Frozen shoulder, also called adhesive capsulitis, is a painful, inflamed, and stiff condition of the shoulder that usually affects people in their middle age and especially between 40-60 years. The symptoms make it difficult for the sufferer to carry out daily chores, as it makes movement of the shoulder very difficult. The condition can make a person so incapacitated that they find it difficult and painful to carry out simple tasks like brushing teeth or even combing hair. There are three stages of frozen shoulder – freezing, frozen, and thawing. The first stage, freezing stage, is when the problem begins and pain and stiffness sets in. In the frozen stage, joints start to stiffen, experience restriction in movement and become most painful. The third stage is thawing, wherein the problem starts to ease. But, thawing does not mean an end of the problem. The problem recurs even after subsiding. There are no specific causes of frozen shoulder but it’s usually caused by trauma or an injury, bad posture, problematic auto-immune system or even heart diseases, diabetes, and lung disease. Women are more susceptible to the ailment than men.

Home Remedies For Frozen Shoulder Treatment

Usually, the treatment of frozen shoulder involves physiotherapy along with moist heat or ice ultrasound. Physiotherapy includes specific exercises for the shoulder and also some stretching exercises, which must be done at home. Even if the exercises are painful in the beginning, one has to continue it to cure the problem.

• Warm oil massages are beneficial for relaxing muscles. Have someone give you a massage to loosen the muscles and make movements easier.
• Soaking black sesame seeds in water overnight and consuming the next morning is known to alleviate pain and stiffness of the shoulder.
• Taking a hot shower or soaking in a bathtub with warm water and half a cup of Epsom salt for 20 minutes everyday also alleviates pain and loosens muscles.
• A warm bath or shower especially before exercise is beneficial as it increases blood flow in the region and stretches the tissues. Applying hot and cold compresses on the shoulder also alleviates the symptoms. Ice is known to be one of the best curers of pain and hot compress is good for relaxing muscles.
• It’s also important to maintain good posture all the time to prevent frozen shoulder. Check for your posture in the mirror before beginning your exercise session. And, remember that the therapy is a long and painful process. Continue it nevertheless to get positive results.

It’s been almost 5 months since the surgery and 7 months since the injury.  Still off work but seeing major  improvements in strength and range of motion over the last month.  There is still constant aching in my shoulder but at least it’s not to the point of distraction that is was before.  Therapy is going well and we are stepping down from three sessions a week to two since my range of motion has been consistent from visit to visit.  It’s been a long road to that happening.  My therapist, Donna, stretches my shoulder and arm for a good 30 minutes before I am ready to do any exercises.  At least now we are moving into weights (although light) and away from passive motions that we did months ago.

It seems the tendonitis that sidelined therapy for a couple of weeks is gone and we can concentrate more on range of motion and gaining in strength.  I was sent to an independent orthopedist for a second opinion that Workman’s Comp ordered.  At least they found an orthopedist that specializes in arthroscopic shoulder surgeries and not some hack.  After they spent a lot of money to have me see their doctor, he pretty much concurred with my current treatment regimen and supported the fact that I should be off work as a fireman for another month or so, given that I can’t lift very much weight.

So, I attend therapy two times a week, take my medicine like directed and do my home exercises.  It’s a long process to get back to work but at least I now see a light at the end of the tunnel and have felt the progress of gaining strength.

The doctor and Workman’s Comp is recommending a Work Hardening Program to get me back to physical strength to be a fireman again.  I was told it can be 4 to 8 hours a day of specific exercises designed to replicate your work environment and get you ready to go back to work in peak physical condition.  I actually would look forward to the program and would love to get back in shape for work.  At least I only gained 8 pounds during this ordeal instead of the usual 20-40 pounds most people put on.  Thank goodness for local forest preserves and time for long hikes.

Hey, it’s been awhile since I’ve posted but there’s been things happening.  Some good and some bad.  About two weeks a go I started to develop tendonitis in my shoulder.  My therapist always says “we listen to the patient” which means the shoulder, not me.  I have been following the prescribed exercises at home and it was just too much for “the patient”.  We backed off the 2 pound weights and using the thera-bands and went back to stretching and assisted movements.  Two weeks later, I’m back to trying weights and was successful for the past two sessions.  We are using only 1 and 2 pound weights and it is amazing how quickly the muscle gives out given the fact that there is no muscle right now.  The atrophy has been pretty severe and the rehab to bring me back to the point of being a firefighter/paramedic again will take some time.

I am impatient at times and feeling like I could do more but I was told numerous times not to overdo it and ruin the therapy.  I’m pleased with the progress so far and am amazed at the range of motion I have regained.  It’s not much but it is more than the two inches I could raise my arm after surgery.

