fix frozen shoulder Archives - Central Wellington - Severn Pain and Injury Care https://severnclinics.co.nz/tag/fix-frozen-shoulder/ Rehabilitation from the ground up Tue, 13 Jun 2023 23:18:11 +0000 en-US hourly 1 https://wordpress.org/?v=7.1.1 https://severnclinics.co.nz/wp-content/uploads/2021/04/Severn-Favicon-36x36.png fix frozen shoulder Archives - Central Wellington - Severn Pain and Injury Care https://severnclinics.co.nz/tag/fix-frozen-shoulder/ 32 32 What Causes Shoulder Pain? https://severnclinics.co.nz/what-causes-shoulder-pain/ https://severnclinics.co.nz/what-causes-shoulder-pain/#respond Fri, 09 Jun 2023 22:04:39 +0000 https://featherstonpainclinic.co.nz/?p=18312 The majority of shoulder pains are caused by mechanical lifestyle factors like sedentary work, chronic postural strain, muscle atrophy, stress and old injuries. Occasionally shoulder pain can have more serious causes; but thankfully these are rare and easy to rule out with straight forward tests like blood tests and x rays.

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What Causes Shoulder Pain?

The majority of shoulder pains are caused by mechanical lifestyle factors like sedentary work, chronic postural strain, muscle atrophy, stress and old injuries. Occasionally shoulder pain can have more serious causes; but thankfully these are rare and easy to rule out with straight forward tests like blood tests and x rays.

Shoulder pain is extremely common, in fact it may be the most common issues that turns up in pain management clinics. Despite this the causes of shoulder pain are quite predictable. Shoulder pain usually isn’t as debilitating as back pain (usually) because the tissues of  the shoulder bear far less weight than tissues in the lower back, and so are exposed to less strain. Shoulder pain is also somewhat of a broad term. The shoulder encompasses a broad area from the upper arm into the upper back, and there are many tissue structures that can be involved. All of these tissues are however impacted in similar ways by the causes of shoulder pain.

Happily there are some very common and predictable underlying causes of shoulder pain. This makes even bad cases very manageable in the longer term. If you can truly identify the underlying cause of a pain, you can usually fix it.

So what are the real causes of shoulder pain? In no particular order, because it varies from person to person, the real causes of shoulder pain are as follows.

Chronic Postural Strain

We used to have to move in order to feed ourselves and survive. Now the majority of us are forced to sit endlessly in order to feed ourselves and survive. In addition to that, much of our leisure and free time involves sitting and screens. Our body’s are simply not evolved or adapted for hundreds of hours of sitting each month.

All of our tissues are designed to adapt to what is asked of them for better or worse. So over time, the excessive sitting we do relative to our evolutionary blueprint causes real changes to occur in our body’s skeleton and soft tissues. Muscles and connective tissues either shorten or tighten, joints lose their natural mobility and fluidity, and every our skeletal structure undergoes changes in shape and alignment. When all these combine we call it ‘bad posture’ and you don’t need a degree in biomechanics to spot it.

Over time the tissue responses to persistent postural stress lead to forms of repetitive strain. These then eventually lead to the tissue integrity being undermined. If you know someone who has had shoulder dislocations or rotator cuff tears; the overwhelming probability is that a weakness had built up over time in their shoulder. So not only shoulder pain but most shoulder ‘injuries’ have some connection to the tissue stress caused but poor posture.

Chronic Muscle Atrophy

Once again, we used to move to survive, nowadays we sit all day to survive. And loss muscle strength is inevitably one of the key impacts this has on the body. Specifically however, the muscles of the upper back and the back of the shoulder girdle do not not get used. Where virtually everyone who lives in an urban setting has some degree of muscle atrophy.

The muscles in the upper back and back of the shoulder are not full activated until we do pulling or climbing movements. And modern life does not ask us to do a meaningful amount of these from day to day.  Notable exceptions would be surfers, rowers climbers and people who’s job involves ‘dragging’ large objects around. Most of us however don’t often have occasion to ‘pull’ under strain very often.

In contrast the muscles at the front off of the body are almost constantly activated as we are doing tasks in front of our body’s almost constantly. This is why every body builder on the planet finds that it is the ‘rear belt’ at the back of the shoulder is the hardest muscle to build up.

Loss of muscle mass means loss of support, loss of resilience and loss of resistance to injury in the tissues of the entire shoulder girdle.

Chronic Stress & Emotional Trauma

The tendency to lift the shoulders up and the tendency to hunch forward slightly in people who are anxious and depressed is probably the single easiest way to observe how our dominant mood affects the alignment and function of the body. There are an infinity of other ways this happens, but the shoulder one is easiest to spot. This is because the neck and shoulders are extremely prone to stored up emotional strain.

When we are in a persistently stressful life situation it creates subtle but chronic muscle tension in the neck and shoulders. Also, if we have unresolved trauma it can have a similar effect even if life is good now. Some of us tend to hold stress in other parts of the body too, but almost all of us hold some in the shoulder and neck region. Over time this extra ‘load’ on our soft tissues can cause them to suffer wear and tear, which eventually becomes painful.

