'Frozen Shoulder' ReBalance 2

Frozen ShoulderAll You Needto Know About It

Adhesive capsulitis is considered fibrosis ofthe shoulder (glenohumeral) joint capsule,with a chronic inflammatory response.Adhesions between SurfacesAs a patient, you will generally experiencepain, limited range of motion, and disabilitylasting anywhere from 1 to 24 months.

The “frozen shoulder” diagnosis,originally thought to be periarthritis, hasbeen used for many years in describingshoulder pain and limited motion.Studies and surgical examination ofpatients with this condition concludedthat frozen shoulder was not periarthritisbut the thickening and contraction of acapsule which becomes adherent to thehumeral head, or adhesive capsulitis.Patients typically describe onset ofshoulder pain followed by loss of motion.

Common Limitationsin Range of Motion:External RotationAbductionForward FlexionWhich Limitation Do You Have?

Types of FrozenShoulderIdiopathic ("primary") andSecondary Adhesive Capsulitis

Idiopathic (“primary”)Adhesive CapsulitisThis form occurs spontaneously without aspecific trigger. Primary Adhesive Capsulitisresults from a chronic inflammatory responsewhich can actually be an abnormal responsefrom the immune system. The primary “frozenshoulder” can happen spontaneously with noapparent external cause or trauma. Generally,the onset and progression of your symptoms arevery gradual. Your symptoms may progress soslowly that you may not even seek medicalattention until you experience severe pain andlossof range of motion. Thistype of frozenshoulder can occurThe likelihood ofin both shouldersdeveloping it in bothbut rarely at theshoulders reaches up tosame time.40-50% of cases.

PRIMARY ADHESIVE CAPSULITISOCCURS MOST FREQUENTLY INPATIENTS WITH: Diabetes Thyroid dysfunction Autoimmune-related conditions Repetitive shoulder strain injury,also known as overuse syndrome Chronic inflammatory arthritisRecent chest or breast surgery Cerebrovascular accident (CVA) Cardiovascular disease

Secondary AdhesiveCapsulitisThis form may occur if you had a severe shoulderinjury or surgery. It may be associated with otherconditions that prolong recovery and limitoutcomes. An example is a fracture-dislocationin the shoulder joint after a fall.The resulting immobilization of the shoulderafter a trauma can cause “frozen shoulder.”The secondary “frozen shoulder” can alsohappen if you’ve had ashoulder surgeryExamples are open orand/or if thearthroscopic shouldersurgery, including rotator operation resulted incuff repair and shoulderseverereplacement surgery.complications.

FROZEN SHOULDER RISKFACTORS:Gender: Women are more prone to the development of“frozen shoulder,” especially in theirperimenopause phase Around 70% of “frozen shoulder” patients arewomen; however, males with “frozen shoulder”are at greater risk for longer recovery andgreater disabilityAge: People between 40 and 59 years old are at ahigher risk It is estimated that 84% of people with frozenshoulder belong to this age groupGenetics: According to recent research, genetics may playa role in the development of “frozen shoulder.” The prevalence of “frozen shoulder” is higheramong white individuals—those with a positivefamily history and individuals with positiveHLA-B27.

“Frozen shoulder” andEndocrine ConditionHaving an endocrine condition such as diabetes or thyroiddisease, both hyper and hypo, is a risk factor for “frozenshoulder.” The link between thyroid disease and “frozenshoulder” remains uncertain, but research still findspossible connections.Diabetes is one of the most common conditions to coexistwith “frozen shoulder”; 11% to 30% of people with frozenshoulder also have diabetes. Diabetic people are five timesmore likely to develop the syndrome compared to nondiabetics.A 2014 study found hyperthyroid patients have 1.22 timesthe risk of developing adhesive capsulitis compared to thegeneral population. Researchers speculated these findingsmight relate to an inflammatory process— stimulated bythe production of proteins known as cytokines—characteristic of both hyperthyroidism and adhesivecapsulitis. One might trigger the other, or they could occurin tandem.

FROZENSHOULDERSTAGES“Frozen shoulder” starts with acuteinflammation of the joint capsule followedby scarring and remodeling.The typical progression of a “frozenshoulder” can be explained in three stages:painful stage, stiffness or “frozen” stage,and recovery or “thawing” stage, with theaverage length of symptoms lasting 30months.

Stage 1:“Painful Phase”In this stage, the following changescan occur: the shoulder starts to ache. the pain becomes worse as thesymptoms progress. the active and passive range ofmotion becomes more restricted.This is also called thefreezing or inflammatoryphase.

Stage 2:“Frozen or StiffnessPhase”Most people progress to this stage,also called the transitional or stiphase.While this stage is the longest,adhesive capsulitis is thought to bereversible in the acute pain stage.In addition to limited range ofmotion, shoulder complex muscleimbalances lead to altered shouldermotion.

Common characteristics ofthe frozen or stiffnessphase include: The individual may limit the use of thearm due to pain at the end of the range ofmotion External shoulder rotation may be verylimited followed by restrictions inshoulder flexion and internal rotation This can lead to muscle disuse andatrophy but shoulder pain does notnecessarilyworsen

Stage 3:“Thawing Phase”In this stage, the individual mayexperience the following: The range of motion starts to improve. Shoulder mobility gradually returns. This stage typically lasts 12 to 42months.In fact, studies show over 20% of peoplewith “frozen shoulder” develop long termlimitations of range of motion, lasting upto 10 years.