There is still some every-day pain in the shoulder and bicep area.  Ice helps the throbbing and sometimes medicine helps me sleep but for the most part, you get used to a certain amount of daily pain and just “suck it up”.  My advice to anyone reading this who may be going through this therapy and rehab it to be patient and let it work.  If you try to lift more than you are able, you could tear something and put yourself back to square one, surgery.

I had my two month follow up visit with my orthopedist.  They say everything is going as planned and that my therapy is moving along at the expected pace.  They reiterated that I need to be patient with the process and not to start lifting any weights since the labrum was still healing itself back to the bone.

I was able to get out for the weekend to a reunion weekend for past staff members of a scout camp I worked at when I was younger.  It was nice to get out of the house and have a weekend to myself.  It is still tough sleeping at night and I am still up at least 3-4 times a night with some shoulder pain.  I refuse to take any more narcotics though as it messes with your head and I don’t like it.  So far so good.  You just get used to a certain level of pain and learn to just handle it.

I received a comment from a blog reader today that thanked me for journaling my experience as she was befuddled with her own experience.  I guess it’s nice to know what to expect and that you are not alone in the whole orthopedic process, which can be time consuming and confusing.  That is the reason I created this blog was to help someone understand the process thru my experiences.   I’m glad I could help.

My partner and I generally make it to the gym together three times per week.  On the early morning Tuesday and Thursday visits we do our own thing but on Sunday mornings we began a routine of working kettlebells together.  These workouts have been on hiatus for many months as I rehabbed from my bilateral adhesive capsulitis, but today we re-ignited our mutual sweat fest.

The workout we completed today was the same workout I put the Friday morning training group through this past week.

a kettlebell pose

Here’s what we completed this morning:

Jump rope warm up and range of motion exercises for various joints.

• 5 Turkish Getups each side
• 5 Windmills each side     *for the TGUs and Windmills I used a dumbbell instead of a kettlebell as I still do not have sufficient rotation in my shoulder joints to complete the moves and support the kettlebell
• 10 clean and racks each side
• 4 sets each:  5 clean and front lunge combinations both sides
• 4 sets each:  8 press and back lunge combinations both sides
• 4 sets each:  5 single arm rows/rack squats both sides
• 4 sets each:  8 single leg deadlifts/crush curls both sides

We finished off the workout with 7 sets of snatches: 30 seconds each side; 25 seconds each side; 20 seconds each side; 15 seconds each side; 20 seconds each side; 25 seconds each side; 30 seconds each side.

We were both able to fire off more snatches in the finishing 30 second intervals than in the starting intervals and it felt good.

Quite sweaty we headed home, happy to share a post-workout breakfast with our daughter, grateful for the privilege of hot running water, anticipating what may hurt tomorrow morning.

Really a great together-start to summer 2009.

When my orthopedist called me at home, we discussed all the procedures he ended up performing during my surgery. He said that with all the damage and extra procedures I needed that he usually breaks it into two surgeries. The first one to manipulate the shoulder, shave all the torn cartilage, remove the floating cartilage piece and take care of the bone spurs and arthritis. Followed by six weeks of physical therapy and then onto a second surgery to repair the labrum damage. He said that since the tears were so acute that he made all the repairs in one surgery. Believe me, I appreciated that because one surgery was enough for me. Since the surgery was so extensive, he said that my rehab was going to be modified to take into account all the “angry tissue” in my shoulder. He said the I was a great risk for adhesive capsulitis, or frozen shoulder.

Your risk of developing frozen shoulder increases if you’ve recently had to have your arm in a sling for several weeks, or if you have had surgery in which your arm was immobilized in a specific position for a prolonged period.

Treatment for frozen shoulder involves stretching exercises and, sometimes, the injection of corticosteroids and numbing drugs into the joint capsule. In a small percentage of cases, surgery may be needed to loosen the joint capsule so that it can move more freely. So physical therapy was going to start right away.

This evening what I’m noticing is the pain in both shoulders is much alleviated.

But most of all, I don’t have that incredible high after I eat, and the inevitable crash that usually follows.

Unfortunately I’ve come to sort of rely on that feeling after I eat, so this is quite a change. Here it is, past my bedtime already, and I could keep going!

Can’t wait to see what changes I notice tomorrow!

I have to say, though, with all the pain I’ve suffered through as a result of my shoulder injuries…that I wish the doctors would have had a handle on this science; the science that leads the body to heal itself!!

For much of my life, I have asked why is life so slow. Why isn’t there a quicker or better way? I, like many of you, have been time crunched for years. With what? Life things, from the regular routine of exercising 3-5x a week, mantaining my hygiene, eating 3-6 well-rounded meals a day, drinking 8 cups of water. We often find it pretty good to live this way until it is interrupted by an incident like an injury or a funny ache somewhere. Then, you are sent in a panic frenzy, asking yourself is it serious, can I wait, or will it go away if I just leave it alone. Most often than not, the latter is most often the worst, and the former is a pretty darn good question.

