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What exactly is frozen shoulder?

Shoulder pain has been rated as one of the worst pains because, not only does it hurt, but it also limits just about everything in daily life. Trying to avoid the use of your arm can be extremely frustrating and frightening.

There are many causes that contribute to shoulder pain, so getting the correct diagnosis is the key.

Let’s explore the “frozen shoulder.” It seems to be a common complaint as we age. You’ll hear a friend speak about their shoulder “freezing up” and typically is accompanied by pain and lack of mobility. The truth is “frozen shoulder” is an over-generalized diagnosis, but the basic idea is that it is painful and your range of motion is limited.

The real diagnosis is called Adhesive Capsulitis. Simply put, if you suffer from Adhesive Capsulitis, your shoulder capsule, a fibrous pouch, has become stuck or rigid (hence the word frozen) and is usually irritated or swollen.

Research has found that, in many cases, adhesive capsulitis affects women more than men and the middle-aged population more than the younger.

How does this happen?

Disuse/Misuse-Use it or Lose it:

If you choose not to use your arm in its full range it can get tight. Normal everyday full-range movement lubricates the shoulder joint and keeps the capsule healthy. If you’ve ever fractured your wrist or elbow, you can compare it to casting it for months. When the cast comes off, it is very difficult to move and the muscles around it have often atrophied.

Possible Infection:

Infection is sometimes suspected. There may have been a “bug” that got into the shoulder capsule to make it inflamed, angry, and painful.

Poor Posture:

This is a wake-up call for all you desk jockeys. Often, poor posture can set you up for a forward shoulder and forward head position. This will create problems as you lift the arm above your shoulder height and cause impingements.

Repetitive Impingement or Injury Perpetuating a Lock-up:

Impingement is when your shoulder bone bumps into the top part of your shoulder (near your collarbone).

Maybe it’s something else…like the beginning of arthritis:

There’s no way to just quickly diagnose arthritis unless you have it checked out by an orthopedic doctor. A simple X-ray will tell you this. Arthritis can cause inflammation and it can be quite painful.

What should you do if your frozen shoulder persists?

-Postural corrections techniques

-Taping the shoulder doesn’t hurt to give you a little support

-In some cases, if we catch it before the freezing process gets worse, myofascial work can speed up the healing process.

-Although quite popular, try to avoid Codman’s pendulum exercises (holding a weight and dangling your shoulder, in theory, to help stretch the tight capsule). We have rarely found it to be beneficial from those suffering from “frozen shoulder”.

-Work the surrounding muscles around the shoulder blade, such as your rhomboids, to help you ease the pain symptoms and redistribute the stress when trying to use your arm

-Acupuncture also has been known to reduce some symptoms.

And there is always rest. You could try resting it, but if you’ve rested it for more than a week and you feel it getting worse then it’s probably something else. I always recommend going to schedule with your trusted physical therapist to get evaluated. If you find your shoulder is getting worse and you are losing more and more range, you may have yourself an angry shoulder capsule aka Adhesive Capsulitis!

Remember, we heal smart, not harder!

Dr. Justin C. Lin

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