Chiropractic is one of the treatments for a frozen shoulder, and they can recommend frozen shoulder exercises.
What is Frozen Shoulder?
The technical name for frozen shoulder is adhesive capsulitis. Frozen shoulder symptoms include pain and stiffness in the shoulder joint. The signs of adhesive capsulitis may start slowly, worsen, and then resolve in 1-3 years. The people at risk of developing this condition are those who are recovering from procedures or medical conditions that keep them from moving their arm, such as stroke patients and those who have had a mastectomy. Frozen shoulder rarely redevelops in the same shoulder, but it can come up in the opposite one. Most people are treated with exercises to help range-of-motion, numbing or corticosteroid injections, or—rarely—arthroscopic surgery.1 The basic anatomy of the shoulder, is a “ball-and-socket joint made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle)”. The shoulder capsule is connective tissue that “surrounds the joint”. Synovial fluid helps the shoulder joint and capsule move freely. With frozen shoulder, the capsule thickens and adhesions, or stiff tissue bands, develop. For many patients, there is less fluid in the joint. The main sign of adhesive capsulitis is being unable to move the shoulder, even with help. There are three stages: freezing (pain and loss of motion for 6 weeks to 9 months), frozen (less pain but more stiffness for 4 to 6 months), and thawing (improvement to normal strength and motion over 6 months to 2 years). The causes are unknown, but there are some medical conditions that can lead to more risk of developing frozen shoulder, including diabetes, thyroid conditions, cardiac disease, Parkinson’s disease, and, of course, immobilization from fracture, injury, or surgery. Pain from adhesive capsulitis tends to be aching or dull, and it is located around the upper arm or outer shoulder area.2
Frozen Shoulder Treatment
Patients often seek help when the persistent pain in the shoulder limits movement. Earlier treatment leads to less long-term stiffness and pain. Typical treatment options include corticosteroid injections, painkillers, shoulder exercises, and physiotherapy. Frozen shoulder surgery should be a last resort.3 Doctors may recommend NSAID medications and heat, followed by stretching. Sometimes medications and ice will be used to reduce swelling. The surgical options include “manipulation under anesthesia”, in which the patient’s arm “is moved into positions that stretch the tight tissue”. In arthroscopic surgery, the arthroscope is used to “cut through tight tissues and scar tissue”. Both surgeries can be done at once. There are some ways to prevent frozen shoulder, include stretching, range-of-motion exercises, and using the shoulder more (especially after injury or surgery).4
Chiropractic management is also possible. In a retrospective case series, 50 patients had received “a novel chiropractic approach” called OTZ Tension Adjustment, which was “focused on the cervical and thoracic spine”. OTZ Tension Adjustment is also known as One-to-Zero, and it “aims to correct occipitoatlantal articular dysfunction (C0-C1 chiropractic subluxation)”. Most of the patients with FSS “appeared to improve with the chiropractic treatment”.5 Other methods that can be used are the Active Release Techniques (ART®).6 Chiropractors can assess for vertebral subluxations and help restore movement to the spine in order to “assist proper nerve function (and)…contribute to…recovery”. FSS treatment usually requires more than joint manipulation; in fact, “according to the American Academy of Orthopaedic Surgeons, exercise and stretching are the most recommended…therapies”. Chiropractors can teach patients what to do at home.7
Frozen Shoulder Exercises
There are many exercises for frozen shoulder. One is called the “pendulum stretch”. The patient relaxes the shoulders and leans over to allow the injured arm to hang, and then the arm is swung in a circle 10 times, in each direction, one time per day. The diameter of the swing can increase over time, and a light weight may also be added. With the “towel stretch”, a patient holds a towel behind the back and uses the “good arm to pull the affected arm upward to stretch it”. Eventually, the patients can drape the towel over the good shoulder to perform the stretch. The “finger walk” consists of facing a wall, less than an arm’s length away, touching the wall at waist level and walking the fingers up the wall, with the elbow bent. The fingers, not the shoulders, do the work. Patients can also do the “cross-body reach”, using the “good arm to lift (the) affected arm at the elbow”, stretching the shoulder gently. The “armpit stretch” has the patient lifting the affected arm with the good arm onto a chest-high shelf. Then the patient bends at the knees to stretch the armpit. Over time, patients can learn to strengthen the rotator cuff with exercises bands, doing such stretches as the “outward rotation” and “inward rotation”.8 It is helpful to think of the good arm as the “therapist arm”. Some exercises and stretches can be done while sitting or lying down. All of the activities should be done after allowing the “muscles to relax so that the stretch can be applied to the soft tissues without muscle interference”. Stretches should be done without force and with minimal soreness. A typical exercise schedule is done about three times a day, after a bath, shower, or aerobic exercise, so that the shoulder is relaxed. By doing the exercises at home, patients are in control and they can check their own benchmarks for progress. Patients should consult with their healthcare professionals about what types of aerobic exercises are safe to perform.9
Find out more about chiropractic and shoulders.