What is a REAL Frozen Shoulder?
Many clients have come in over the years with a diagnosis of ‘frozen shoulder’. A REAL Frozen Shoulder occurs when the joint capsule develops ‘Adhesive Capsulitis’. Most shoulders are not really frozen but immobilized by co-contractions of external and internal rotators.
What can be done when the shoulder is not really frozen; when palpation and passive ROM reveal that the capsule itself is not involved but movement without pain and restriction is not possible.
The Emotional Component
I have heard that frozen shoulder can follow an emotional trauma. A former student came in to see me as a client. She had recently gone through two losses of people dear to her. She developed frozen shoulder. I’ve also heard that frozen shoulder will go away on its own after a couple of years. Can that process be speeded up? Yes, it can.
Any condition with an emotional component as history requires checking for Contralateral Coordination Dysfunction. Muscle testing reveals ALL shoulder muscles are weak. Brain Buttons turned on some of the muscles, but the shoulder is still dramatically dysfunctional. Many external rotation functions are inhibiting the internal rotator of the Subscapularis.**
Once internal rotators were working, we worked adhered and rigid shoulder tissues.
4 NeuroMuscular Reprogramming NMR® treatments
4 neuromuscular reprogramming treatments one month apart has almost completely removed the restriction and pain.
Now that the emotional factors have been addressed, in session 2 we were able to deal with some of the peripheral dysfunctions created by the main restrictions in the shoulder. We also began to work with the support and function of the neck muscles and how they contributed to the shoulder dysfunction.
In frozen shoulder, the muscles of shoulder depression dominate those of elevation. The client cannot lift their arm. Neither can they internally or externally rotate to a full potential ROM. External rotators are usually inhibiting internal rotators to begin with…
Resolving Scapular Adhesions in this case of Frozen Shoulder:
First, I addressed Scapular Adhesions, specifically…
Lt Rhomboid AND Lt Coracobrachialis inhibited Lt Teres Maj, Subscapularis
PMC inhibits Post Delt; Traps; Supraspinatus
The next layer of dysfunction:
Lt Subscap inhibits Lt Infraspinatus AND Supraspinatus (int rot’n inhibits ext rot’n) This was revealed after decompressing the shoulder with traction and tissue manipulation to reduce tissue rigidity.
More neck work resolved Lt Scalenes inhibit Rt Scalenes.
Lt OCI inhibits Rt OCI
Rt OCS inhibits Lt OCS
Lt Rec Cap inhibits Rt Rec Cap
(Yet another seeming reversal in dysfunction is now apparent as the neck compression issues of rotation and counter rotation are resolved.)
(Next session we need to connect the low back to Lt neck and shoulder.)
The Final Session: Pain on movement is gone, but details remain
Lt Sterno-Clavicular Joint is stuck (immobilized).
Infraspinatus inhibits Subclavius; Serratus Posterior Superior (SPS); Subscapularis
Ant Serratus inhibits Ant Deltoid. (Remember that Infraspinatus and long head of Tricep inhibited Lt Lat and Infraspinatus was the most fixated muscle in the superficial shoulder
The synergist of Subclavius, PMC is likewise inhibiting Subclavius; also P. Delt and Bicep.
Now we begin to see the layer of dysfunction under the layer we’ve been able to work with.
Subscapularis inhibiting Teres Major; Teres Major inhibiting Subscapularis (how can this be? An increase in the ROM in the joint reveals YET ANOTHER layer of dysfunctional synergistic muscle relationships.)
Teres Minor inhibits PMC AND Subclavius (once again we are looking at reciprocal inhibitions).
Rt Obliquus Capitis Superior (OCS) inhibits OC inferior (OCI); Lt eye tracking. Rt Eye tracking inhibits Lt OCI. Needs more work.
Did extensive tissue mobilization throughout the structure of upper chest and all through the arm muscles.
Client is quite satisfied with her progress but still can’t ‘lift’ her hand behind her back to the range it was before. These details will continue to progress with more work, but 4 sessions is extraordinarily fast to accomplish freedom from pain on movement.
NOTES: *In the case of True Frozen Shoulder, the medical approach of forced manipulation under anesthesia is called for.
**(PT approaches given for frozen shoulder begin with exercising the external rotator functions of the shoulder. Since external rotation is usually dominant in frozen shoulder this would seem counter indicated.)