Shoulder pain is the third most common musculoskeletal disorder, following low back pain and cervical spine pain. The mechanics of the shoulder girdle is very complex.
The term frozen shoulder references a set of symptoms in the shoulder involving pain and limited motion in the glenohumeral joint. Frozen shoulder is used interchangeably with adhesive capsulitits. However, adhesive capsulitits refers to a discrete clinical pathology whereas frozen shoulder refers to a variety of pathologies.
The common element between, frozen shoulder and adhesive capsulitis is functional limitation in range of motion associated with pain and stiffness. With frozen shoulder, the culprit is associated with the symptoms related to the inert tissues, whereas with adhesive capsulitis, it's due to a loss of active and passive range of motion due to adhesions within the glenohumeral joint.
The glenohumeral joint has the greatest range of motion of any joint in the body. Consequently, a degree of slack or pliability in the joint capsule and surrounding soft tissues is necessary to allow full range of motion. Pathologies associated with a decrease in range of motion in the glenohumeral joint include: bursitis, calcific tendinitis, arthritis, myofascial trigger points, and shortening of capsular tissues to name a few.
Frozen shoulder is divided into two catagories: primary and secondary. Primary frozen shoulder is idiopathic with some indication that it may be autoimmune. Secondary frozen shoulder rsults from rotator cuff tears, arthritis, bicipital tendinosis, shoulder seperation, or diabetes. With secondary frozen shoulder, along with pain, stiffness, and decrease range of motion, there is also more evidence of capsular adhesion.
The development of frozen shoulder and its resolution proceeds in stages: pain, stiffness, recovery, or stages one, two and three and it can also be described as freezing, frozen, thawed (my personal favorite). Stage One: increasing pain and gradual loss of joint volume lasting 2 to 9 months. Stage two has dimininshed pain and more limited range of motion lasting from 4 to 12 months. Stage three is reduction in pain and gradual restoration of motion lasting 12 months to years.
How Four Wellness Massage can help? Regardless of whether the condition is primary or secondary frozen shoulder, the affected inert tissues need to be lengthened and mobility enhanced. Deep tissue massage can play a major role in addressing and healing restrictions. Hydrotherapy (heat) as well as stretching the area is added into the massage sessions. Range of motion improvement is more effective when repeated regularly. I have had amazing results when clients see me weekly till the shoulder is thawed. The number of sessions is solely based on the stage you are in. Surgery, in my opinion, should only be an option if conservative therapy is unsuccessful! Along with your weekly sessions, I will also add in homework including strengthening and stretching exercises.
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Orthopedic Assessment in Massage Therapy by Whitney Lowe 2006
Diseases of the soul are more dangerous and more numerous than those of the body.