Is it serious? OF COURSE IT IS! Why would you be panicked if it wasn’t? Things that break up your norm is a serious thing to consider; maybe not right now, but eventually it will take a toll and if you don’t take action, it will lead to a cascade of events from something small to something big, bad and ugly.

Back to my dilemma…
I was raised to believe that there is “always a better way” in this consumer society filled with quick slim/trim diets, mobile phones, internet, and excel sheets. Like most of you, I wanted it now and I wanted it cheap with the best results. I always questioned the traditional and conventional theory—that hard work produces the best results. Who wants to sit through the mundane and boring materials, exercises, classes.

Practicularly, as a practicing physical therapist, most of us forget that you all have lives out side of PT and can’t afford to spend a couple of hours per day to rehab a knee. Too many exercises, too much time, little gains are frustrating. Now I am not saying that shortcuts work in every case, but I believed that there MUST be bridges and shortcuts in life. You just have to look hard to find it.

So I began my quest in my youth to see if there was a more efficient way to reach the best outcome. Originating from a patient standpoint years before I started pursuing a Physical Therapy degree, I had it in my mind to find a better way for everyone. I felt as if I have devoted my whole life to prepare me for this point and I believe you all will be satisfied with the product. (See also Justin’s Journey and Testimonials)

What makes Wellness Revolution 101 any different from other quick self instruction applications? It’s built on the same concepts as all my predecessors, however, like Google, I realized that there were ways to simplify concepts, make the exercises quick, efficient, and applicable in daily life. It’s made to be easy and to memorable, with little to no aid needed. But I do plan on providing as much description or visuals as necessary. If you have some sort of ache and pain to alleviate and/or goal in mind to achieve and is one who is time consumed, give this a shot. I’ll be disappointed if you let this creative work pass by. Let me preface this, as in my disclaimer, that I DO recommend you see a professional before you start with my programs. You should not self-diagnose anything.

This site is made and developed by one of you…for all of you dreamers and free thinkers. Don’t ever give up your quest for a better solution!

Let’s begin!

Justin

This past week has been incredibly busy.  Selling trick-or-treat bags at the local farmer’s market, preparing for company for an extended visit,  and the best of it all, became a distributor for the BodyBolster(tm) and started selling them on EBay. 

I discovered the BodyBolster when I was searching for tools/methods to help me stretch out this shoulder.  My first stretch (the arm up the wall on a towel) went 2 inches higher than the previous day when I used this bolster.  It was smooth, easy and felt good!  And, the other shoulder stretches definitely challenged my shoulder but it’s adjustible, so I’ve started with some air removed and I can inflate as I gain more flexibility. 

Anyway -I’m running out of time tonight, so I’m putting a link to my Ebay items – look for the BodyBolster.  I swear by it.

It’s amazing what is available on the internet now.  Here’s some links I found on youtube that show:

• How the shoulder works <a href=”http://www.youtube.com/watch?v=GOZjgz18eOQ“>
• A demonstration of how the shoulders should work (a doctor’s examination) http://www.youtube.com/watch?v=VSrLbzZzJU8  It’s amazing at how many of these tests I could NOT do. 
• Arthoscopic surgery to release a frozen shoulder (graphic) http://www.youtube.com/watch?v=5To9tcYWrss

There’s more videos – seach on frozen shoulder.

A couple days ago, I was talking about a new hobby that I’ve started.   This started me thinking about some hobbies that I’ve had to give up, at least temporarily, and maybe permanently.  They mostly require using both hands at the same time.  I’ve discovered that I’ve been able to keep up with some hobbies, such as gardening, because I can switch off hands/arms, giving them a break.

One of the hobbies I’ve had to give up is crocheting.  While I can do most things with both hands (including writing luckily!), I’ve never developed the ability to use a crochet hook with either hand.  I have an afghan with about 8 rows left.  I pulled it out last night to see if I could finish it off and I lasted about 15 minutes before my left elbow and shoulder started to hurt.  Maybe I can try this again AFTER my shoulder has completely healed.

I’m also a classically trained flautist and I haven’t been able to play for over 5 years now, even for my own amusement.  I probably will never be able to play again since the many (MANY) hours of practice in my teens and 20s are probably the beginnings of my tendonitis.   I really miss this.

Tell me what you have had to give up.

I’ve had a busy last few days.  I’m starting up an internet business and during my research I found some canvas tote bags that would work well as trick or treat bags - they don’t tear like plastic or paper bags, they are reusable, and fold up small for storage.  I contacted my local farmer’s market and they indicated that I could sell them if I embellished them.  So, I made a jack o’ lantern face stencil and some friends and I spray stenciled a BUNCH of bags on Saturday.    Had fun!  Here’s the Field of Orange that my backyard became while the bags were drying.

