Frozen shoulder, often referred to as adhesive capsulitis in the medical community, is a disorder that can cause chronic pain and dramatically restrict the natural motion of the shoulder. Many suffering from frozen shoulder frequently complain of just how debilitating the disorder is and the substantial impact it has on independently accomplishing activities of daily living. While there are many groups at risk for frozen shoulder, the exact causative factor(s) still aren’t clear.
Anatomy As It Relates To A Frozen Shoulder
The glenohumeral shoulder joint is a ball and socket joint that articulates the scapula bone and the head of the humerus bone. Three main ligaments are associated with the joint - the superior, middle and inferior glenohumeral ligaments; the coracohumeral ligament; and the transverse humeral ligament. A capsule of connective tissue encases the bones, ligaments, and tendons of the glenohumeral shoulder joint.
Frozen Shoulder
When the capsule, described above, becomes thickens and tightens around the shoulder joint and becomes inflamed, frozen shoulder occurs. There’s also a lack of synovial fluid to lubricate the space between the shoulder blade and upper arm bone. The combined action results in the shoulder bones not being able to move freely within the joint, and thereby restricting the range of motion a person has when using their shoulder.
Symptoms Of Frozen Shoulder
* Stiffness of the shoulder joint that gradually worsens over time
* Pain in the shoulder joint that gradually worsens over time
* Decreased shoulder mobility or lack of mobility that progresses over time and ceases after a number of years.
* Difficulty sleeping or finding a comfortable position
* Pain that’s worse at night and during colder weather
* Momentary intense pain and/or cramping that occurs after certain movements
The symptoms of frozen shoulder generally occur in three stages, with each stage lasting for months at a time.
1. Painful stage - pain with any shoulder movement and the beginning of motion limitations. This stage usually lasts for around six weeks to nine months.
2. Frozen stage - while pain decreases during this stage, the stiffness worsens and range of motion notably decreases. This stage may last for four to nine months.
3. Thawing stage - range of motion gradually improves. This stage can last anywhere from five months to over two years.
Causes Of Frozen Shoulder
Most experts agree that the exact cause of frozen shoulder has yet to be revealed. Some sporadic research has shown injury to the shoulder capsule may result from rotator cuff injuries; tendinitis; bursitis; and other injuries that cause shoulder joint scarring, thickening, inflammation, or capsule shrinkage. Research has also linked the following as risk factors in developing frozen shoulder:
* Cardiovascular disease
* Tuberculosis
* Parkinson's disease
* Diabetes
* Thyroid disease
* Chronic inflammatory arthritis affecting the shoulder
* Any event that causes a long term immobility of the shoulder joint, such as surgery or stoke.
* A previous trauma to the shoulder area
* Statistically, women over 40-years-old are at the greatest gender and age-related risk (around 70% of frozen shoulders occur in women)
* May be a possible adverse reaction to certain forms of highly active antiretroviral therapy (HAART)
Strengthening Exercises
These Frozen Shoulder Exercises are ideal to build strength and flexibility.
Massage Treatment
These Frozen Shoulder Massage Techniques are of great value in pain relief; circulation stimulation; dispersing blood and fluid accumulations; swelling reduction; and relaxing muscle spasms, especially when used alongside the Sinew Therapeutics liniments, soaks and massage oil.
ACUTE STAGE SYMPTOMS AND TREATMENT
This stage is characterized by swelling, redness, pain, and possibly a local sensation of heat, indicating inflammation. If coolness makes your pain feel better, then the Acute Stage Treatment is recommended.
ACUTE STAGE SYMPTOMS:
The acute stage starts the moment an injury occurs and lasts until the swelling and inflammation are gone. The swelling is the result of the blockage of blood, tissue fluids and circulation in the shoulder because their normal movement has been disrupted by the force of the injury. Just like cars back up behind a traffic jam, causing congestion, exhaust and overheating; blood and fluids back up behind the injured shoulder, causing pain, inflammation, lumps and swelling.
The sensation of heat is due to the warming action of the blood and fluids overheating in the injured shoulder as they back up and accumulate. Stiffness and decreased mobility are due to spasms in tendons and ligaments that have contracted reflexively beyond their normal range from the impact of the injury.
