My first experience with a client who had frozen shoulder was when I was undergoing practical training. The client was already diagnosed with frozen shoulder and the major concerns were extreme limited range of motion, certain movement causing pain and discomfort that is effecting daily life such as brushing or drying hair, putting cloth on. I still remember the face of the client telling me the story, the unhappiness, almost given up to this irritable shoulder.
I will come back to this story towards the end in ‘Treatment options and Remedial massage’ section to learn about remedial massage for frozen shoulder.
Firstly, we will learn more about this condition called adhesive capsulitis; AKA frozen shoulder, the condition that challenges your patience level.
What is Adhesive Capsulitis; AKA Frozen Shoulder
Our shoulder joint is a ‘ball-and-socket’ joint. Made up of three bones; upper arm bone (humerus), shoulder blade (scapula), and collar bone (clavicle). The head of the upper arm bone fits into a shallow socket in the shoulder blade with surrounded by strong connective tissue, called the shoulder capsule.
When the shoulder capsule thickens, inflames and becomes stiff and tight. Thick band of tissue, called adhesions, develop. Causing adhesive capsulitis; aka frozen shoulder. In many cases, there is less synovial fluid in the joint than it should.
Frozen shoulder is still not fully understood. There is no clear connection to arm dominance or occupation. Only few factors have higher chance of risk for developing frozen shoulders, which are; Diabetes, immobilization due to an operation or injuries, other medical diseases which involves hypo/hyperthyroidism, Parkinson’s and cardiac disease. Also, most commonly affects people between the ages of 40 and 60, and occurs in women more often than men.
Stages and Symptoms
Frozen shoulder doesn’t happen suddenly, especially the ‘frozen’ phase. Pain gradually starts and the more discomfort that you feel, then leads to the frozen state which lasts long from few to multiple years.
Freezing: You slowly have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.
Frozen: Painful symptoms may actually improve during this stage, but the stiffness and limited range of motion remains. During the 4 to 6 months of the “frozen” stage, daily activities may be very challenging.
Thawing: Shoulder motion slowly improves during this stage. Complete return to normal or close to normal strength and range of motion typically takes from 6 months to 2 years.
As above the main symptoms are simple; pain in the upper arm or outer shoulder, dull or aching, and limited range of motion.
Treatment options and Remedial Massage
There are surgical and non-surgical options. Surgical treatment such as manipulation under anesthesia or shoulder arthroscopy, are medically releasing the capsule’s stiffness and freeing the shoulder joint from being in tight, thickened band of tissue.
Non-surgical treatment includes anti-inflammatory medication, steroid injection, other type of injection, and physical therapy/manual therapy and other complementary therapy; such as Remedial massage, dry needling therapy or acupuncture, which still helps to improve the symptoms.
These complementary therapies help to free up the surrounding soft tissues; muscles, tendons, myofascial, without being too aggressive to the tissue. And also, including specific exercises and stretches to improve mobility and re-setting neurological relationship.
Side note, if you’re getting an injection type treatment, it is better to rest, let it settle into the joint for 2 weeks and revise any manual therapy on the area of injection.
Back to my story with the client who had frozen shoulder when I was undergoing practical training. The client received 3 sessions of remedial massage each week and I included some deep tissue, trigger point therapy, lots of myofascial works around the shoulder, then some stretches were given to do at home. The client started to feel the improvement by reduce of pain, and range of motion of the shoulder was visibly increased by the end of the case study.
I occasionally still see clients with frozen shoulder and it is a great feeling that remedial massage treatment can help their daily life activity and chores. So yes, you can still receive light manual therapy and appropriate remedial massage techniques you’re your frozen shoulder/s. They are perfect for giving relief, increase of range motion and reduce pain level while moving the joint. I would definitely recommend myofascial massage, stretches and light dry needling therapy above the other techniques.
Daily tips for Frozen Shoulder
Stretches: light shoulder, arm stretches will help loosening tension around the shoulder joint. Well known ones are Door frame shoulder stretch, Forward flexion stretch, Crossover arm stretch.
Taping: Shoulder support sports tape will help easing the load off the shoulder joint and support the movement. This one you'll need to see a therapist to guide you first but it's relatively easy for you to self taping afterwards!
Myofascial stretch; assisted: Gentle tug, stretching the shoulder joint by getting hand from someone, this will give you relief and increase mobility for a period of time.
Magnesium and mineral supplement
Cold shower in the morning to ease the inflammation
At Harmonize Body Works, we're here to help your concern but also willing to teach you how to take care of your body while you're at home. To learn how to stretch, tape and massage yourself correctly, see Seonkyo from the clinic!
Reference:
Written by Seonkyo Kim; Dip. RMT
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