Frozen Shoulder : Known In Medical Texts As Adhesive Capsulitis...

› [Frozen Shoulder]
Adhesive capsulitis is progressive and immobilizes the shoulder...

Frozen shoulder to this day has remained a mystery to all who observe, treat, and study joint pain...

Findings back in the year 2000 revealed that this type of shoulder pain does not altogether have its origins in 'joint pain', but is rooted in gene expression:

In a case report on adhesive capsulitis, J Can Chiropr Assoc. 2000 Sep; 44(3): 169–176. written  by Mohzen Kazemi...

The conclusion was as follows:

'Elevated levels of TNC and FN1 expression may be a marker of capsule injury. Upregulation of TGFβ1 receptor I seems to be dependent on symptom duration; therefore, TGFβ signaling may be involved in adhesive capsulitis. As such, TNC, FN1 and TGFβ1 receptor I may also play roles in adhesive capsulitis by contributing to capsule inflammation and fibrosis. PMID:27438566 '


It has also been noted that adhesive capsulitis occurs more often in women than in men, and usually in the age range of 40 -60 years of age...

Frozen Shoulder
During
Menopause...

Normal vs. inflamed shoulder capsule. This is known as the hot phase. During the hot phase do not massage, and use ice only...

After having a look at the above study, I came by a paper written by a nurse practitioner who targeted menopause as a suspect in the formation of adhesive capsulitis – it was her thesis...

She worked with a group of women who were both perimenopausal and menopausal, and found when they were put on HRT the pain resolved, and they could once again begin to establish a range of motion in the affected shoulder joint...

One woman reported feeling like she had received 'a new, well-oiled shoulder...'

Human endocrine systems are among the most complex systems in the body to examine and regulate because each of us has a slightly varying hormonal chemistry. Slightly, but enough to make each of us unique...

This has to do with our internal genetic environment as well as our outer environment which includes quality of food, stress, job satisfaction, relationship satisfaction; and the list goes on..

All of these things affect our endocrine systems and 'shape' us in a particular way hormonally. And, will also affect genes that are subject to getting switched on and off at different times in life according to all the variables in your life and how they affect your internal biological systems...

So, while some women may sail through menopause, for example...

Later, they often run into joint pain, such as frozen shoulder due to the change in their hormones, which theoretically, could be causing the contents of the  synovial fluid to change...

And, this continues to support the hypothesis that gene expression is responsible for adhesive capsulitis,  as genes get switched on and off as we age, and especially when a woman goes through menopause...

Again, this is also due to the unique combination of the stressors in our environment, in combination with how we are pre-dis positioned to respond to those stressors mentally, psychologically, emotionally and also in terms of our  genetic expression in response to life...

Anatomy Of The
Frozen Shoulder...

The capsular tissue, that wraps the head of the humerus into the  Glenoid Cavity, has become inflamed and is in the process of gradual swelling and thickening...

Normally, the soft tissue that forms the capsule folds in and hangs  loosely when the arm is down at your side and stretches and lengthens as you move your arm out and around...

When it 'freezes', there is a chemical change in the tissue that, in the early stages, leaves this tissue brittle...

As it thickens, it becomes more immovable and there is less room for the head of the humorous (the top of the bone of the upper arm) to sit - eventually the the humoral head will be displaced anteriorly (forward).

When the bone is pushed sufficiently out of the cavity, there will be little or no ability to move the arm...

Changes To Range
Of Motion That Make
Daily Life Difficult...

Regular daily activities such as:

  • Bathing...
  • Dressing...
  • Hanging wash...
  • Combing hair...

Tasks we consider second nature like:

  • Driving may start to cause pain, and sometimes, become impossible...
  • Catching or throwing a ball...

Sleep becomes difficult and sometimes, just does not happen due to the amount of pain you may be experiencing...

Timelines For
Healing...

If no effort is made to resolve the problem, frozen shoulder has a tendency resolve itself within 8-10 months to a year depending on your state of health....

It has been noted that cigarette smoking inhibits healing and will extend this period of time...

The shoulder will heal naturally, but the end result, if no effort is made to resolve a frozen shoulder is that you may have a limited range of motion, and shoulder pain permanently...

What Can Help
Your Frozen Shoulder...

Illustration of hot tissue that has lead to the adhesive quality of Adhesive Capsulitis...

A few things to understand about the shoulder joint itself...

The shoulder has the greatest range of motion of any joint in your body – just wave your arms around in just about any direction you want. If your shoulders are working correctly that is not a problem...

But, there in lies the advantage and the dis-advantage...

When you have a lessened blood supply into a joint, that must mean that it gets it's blood supply and nutrition from the circulatory AND from movement – which is the forte of the shoulder joint...

A chiropractor, physical therapist, or athletic trainer who have specialized in mobilization of the shoulders post injury or a frozen shoulder are the people you need to see...

A well seasoned practitioner will know:

  • NOT to massage your frozen shoulder,
  • How to asses the phase it is in (which is not always clear cut)
  • And will know how much exercise is the right amount (if any ) for the stage it is in...

Chiropractic:

It has also been noted, in the world of chiropractic, that shoulder adjustments in conjunction with adjustments to the thoracic spine have brought about significant pain reduction...!

  • The function of the chiropractic adjustment may be that it is able to break the cycle of the cytokine influx that has been observed flooding the synovium of a frozen shoulder (via a sampling of synovial fluid and a staining technique that revealed cytokine populations)...
  • You can also apply ice during the hot phase of frozen shoulder...
  • After the heat is out of your shoulder apply ice for ten minutes, then apply heat for ten minutes...

Diagnostic imaging:

Pictures should be MRI or MRA as these pick up soft tissue and soft tissue activity...

*The key message is to be pro-active and do everything you can, from ice and heat, to contacting different practitioners to see who is moThst experienced, and to insist on the correct imaging to get yourself out of pain as quickly as possible to avoid permanent damage... *

› [Frozen Shoulder]

Disclaimer – This is information on joint pain. I teach, but I do not diagnose, prescibe or treat people who contact me. You are responsible for your condition using your own best judgement combined with what you have learned. Just a heads up - bodies carry unusual differences from time to time, in saying that, you could be one of those rare and unusual beings; if you are in doubt, please contact a physician in your area, so you can rule it out.

Move Freely and Knowledgeably and Be Well!

Dr. Jo

P.S...    “Greater certainty of your condition alone can be a powerful form of pain relief.”