I personally think frozen shoulder is very easy to fix. The period for frozen shoulder patients to regain 100% of their range of motion isn’t excessively long, but the treatment process can be quite painful. I would say most cases of frozen shoulder recover full range of motion in 3~4 sessions. Therefore, it is recommended to take anti-inflammatory and pain relief medications before and after treatment. Especially after treatment, taking these medications is essential. Without them, inflammation may occur, leading to the re-stiffening of the shoulder.
Detailed explanation about frozen shoulder is written here.
Case
Patient
A chef in her early 40s presents to the clinic with right shoulder pain. She shows no signs and symptoms of neurological involvement. The pain is 7/10, and it affects her daily activities and work. She says she does a lot of repetitive movements with arms, she denies she lifts anything heavy at work.
Physical examination
On physical examination, she has painful and reduced range of motion on flexion, extension, abduction, horizontal adduction, internal rotation, and external rotation. Other findings is she has significant rounded shoulder with restricted movements in the thoracic spine.
Mechanism
When the thoracic spine lacks flexibility, it can lead to compensation in the glenohumeral joint. Rounded shoulders can also hinder scapular movement, potentially causing further compensation in the glenohumeral joint. When both of these factors are present, and patients engage in frequent repetitive shoulder movements, it can result in continuous micro-tears within the glenohumeral joint. This sets off a repetitive cycle of damage and recovery. As mentioned earlier, this cycle of damage and recovery eventually leads to stiffness and progresses over time into frozen shoulder.
Treatment
This is a very typical case of frozen shoulder. I treated her accordingly to the findings. Going through physical treatments, stretches and exercises, then I gave advices on what to do and what not to do. It is recommended to do stretches for frozen shoulders. She was able to recover her range of motion in 3 sessions, 80% similarity to the left shoulder. After the 4th session, her right shoulder range of motion was 100% similar to the left. The pain was down to 2/10. Eventhough the pain is there, as the shoulder does not compensate anymore, the micro-inflammation will disappear over time and the pain will eventually go away in these cases.
Prevention
We must also make sure she keeps doing her thoracic flexibility stretches and does not round her shoulders. Most shoulder problems come from rounded shoulders as it reduces the range of motion of our shoulders. In addition, we must monitor the patients recovery in the next 3 months. If the pain is still there after 3 months eventhough the range of motion is fully restored, it indicates there is another problem going on such as bursitis or tendinitis, and we must make sure to check these.
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