Frozen shoulder

Myofascial release and trigger point therapy for Frozen Shoulder

What is frozen shoulder?  Frozen shoulder – or Adhesive Capsulitis – is a condition in which the connective tissue at the top of the arm bone is literally stuck (‘adhesive’) in the shoulder joint.  The shoulder joint is made up out of the bones on the top of the shoulder which form the hollow into which the arm bone fits (the ‘capsule’). The joint then becomes inflamed (‘-itis’) and it becomes increasingly difficult and ultimately impossible to move the arm without severe pain. 

At the Trauma Recovery Clinic we use myofascial release techniques, trigger point therapy and a range of simple, easy home exercises to release a frozen shoulder. This involves releasing all the fascia and connective tissue surrounding the joint, treating trigger points, and stretching and rebalancing all the muscles involved in moving and stabilising the arm bone in the joint.

Symptoms of a frozen shoulder include the following:

• Chronic pain or stiffness in the shoulder, front or back

• Inability to move the shoulder without pain or stiffness

• Increasing lack of movement in the joint, either reaching across the body in front or reaching behind the body

• Inability to reach up higher than shoulder height

• Pain in the shoulder when lying on either side

• Pain traveling down the outside of the arm 

How do we approach a frozen shoulder?

At the Trauma Recovery Clnic we employ a range of approaches and techniques to ensure that a frozen shoulder releases and stays released.

Testing

First we test for movement and note what the range of movement is for the arm and shoulder, and, if there is movement, what the pain level is.  

When we have this ‘baseline’ we release all the muscles surrounding the joint and involved in moving or stabilising the shoulder. Hands-on treatments include trigger point therapy, myofascial release, visceral manipulation and myofascial stretching.  

Trigger Point Therapy

As we are releasing muscles we ‘sweep’ for Trigger Points, releasing each one as we meet them. These are areas of muscle fibres which are permanently contracted and painful on palpation. They refer pain to other areas and cause the brain to resist movement in their own immediate area. They have the effect of shortening and eventually immobilising the entire muscle. Once trigger points are released the muscle can function normally. Trigger point therapy is always accompanied by local fascial release, because if the fascia in the area of a trigger point has not been released, the trigger point is likely to return.  

Myofascial release

After the muscles and Trigger Points have been released the whole area is revisited for fascial restrictions. Fascia is the membrane that surrounds entire muscles, muscle fibres, fibrils and smaller structures down to cellular level. When fascia is adhesed or restricted, movement is not possible without pain. MFR uses specific techniques to release fascia, deep down into the joint. Further trigger points may be found in the fascia itself, which are then released. Nerves and circulatory vessels all move through the body wrapped in fascial membranes. If fascia is stuck, it squeezes the structures it surrounds, inhibiting movement and circulation. If fascia is not moving freely the whole area will experience pressure, malnourishment and ultimately painful restriction in movement and at rest.  

Retesting

When as much soft and connective tissue around the joint has been released as is possible in one session, we return to the muscles to check that they are in balance, sweeping once more for any trigger points we any have missed. We aim to keep any treatment in balance during each session so that even if all trigger points and adhesions are not released, the overall movement of the arm in the shoulder joint is balanced, preventing any further problems.  

Moving the joint

When we have released muscle, trigger points and fascial restrictions we retest the joint for mobility noting again the range of motion and the pain on movement and at rest. This gives us information as to where there may be further adhesions and a starting point for any following treatments.

In normal circumstances it takes between 6 and 8, 55 minute sessions for there to be a substantial increase in pain-free movement of the shoulder. Between sessions the tissues will continue to free up, both through natural every-day movement and with specific, easy exercises we will teach you.

Home exercises

At the Trauma Recovery Clinic we show you simple but extremely effective exercises to do to speed your recovery.

The Wider impact of frozen shoulder

Frozen Shoulder can cause problems in other areas which are compensating for the restrictions in the shoulder and arm. When the fascia and muscles around the shoulder joint are released we check the functioning of other nearby structures for possible restrictions.

Equally, Frozen Shoulder may be caused by other problems, so during the treatments we check that there are not also other areas of restriction which are actually causing the Frozen Shoulder problem or contributing to it.

What clients say about our approach to frozen shoulder and RSI

RW, Brighton

“For many years I experienced severe RSI in particular in the right arm. Last year this became extreme and made movement in my right shoulder very limited and painful.

After two sessions with Anne my shoulder began to improve significantly and the other symptoms of RSI reduced to a manageable level. After six treatments I am well on the road to being free of pain and have regained the majority of my flexibility lost some years ago.

I have found this treatment fantastic, especially as I have tried every other treatment – both conventional and complementary – with no particular effect. I have recommended it to many people and would tell anyone to give it a go!”