Perhaps you have noticed a very gradual limitation in your shoulder motion that is also painful. You haven’t been using your shoulder very much lately, but you are blaming the problem on a recent mild injury to the shoulder. Over several weeks, your shoulder becomes stiffer and more difficult to move. Sleeping is not very comfortable. Even though you are hoping that the shoulder will improve, it is more likely to progress into a “Frozen Shoulder.”
When you try to picture what a Frozen Shoulder might be, you accurately think of a shoulder that is difficult to move yourself or to have mobilized by someone else.
Another term for a Frozen Shoulder is “Adhesive Capsulitis.” Adhesions and contractures are a shortening and tightening of structures that are responsible for shoulder motion.
Slumped forward or drooped shoulders, tension and emotional upsets are common with Frozen Shoulders. If you have had a shoulder or arm injury where the arm is in a sling for a period of time, your muscles can begin to atrophy or shrink. Your shoulder can lose it’s flexibility, setting you up for a possible Frozen Shoulder.
Many people have weakness of some of the shoulder muscles. In many activities, we hold our arms in front of us. Driving a car, reading, typing and fixing small machines all utilize certain shoulder girdle muscles while weakening shoulder blade muscles. Small, repeated injuries to the rotator cuff muscles, or muscles at the shoulder cap area, add up over time, disrupting the normal shoulder motion.
Early on in this syndrome, you might notice some spasms in your shoulder muscles, around the shoulder blade, and the pectoralis and chest muscles. The shoulder blade may be pulled by the muscles so that is appears to stick out. Pain from the shoulder is often at the front side of the shoulder and traveling down.
Muscle spasms protect you from using an injured area. But, avoiding all use of an area allows those muscles to tighten even further, which is called muscle splinting. Not using a joint at all can stop blood flow. Then, inflammation and swelling further aggravate the problem. The next step is a build up of fibrous tissue, locking the joint and causing a functional disability.
The best treatment for shoulder problems is prevention! But, if you have waited too long, you need to start treatment as soon as possible to avoid the downward spiral of the shoulder locking up. During your examination, the shoulder x-rays will typically be negative unless there is a complicating calcified tendonitis or other problem.
A chiropractic postural examination can reveal associated postural instigators of the shoulder problem. Lower neck problems can irritate the nerves that directly connect to and control the shoulder muscles. Your first rib can be locked up and thus disturb normal shoulder motion. If you have had a shoulder beginning to “freeze,” accessory muscles will try to compensate and take over the function of the shoulder muscles. Your chiropractor will probably point out that your shoulder and neck are drawn together in an upward direction. The involved muscles can have certain trigger points or tender spots that radiate pain when touched. These problems need to be addressed as part of the treatment plan.
Once again prevention is the key! You need to keep your shoulder moving gently. Your treating doctor can show you some gentle exercises to prevent “freezing”. Trigger point therapy and ultrasound to the involved muscles can be beneficial. Your nerve supply to the shoulder muscles should be checked. Chiropractic adjustments can help relieve first rib and neck motion limitations that aggravate shoulder problems. In extremely severe cases, a physician may recommend an injection of anesthetic to help free up the shoulder joint.
At home, you need to follow instructions and exercises to bring back full motion. Ice can help remove pain in a natural way.
Too often, I have had a patient come into my office describing a very painful shoulder which has limited movement. The patient thought that it would get better on it’s own accord. Don’t wait until the problem is so painful and difficult for us to work on together. Prevent the problem at the onset, and know that you are taking care of your ability to work, and your health.