Frozen Shoulder is Unlocked with Bodywork

by Diana Khoury

Frozen shoulder is a disabling condition characterized by pain, inflammation, stiffness and limited range of motion in the shoulder joint. The first symptoms are pain and an inability to perform daily tasks such as reaching or lifting. Shoulder function may be restricted for months or years, depending on the severity and course of treatment sought. Triggered by minor injury or improper movement (such as reaching backward from an abnormal position), the onset of frozen shoulder is gradual. Bodywork is often recommended as primary treatment for frozen shoulder – to improve function of the joint, reduce pain and facilitate increased range of motion.
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Frozen shoulder currently affects around 5% of the population. However, the condition is 5 times more common in Type I and II Diabetics, possibly due to elevated blood sugar levels, which cause increased stiffness (glycosylation) in connective tissues over time.1

Those additionally at risk for incidents of frozen shoulder include:

  • Individuals between the ages of 40-65
  • Women (60-70% of cases)
  • People with poor posture
  • Those engaged in regular overuse of shoulder muscles (in sports, manual labor, etc.)
  • People with recent shoulder injuries
  • Patients recovering from shoulder or reconstructive breast surgeries
  • Family members with a history of frozen shoulder issues (genetic component)1

The onset of frozen shoulder is gradual and symptoms may last from 1-2 months to over 3 years, depending on treatment. Once a frozen shoulder is treated and healed, recurrence is uncommon. However, a small percentage of patients develop it in the opposite shoulder within 5 years.

There are three identified stages of frozen shoulder:

The acute stage (lasting 2-9 months), is characterized mainly by pain, limited range of motion, and interruption of sleep due to increased pain at night.2

The subacute or “frozen” stage (4-12 months) is marked by reduction in pain, increased stiffness and severely restricted range of motion.

The chronic or “thawing” stage (12-42 months) is the beginning of recovery, where pain is gone and range of movement gradually starts to improve.3

Since many shoulder problems are misdiagnosed as frozen shoulder, a proper evaluation should be performed by a medical professional to determine the most appropriate course of treatment.4

The standard medical treatment approach may include anti-inflammatory medications, cortisone injections, forced shoulder joint manipulations under anesthesia, or in the most extreme cases, surgery.3

A more conservative approach to frozen shoulder treatment includes manual therapy, bodywork and exercises, and is often recommended as a primary course before more invasive treatments are entertained.

Acupuncture used in conjunction with exercises have been shown to be an effective treatment for frozen shoulder.5Acupuncture releases endorphins which act as pain inhibitors, and stimulates the body’s natural healing abilities. The Healthcare Medicine Institute reports new research out of China and Germany that concludes acupuncture can release frozen shoulder pain and improve joint function and range of motion by targeting specific points related to muscle release in the shoulder capsule.6

Therapeutic massage techniques such as trigger point therapy, myofascial release, stretching and joint mobilization can be applied individually or in combination to address frozen shoulder, with positive results.7

For maximum effectiveness, therapeutic massage techniques are applied in moderation to break down adhesions (stiffness) in the shoulder joint, increase circulation (of blood, oxygen, synovial fluid), release locked muscles, and facilitate movement. Depending on which phase of frozen shoulder the patient is in, the massage therapist can design a series of therapeutic sessions to continue to unlock and unwind the stiffness in the shoulder, improve function and gradually restore normal range of motion.

This is an original article from Dreamclinic, Inc. Dreamclinic is a Health and Wellness company committed to sharing information about commonly experienced health conditions and how they may be impacted through the use of bodywork and other natural approaches. Dreamclinic offers massage, acupuncture, and Reiki sessions at its Greenlake and Queen Anne clinics, as well as onsite massage at workplaces around Puget Sound. Contact us to learn more about how Dreamclinic can help you, your family or your workplace experience greater health.

References:
1. www.frozenshoulder.com
2. http://www.massageworld.co.uk/articles/sports-massage-getting-the-frozen-shoulder
3. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0047043/
4. http://www.massagetoday.com/mpacms/mt/article.php?id=10941
5. http://www.ncbi.nlm.nih.gov/pubmed/11773673
6. http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1214-acupuncture-unlocks-frozen-shoulder-pain-new-research
7. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096148/

Other Resources:
http://acupuncturetoday.org/mpacms/at/article.php?id=28032

Myofascial Release for Posture and Chronic Pain

By Laura G., LMP

 

The Nature of Fascia

Fascia is connective tissue that’s made of thin sheets of collagen, the  main protein that supports all of our bodily tissues and organs. This paper thin tissue wraps each muscle fiber, group of fibers, muscle, group of muscles, and lastly each limb. Layers of fascia go from very superficial (directly under the skin) to very deep (inside joint capsules). Regular movement and good hydration keep fascia healthy. When fascia is working correctly, it provides a flexible structural support to your organs and muscles.

 
How Adhesions are Formed

When muscles are tight and circulation is sluggish, fascia becomes dehydrated and sticky. The layers may of fascia may stick together or fascia may stick to muscles or skin. Following an injury, fascia may also become attached to scar tissue as it forms. Because these adhesions are frequently painful to stretch, they tend to persist, limiting free movement and reinforcing dysfunctional muscle patterns. A person may feel a burning or tearing sensation when these adhesions are stretched.

Adhesions Restrict Movement and Effect Posture 

If the adhesions are close to the skin, there may be a feeling of tension around the affected muscles or even in the whole limb. A large area may feel too tender to touch. This painful, restricted feeling discourages a person from using the full range of his or her muscles and thus these adhesions limit movement. As movement decreases, fascial adhesions become more solidified and muscle patterns become more entrenched. When there are long term adhesions, even thorough massage that works the muscles, can still leave us feeling as if some tension was fully addressed.

 
Addressing Adhesions through Myofascial Release

Myofascial Release is massage designed specifically to address the problems associated with fascial adhesions. Myofascial massage is usually done without oil, so that the individual layers of fascia can be felt by the therapist. Although there is a common perception that fascial massage is painful, there are many forms of fascial massage. Some are very light to work on the superficial layers. Others use movement to release adhesions in the joints and deep muscles. Still others release fascial layers between muscles.

Though the breaking up of fascial adhesions can feel like a burning or tearing sensation, most fascial massage is not painful or uncomfortable. A skilled practitioner releases fascial adhesions gently and without pain. People who receive fascial massage usually experience a sense of profound relaxation as long standing patterns of posture and movement open up to freer movement. Many also feel a sense of emotional openness as these patterns release.

 

When combined with specific muscle work, myofascial massage promotes more rapid progress toward postural balance and injury recovery. Fascial massage addresses chronic pain patterns as well. Releasing fascial adhesions relieves pain patterns that other modalities may miss. Including fascial work in one’s massage regimen promotes an added sense of ease and freedom of movement to the other numerous benefits of regular massage. If you are experiencing chronic movement limitations, stubborn pain patterns or areas of extreme tenderness, myofascial massage may be just the answer.