related to diabetes or thyroid conditions, improving the symptoms related to these conditions, could help alleviate the discomfort too.

Here are three ways to strengthen the connective muscles and keep them mobile and supple:

• Interlacing your fingers and pointing both palms up towards the ceiling, while hugging your ears with your arms. This stretch lengthens the biceps and forearm muscles, maintains range of motion in the wrists to not compromise movement in poses like downward dog.

• On all fours, thread your right arm through to the left side, under your left armpit and then rest on the outer arm and your right temple. This stretches the back of your arm, shoulder and into the midback.

• Sitting comfortably on the floor or on a mat, hold the right side of your head with your left arm and gently pull your head to the left. Now shrug your right shoulder up and then release and relax it down while pressing into the floor with your right hand to create some stretch and tension. This releases the trapeze muscle and muscles in your neck.