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Frozen Shoulder (Adhesive Capsulitis)

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Health In The Bay Frozen ShoulderSigns/Symptoms

  • Frozen shoulder is characterised by stiffness and restriction of movement leading to a high degree of shoulder joint immobilisation (passive and active movements).
  • In most cases there is also some localised pain that can also cause secondary pain in the neck and trapezius muscle.
  • Patients are generally unable to raise their arm above 45 degrees and often any movement that involves external shoulder rotation inhibits pain.
  • Pain at night is often more severe, and a secondary side effect of frozen shoulder is insomnia.
  • It is most common over the age of 40 and more prevalent in woman.
  • Symptoms can often last from 5 months to 3 years, but healing time can be reduced with appropriate therapy, stretching and preventative techniques.

 

Causes

  • It is most commonly caused by thickening and contraction of the joint capsule – the connective tissue around the bony structures of the shoulder joint. There can also be a lack of synovial fluid in the joint
  • Can be caused by injury, however, it may also be a secondary symptom of thyroid, metabolic disease, stroke and auto-immune disease. Higher incidence in smokers. In many cases, there is no recognisable cause.
  • In Eastern medicine – deficient cases, there is a lack of nourishment (Ying Qi), leading to tendon/muscular weakness. In excess cases, wind/cold/damp/injury penetrates the shoulder joint causing local Qi/Blood stagnation in the channels (often Colon/Small Intestine channels). Can also include Gall Bladder, Lung, Triple Heater and Pericardium channels.

 

Treatment

  • Aims to reduce pain, increase recovery time, increase range of movement and prevent worsening of symptoms.
  • Western medicine treatment aims to reduce pain and inflammation with anti-inflammatory drugs, and if particularly severe, steroid injections are used. Chronic painful issues are sometimes treated with surgery.
  • The most effective method of recovery is to continue a full range of movement within the joint to prevent further joint stiffness and muscle loss/weakness. Therefore, physical therapy generally involves range-of-motion exercises. Functional exercises should include moving the diseased shoulder in abduction, adduction, internal rotation and external rotation – morning and night.
  • Other therapies that can be effective are massage, acupuncture, herbal linaments and stretching. Common acupuncture points include SI9,10, LI4, 11, 14, 15.

 

A Knotty Problem

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Health In The Bay Knot

It is likely that most individuals have at some point in time experienced sensations of pain and discomfort caused by “knots”, also known as Trigger Points. These are painful areas in the muscles that cause pain to refer into other parts of the body, as well as create symptoms of weakness and fatigue.

A Trigger Point is the body’s response to a physical, emotional or chemical disturbance where the muscle becomes contracted or over-lengthened for extended periods of time preventing it from returning to its rest position. This then restricts the movement of the muscle and decreases circulation. The muscle then becomes deprived of nutrients and oxygen, which results in a collection of metabolic waste.

The most common causes of Trigger Points are poor posture, structural imbalances, repetitive activity and overuse, emotional factors, and direct trauma or injury. These points can occur in any muscles of the body, but are most commonly found in the neck and upper back. Trigger points can themselves bring about a variety of issues, such as tension headaches, tinnitus (ringing in the ears), jaw pain, lower back pain and carpal tunnel syndrome.

Trigger Points can be effectively treated with massage therapy where direct pressure is applied to the area in question. Upon compression, the Trigger Point will often reproduce the individual’s pain pattern. As the muscle relaxes, the pain and discomfort should then diminish.

Self care is also important to help prevent the re-occurrence of Trigger Points. This can include using a heat pack when muscles are tense or painful, having hot baths after treatment, keeping well hydrated, and carrying out simple stretch and range of motion exercises. Your massage therapist will be able to assist you with such exercises, and is also there to answer any questions or concerns that you may have.