The shoulder joint is composed of bones, ligaments and tendons secured within a network of connective tissue. When this capsule of tissue becomes thick and tight around the shoulder, it begins to restrict movement. This is what is known as frozen shoulder.
The most common form of frozen shoulder occurs with adhesive capsulitis. The fascia around the joint capsule that is the ball and socket of our arm and shoulder blade start to adhere down and stick to the bones and inhibits motion. The second most common type is where the medial border of the scapula, or inside of the shoulder blade closest to the spine starts to adhere down to the rib cage itself. This inhibits the shoulder from being able to move freely and eventually can lead to adhesive capsulitis.
What causes frozen shoulder?
There are several factors that make frozen shoulder more likely. These factors include:
Age
- People over the age of 40 are more likely to suffer from frozen shoulder.
Sex
- Frozen shoulder occurs more frequently in women.
Mobility issues
- Those with preexisting limited mobility are more likely to develop frozen shoulder.
- This limited mobility is typically caused by factors such as rotator cuff injury, broken bones in the arm, surgery recovery and past strokes.
Disease
- There are several diseases, including diabetes, cardiovascular disease and Parkinson’s disease, that seem to put people at higher risk as well.
Symptoms and Stages of Frozen Shoulder
There are typically three stages that develop slowly and gradually. These stages are as follows: freezing stage, frozen stage, thawing stage.
The freezing stage refers to the period in which shoulder movement begins to result in pain. During this stage, range of motion in the shoulder may become limited.
The frozen stage may consist of reduced pain, but increased stiffness. Use of the shoulder may become more limited.
The thawing stage is the uphill slope in which the shoulder begins to loosen and range of movement becomes wider and easier to achieve.
Diagnosis and Treatment Options
Frozen shoulder is typically diagnosed via a physical examination in which a doctor will ask the patient to move in a variety of positions to monitor range of motion and stiffness. Because frozen shoulder affects both passive and active movement, the doctor will also ask the patient to remain relaxed while they move the patient’s arm. Occasionally, doctors may inject patients with an anaesthetic in order to further evaluate range of motion.
Doctors typically only request imaging in order to rule out other causes of injury. This imaging may include ultrasound or MRI scans.
Over-the-counter medication such as NSAIDs are typically used to alleviate the pain associated with frozen shoulder. Doctors may also prescribe stronger medication on a case-by-case basis.
Chiropractic treatment and physical therapy are also commonly used to treat this condition.
Physical therapy is used to demonstrate a range of exercises to frozen shoulder patients that aim to increase and recover mobility.
There is a specialised fascial treatment called The Fascial Distortion Model, that the Dr.’s Zandi have been treating patients with for almost a decade and have taught around the US and Canada to practitioners and professional as well as collegiate sports teams and programs.
By understanding where the fascial distortions or restrictions are, a skilled practitioner can significantly shorten the recovery process.
Though most frozen shoulder cases clear up with traditional methods within 12 to 18 months, some cases may require surgery.
About Zandi Chiropractic | Boulder & Denver Chiropractors Specializing in Frozen Shoulder Care
Dr. Sepehr Zandi and Dr. Christina Zandi both specialize in full body chiropractic care and soft tissue manipulation. With chiropractic offices in Boulder and Denver, you’re not far away from getting the treatment you need to start feeling better today.
Dr. Sepher Zandi is located at 1810 30th St., Suite D Boulder, CO 80301 and Dr. Christina Zandi is located at 2750 S Wadsworth Blvd Suite D-201 Denver, CO 80227. The Boulder office can be reached by telephone at (303) 499-0225 and the Denver office can be reached at (303) 653-3490.
Further Reading & Resources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3706702/