DIAGNOSISDiagnosing “frozen shoulder” can be trickybecause its main symptoms—pain andstiffness—are common of numerous otherconditions, including rotator cuff injury.In fact, “frozen shoulder” is oftenmisdiagnosed as a tear in the rotator cuff.Furthermore, people with “frozenshoulder” sometimes compensate forreduced shoulder joint movement bymoving their shoulder blades and spine incertain ways, adding to the challenge ofgetting an accurate diagnosis.There is no diagnostic test like an X-ray orMRI to confirm the syndrome. A diagnosisis made by observing the mobility of yourshoulder, taking a detailed history, andperforming thorough orthopedic andphysical examinations.

PERFORMING A SELFASSESSMENT:1. Stand in front of a mirror or have acompanion observe you as you move your armand shoulder. Watch for the quality of yourshoulder motion, as well as the quantity.2. Slowly raise both arms up in front of youand overhead. If you have a “frozen shoulder,”your painful arm may only raise to a point justpast parallel with the floor. Plus, your shoulderblade will rise up unnaturally and your painfulshoulder may move up towards your ear. Asyou lift your arm, you may also feel pain inyour shoulder. Slowly lower your arm.

PERFORMING A SELF-ASSESSMENT3. Now, slowly lift your arm out to the side, againobserving the amount of motion. If your shoulderonly goes up to a point that is just level with thefloor and it is painful, then you may have “frozenshoulder.” Your shoulder may also move uptowards your ear like in the previous motion test.4. Finally, stand with both arms at your side andkeep your elbows bent to 90 degrees. Whilekeeping your elbows tucked into your sides, rotateyour arms out. This direction of motion is calledexternal rotation. If you have “frozen shoulder,”the painful side will not rotate as far as your nonpainful arm.

DIAGNOSIS, CONT’DDue to the complexity of causes behind thiscondition, seeking timely, professional helpand professional detailed assessment of yourcondition is key to recovery.Its connection to various autoimmunedisorders andhormonal changesmeans detailed bloodwork should beperformed as a part ofa diagnostic work up.Identifying these connections often helpsdoctors get your symptoms under controland prevent this condition from repeatingitself.

TREATMENTFrozen shoulder may heal itself in one tothree years, but it is possible for individualsto develop long-lasting symptoms.In fact, studies show over 20% of people with“frozen shoulder” develop long-termlimitations of range of motion that can last upto ten years.The primary goals of treatmentare to relieve pain and restore joint function.There are two main treatment options for thiscondition: “Conservative Treatment” and“Surgical Treatment”

“Conservative Treatment” The fastest and most successful resultsare seen when a patient specific,customized program is executed “Frozen shoulder” often turns out to bea very complex problem with multipleunderlying causes and accumulatedchanges These must be addressed in order tostop its progression and reverse theeffectsKeep reading to findout the ReBalance FrozenShoulder RecoveryProgram

ReBalance FROZENSHOULDER RECOVERYPROGRAMTrigenics:Trigenics is a neurological-based manual orinstrument-assisted assessment andtreatment system. Trigenics combines threetreatments in one, which developers claimleads to an increase in neuro-summation.Trigenics is a neuro-kinetic, sensorimotorassessment, treatment and training system,which instantly relieves pain and increasesstrength and movement.

ReBalance FROZEN SHOULDER RECOVERY PROGRAMART:Active Release Technique (ART) treats yourbody’s soft tissue by combining manipulationand movement. ART entails identifying,isolating, and targeting the affected area tobreak up scar tissue. This promotes bloodflow and faster healing of injuries.Chiropractic Spinal and JointsManipulation:Chiropractic manipulation is the applicationof pressure to a person's spine or other joints.This pressure allows a chiropractor to adjustand correct alignment. Chiropracticmanipulation aims to reduce pain andimprove mechanical function.

ReBalance FROZEN SHOULDER RECOVERY PROGRAMRadial ESWT ShockwaveRegenerate Treatment:Radial ESWT shockwave regeneratetreatment shows a tremendous benefit intreating “frozen shoulder.” It disintegratesscar tissue and calcifications, re-vascularizesjoint capsule, regenerates cells, enhances therepair of muscles, tendons and ligaments,decreases pain, and stimulates collagenproduction.Dry Needling Trigger PointTreatment:Dry needling is a treatment that pushes a verythin needle through the skin to stimulate atrigger point. Dry needling may release tightmuscle bands associated with trigger points,leading to decreased pain and improvedfunction.

ReBalance FROZEN SHOULDER RECOVERY PROGRAMMultispectral Cold LaserTreatment:Laser’s powerful anti-inflammatory and painrelieving effects improve the quality of life inpatients suffering from rotator cuff injuries. Itenhances circulation and encourages injuredcells and tissue to repair, helping to restorenormal function.Anti-Inflammatory IontophoresisTreatment:This is used to reduce inflammation seen inmusculoskeletal conditions such as shouldertendinitis, lateral and medial epicondylitis,plantar fasciitis, tendo-nitis/bursitis,rheumatoid arthritis, and enthesopathicconditions of various origins.

ReBalance FROZEN SHOULDER RECOVERY PROGRAMAnti-Inflammatory IntravenousInfusions (IV) treatment:These treatments reduce inflammation andslow down the degeneration of joints and softtissue. Included is vitamin C,MethylCobalamin(B-12),PLUS: Taurine, MTE, Alanyl-L-Glutamine,Calcium, Chromium, Copper, Magnesium,Manganese, Selenium, Zinc.In particular, vitamin C assists in producingcollagen, an important protein used to makeskin, cartilage, tendons, ligaments, and bloodvessels. Calcium and magnesium help tosupport bone and muscle functions. Thisformula is perfect to support inflamed jointsand provide your body with the necessaryvitamins and minerals for joint health.