The tendency that chronic stress and unresolved emotional trauma have is to cause pain by irritating other pre-exisiting issues like posture and old injuries. Stress and trauma have a way of letting  us know where the weaknesss are in our body’s. For somer they impact the gut or the skin, for others it could be the lower back, and for others they expose weaknesses in the shoulder.

Old injuries

When we injure our shoulders or upper backs there are often residual changes that occur which we fail top target with effective longer term rehab. Because we are not really a rehab culture and we lead such sedentary lives there is a tendency for these ‘post-injury-tissue-changes’ to become chronic.

When we injured ourselves in the big outdoors we would mostly have had to keep going. Only the most severe of injuries stop a hunter from hunting. This would not have been fun for our ancestors, but it would have meant that they retained far more muscle mass after injury than we tend to. It would also have meant that their scar tissue formation would have been nice and pliable. For modern humans a lack of movement often means we end up with residual long term problems after shoulder injuries.

A shocking number of shoulder pain sufferers have some residual weakness or scar tissue that is causing their pain and injuries. And eventually it becomes nearly impossible in many cases to discern between the the injury and the harm caused by postural pain etc. Yet if you have residual, re-occuring or relapsing shoulder pain after an injury you can bet good money on there being scar tissue and weakness left in the wake of the injury.

Wrapping Up The Causes Of Shoulder Pain

This blog discussed the various causes of shoulder pain, which is a very common issue in pain management clinics. The shoulder encompasses a broad area from the upper arm into the upper back, and there are many tissue structures that can be involved. The underlying causes of shoulder pain include chronic postural strain caused by excessive sitting, chronic muscle atrophy caused by a lack of physical movement, chronic stress and emotional trauma causing chronic muscle tension in the neck and shoulders, and old injuries. It is essential to identify the underlying cause of the pain to manage it effectively in the long term.

The good news about shoulder pain is that it is very treatable in the vast majority of cases. For most of us choosing to live with shoulder pain would be a bit like choosing to live with toothache. Not fun and not necessary. That is, as long as you have the right tools and the right help.

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]]> https://severnclinics.co.nz/what-causes-shoulder-pain/feed/ 0 Introduction To Frozen Shoulder Treatment https://severnclinics.co.nz/introduction-to-frozen-shoulder-treatment/ https://severnclinics.co.nz/introduction-to-frozen-shoulder-treatment/#respond Sun, 09 Oct 2022 03:18:47 +0000 https://featherstonpainclinic.co.nz/?p=17691 Introduction To Frozen Shoulder Treatment Frozen shoulder is a horrendously disabling, painful and frustrating complaint. Most people who experience frozen shoulder have been extremely healthy and active their whole lives and suddenly, out of the blue, get the bitter taste of what it’s like to live with an actual disability. No fun at all. The […]

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Introduction To Frozen Shoulder Treatment

pain, chronic pain, shoulder pain, acute pain, hip pain, soreness, painful, foot pain

Frozen shoulder is a horrendously disabling, painful and frustrating complaint. Most people who experience frozen shoulder have been extremely healthy and active their whole lives and suddenly, out of the blue, get the bitter taste of what it’s like to live with an actual disability. No fun at all. The only positive you can take from the pain and disability that frozen shoulder brings is that it makes you highly motivated to get well. This is lucky because frozen shoulder takes a fair amount of tenacity and skill to resolve successfully in a satisfactory timeframe. When the rubber hits the road, and you’ve decided to get treatment for your frozen shoulder, what matters is making sure you are getting the right treatments and not the wrong ones. So, what are treatments that work for frozen shoulder?

Shockwave Therapy for Frozen Shoulder

Shockwave therapy is an excellent research-based way to treat the symptoms of frozen shoulder and dramatically speed up frozen shoulder recovery. Shockwave therapy was developed originally for the treatment of kidney stones. Amazingly, once this treatment was established, it became apparent to researchers that in addition to dissolving kidney stones, patients were also experiencing spontaneous resolution of stubborn pains. 

There is a wide range of applications for shockwave therapy in pain management; it can be used for anything from tendinitis in your thumb right through to resolving stress fractures. In the instance of frozen shoulder, shockwave therapy helps dissolve the fibrous thickening in the joint capsule, much the same way it resolves the stones in kidney stones and the way that it dissolves calcification and shoulder tendons with calcific tendinitis. A few (if any) treatments can accelerate recovery from frozen shoulder as quickly and consistently as shockwave therapy.

Rehabilitation For Frozen Shoulder

The word rehabilitation is used here to refer to our actions in the long term to ensure the frozen shoulder doesn’t come back. So we are talking about relieving frozen shoulder and preventing future attacks of frozen shoulder. Rehabilitation for frozen shoulder is essentially the same as rehabilitation of posture. One of the primary underlying causes of frozen shoulder is the combination of sedentary work at a desk, usually combined with postural weakness (and also stress, FYI).