As ligaments and tendons stretch and tear, blood from ruptured blood vessels becomes trapped in the local tissues. As the trapped blood clots up, it sticks the tissues together creating adhesions. Adhesions cause pain, inflammation and restricted movement because the layers of tissue that used to slide smoothly across one another now adhere and snap which interferes with normal functioning. It is essential to break up clotted blood as quickly as possible to prevent adhesions and scar tissue from forming.
During the acute stage it is very important to restore normal circulation to the shoulder, break up clotted blood and stagnant fluids, reduce swelling, and reduce the redness and heat associated with inflammation. By restoring the flow of blood, fluids, and circulation in the shoulder, then pain is relieved, damaged tissues can regenerate with healthy functional tissue, and the shoulder can strengthen and regain it's mobility.
ACUTE STAGE TREATMENT:
1. Apply the Sinew Herbal Ice on your shoulder to reduce redness, swelling, and inflammation while dispersing accumulated blood and fluids to help restore normal circulation to the shoulder. This first-aid treatment is used in place of ice to significantly speed up the healing process. It reduces the swelling and inflammation more effectively than ice, allowing you to more quickly regain range of motion. Acute Sinew Liniment can be used in-between applications.
Ice is not recommended because it does not help repair damaged tissues and keeps everything in the injured area frozen, causing the stagnation of blood and fluids and the contraction of muscles, tendons and ligaments. In Chinese sports medicine ice is not used and is considered a culprit in injuries that don’t heal well.
2. Massage your shoulder with Acute Sinew Liniment to relieve pain, reduce swelling and inflammation, break up clotted blood and stagnant fluids, and stimulate circulation of blood and fluids to help cells quickly repair damaged tissues. Sinew Herbal Ice can be used in-between applications.
3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.
CHRONIC STAGE SYMPTOMS AND TREATMENT
This stage begins once the swelling and inflammation are gone, but you still feel pain, stiffness, weakness, and/or sensitivity in cold and damp weather. If heat makes your pain feel better, then the Chronic Stage Treatment is recommended.
CHRONIC STAGE SYMPTOMS:
The chronic stage begins once the swelling and inflammation are gone, but you still feel aching pain and stiffness. This is because there are still accumulations of stagnant blood and fluids in your shoulder that are blocking circulation and blood supply to damaged tissues, creating residual pain, stiffness and weakness. You may actually feel hard nodules like sand in the tissue, indicating accumulation, calcification, and adhesions, which all cause pain, stiffness, and joint instability.
Your shoulder may feel more sensitive to the cold and ache in cold and damp weather due to impaired circulation. When you move your shoulder you may hear a clicking or popping sound from the tendons and ligaments slipping very slightly in and out of their natural alignment indicating weakness and joint instability, causing chronic pain and a cycle of reinjury. These symptoms are often the result of failure to treat the injury properly from the outset and overicing.
Increasing circulation and blood supply to the damaged tissues is very important in treating chronic injuries because tendons and ligaments do not have an extensive direct supply of blood. That is why chronic injuries can be slow to heal. Increasing local circulation also prevents cold and dampness from penetrating the injured area, preventing pain and stiffness.
During the chronic stage it is very important to break up remaining accumulations of blood and fluids, and increase circulation and blood supply to the damaged tissues. By increasing circulation and blood flow in the shoulder, then pain and stiffness is relieved, and the tendons and ligaments can strengthen to restore stability.
CHRONIC STAGE TREATMENT:
1. Massage your shoulder with Chronic Sinew Liniment to relieve pain and stiffness, strongly stimulate circulation to damaged tissues, and promote the healing of overstretched tendons and ligaments. Sinew Injury Poultice and/or the Sinew Relaxing Soak can be used in-between applications.
2. Apply the Sinew Injury Poultice on your shoulder to relieve residual pain and stiffness, significantly stimulate circulation to damaged tissues, and further promote the healing of overstretched tendons and ligaments. The Sinew Injury Poultice is particularly useful if your shoulder is more painful in cold and damp weather. Chronic Sinew Liniment and/or the Sinew Relaxing Soak can be used in-between applications.
2. Soak your shoulder with the Sinew Relaxing Soak to relax muscles and tendons that are in spasm, ease joint pain and stiffness, and improve range of motion. The Sinew Relaxing Soak is particularly useful if you feel restricted mobility in your shoulder. The soak can be used by saturating a towel in the liquid and applying it to your shoulder. Chronic Sinew Liniment and/or the Sinew Injury Poultice can be used in-between applications.
3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.