So in the long term, rehabilitating frozen shoulder is about strengthening the postural muscles and ensuring that you’re more upright over time. In nitty-gritty practical terms, this means spending 10 minutes a day doing strength exercises for your upper back. These can be done at the gym, but they can also be done at home quite quickly with some essential equipment, and ultimately, they are no more trouble than you already take to look after your teeth. This takes the pressure off the shoulder joint capsule, making you less susceptible to repeat cases of frozen shoulder.

Acupuncture for Frozen Shoulder

Acupuncture is a treatment that has been used for literally thousands of years. And there’s a good reason for this; it reduces the symptoms of innumerable painful conditions. It seems a little weird that just putting some tiny needles into an injured or stiff body part would be helpful. It’s not as if you inject beneficial nutrients or chemicals into the area, yet it often brings excellent results. But the reason acupuncture is so often helpful is logical once you understand it. 

When we go to the gym and lift weights, the muscle gets more robust because it has been moderately stressed; a moderate amount of stress is essential for healthy muscles, which is why we need to exercise regularly. Understanding this is the key to understanding acupuncture. Acupuncture puts low-grade pressure on the body and triggers changes in tissue, much like exercise does. Scientists refer to this as hormetic stress or ‘healthy stress’. In the case of frozen shoulder treatment, acupuncture and dry needling are excellent options for reducing pain signals, increasing blood flow and reducing muscle spasms. You could say the stimulation of needles generally helps with the ‘unfreezing’ campaign.

pain, chronic pain, shoulder pain, acute pain, hip pain, soreness, painful, foot pain

 

Acupuncture for Frozen Shoulder

Acupuncture is a treatment that has been used for literally thousands of years. And there’s a good reason for this; it reduces the symptoms of innumerable painful conditions. It seems a little weird that just putting some tiny needles into an injured or stiff body part would be helpful. It’s not as if you inject beneficial nutrients or chemicals into the area, yet it often brings excellent results. But the reason acupuncture is so often helpful is logical once you understand it. 

 

When we go to the gym and lift weights, the muscle gets more robust because it has been moderately stressed; a moderate amount of stress is essential for healthy muscles, which is why we need to exercise regularly. Understanding this is the key to understanding acupuncture. Acupuncture puts low-grade pressure on the body and triggers changes in tissue, much like exercise does. Scientists refer to this as hormetic stress or ‘healthy stress’. In the case of frozen shoulder treatment, acupuncture and dry needling are excellent options for reducing pain signals, increasing blood flow and reducing muscle spasms. You could say the stimulation of needles generally helps with the ‘unfreezing’ campaign.

Mobilisation For Frozen Shoulder

One more conventional and controversial way to treat frozen shoulder is to apply a general anesthetic and have an orthopaedic surgeon wrench the joint capsule complimentary; in much the same way as you might snap a big thick piece of wood off your knee. Truly. When a joint manipulation is so violent that you need to be knocked out for it, rest assured you are looking at a reasonably nausea-inducing spectator sport. For understandable reasons, orthopaedic surgeons are generally somewhat reluctant to give people a general anesthetic and then Hulk Hogan their shoulder joint loose. So many people with frozen shoulder ultimately don’t get offered this option and elect for the more common method of just waiting.

At the more soft and cuddly end of the frozen shoulder treatment spectrum, it is possible to gradually mobilise frozen shoulder over months—much the same as you might think about increasing progressively hamstring flexibility by putting in gentle repetitions. However, the difference between mobilising frozen shoulder and stretching a hamstring is that you need a practitioner to do much of the work with the shoulder. Regular weekly joint mobilisation combined with some of the other frozen shoulder treatments can be a very effective way to speed up the recovery of the frozen shoulder;  for those who don’t want to be anaesthetised and get beaten up by a grown man.

 

Conclusions On Frozen Shoulder Treatment

The journey towards full resolution and long-term prevention of frozen shoulder can feel a little daunting. However, it need not feel that way if you start from acknowledgement and faith that millions of others have been on this journey and had successful outcomes. With the right tools,  sensible approaches and the right mindset, the whole process becomes something you chip away at and eventually get there. Then you’re back to being one of those fortunate people who doesn’t live with a permanent disability in no time.

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ankle pain ankle sprain arch pain back pain back pain treatment back pain treatment wellington back soreness chronic pain custom orthotics exercise foot pain frozen shoulder headache heel pain hip pain holistic pain management knee pain lifestyle lower back pain migraine Migraine headache neck pain numbness pain pain clinic pain clinic wellington painful shoulder Pain management pain rehabilitation pain relief pain science pain treatment physical migraine treatment plantar fasciitis plantar fasciitis relief plantar fasciitis treatment rehabilitation sciatic pain shoulder pain shoulder pain treatment shoulder rehabilitation sleep sore shoulder tension headache Wellness

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