I did use my shoulders differently doing this and paid with stiffness and additional pain.  However, I have discovered that I like to hand stencil items!  It uses some different muscles (always a good thing!) and it is something I can do while watching/listening to TV or the radio.  I now have a new hobby that my friends are telling me that they like.  So, I’m also going to see if my hand-stenciled totes (not just the jack o’ lanterns) sell at the farmers market, and if they do, I may start to sell them on etsy.com. 

Has anyone else learned a new skill or hobby as a result of going thru rehab?   I’m trying to come up with new hobbies and skills to replace those that I can’t do anymore. 

Friday is usually a good day.  It’s been 4 days since the latest round of therapy.  Today I was busy preparing for a stenciling project with friends tomorrow (I’m finding that I’m not very good at this! – hopefully my friends have some suggestions) so I’ve used my arm alot.  Now that I’m solidly in the thawing stage I usually don’t have pain if I’m using my arm within it’s range of motion (ROM) but I’m tired and achy tonight.

On another blog recently, someone was wondering how to tell what stage one’s shoulder was in.  This is how I describe it…

For me the Freezing stage was characterized by excruciating pain (I called them white-outs because I that’s all I would see for several seconds) (my avatar is a photograph from my yard that reminds me of white fireworks) when I moved or jerked my arm outside its current ROM.  I’ve also heard it called “exquisite” pain.  My shoulder slowly locked up, even with stretching exercises.  Tendonitis in both hands and arms hurt.  Except for very mild stretches, I stopped using the affected arm.

Frozen, my arm was stuck, wouldn’t move, would hurt if we tried to move it (but not that sizzling white-out) and the muscles and tendons in my shoulder and upper arm were like lumpy rocks and rubber.  The tendonitis in both hands and arms still hurt.  I wear a wrist brace on my right arm at night because I ended up straining some muscles across the top of my right hand.  It’s amazing how unbalanced we can be when a quarter of our body doesn’t want to move!

Thawing, I could start stretching out that scar tissue and the rigidity in my muscles and tendons started to release.  Pushing past my range of motion causes pain but it’s more like extreme workout pain, muscle cramps or strain.  The tendonitis in my left hand and elbow don’t hurt anymore (probably because that arm didn’t move for months) but my right forearm and sometimes hand does still bother me.

These stages take different times for different people and even for different shoulders.  How do you describe the different stages?

Yesterday was not a good day.  I woke early in pain and couldn’t get back to sleep.  With the cloudy day, I never seemed to get past that.   I have therapy every Monday and usually a Tuesday or Wednesday proves challenging as my muscles work out what my Dr and therapist have done.  And, this week it was yesterday!  Today is better though.

Part of the problem for me in sleeping is that I’m still not moving when I sleep.  I have 2 positions that are comfortable, and I seem to stay in one position until my body screams at me to move (of course, waking me up!). 

When I was in the freezing stage, I slept on my back with a memory foam wedge and pillows to support my arm and to keep from turning over.  Now I sleep on my right side (opposite the frozen shoulder) using a body pillow to position my arm so there’s no drag on the shoulder joint.  Sometimes I even shove another squishy pillow under my shoulder to make sure it doesn’t move. 

How do you manage sleeping?   Even though I’m in the ‘thawing’ stage and pain management is better, I’m still sleep deprived.   I wonder if it’s ever possible to make up the sleep deprivation this condition causes!

The medical community doesn’t know what causes frozen shoulder but the people I’ve talked to say that it usually has a physical trigger such as a rotator cuff injury or strain.   My trigger was tendonitis caused by overuse of my hands.   Can you believe that using your hands can cause problems with your shoulder?

I’ve been in IT since 1971 and my thumbs and hands have hurt off and on since I started using a mouse.  I’ve used just about every type of mouse available and trained myself to alternate hands in order to keep the pain down but when I added an on-line MBA (adding another 2-3 hours of computer work a day) to my hands, my body rebelled.  The tendonitis flared into one wrist, switched to my opposite elbow and then back to my entire right arm.  And then it started – the shoulder pain.  It took 3 months to get a diagnosis and by then I had lost about 50% of my range of motion.  That was 5 years ago and there was not as much on the internet about frozen shoulder as there is now.  This was one of the sites that I found with a straightforward description: http://www.mayoclinic.com/health/frozen-shoulder/DS00416.

What started your frozen shoulder.  Has anyone out there had this start without a physical trigger?

BTW – I did get that MBA by the help of my school teammates and some computer tools, but I’ll talk about that another day. 

Adhesive Capsulitis (Frozen Shoulder) presents a good reason why one should not always let pain dictate the level of activity done. Usually it’s good to allow body parts complete rest (after the necessary repair work if needed) to heal on their own after an injury, but sometimes it’s bad. I learned the hard way (through ignorance) how that can be.

A few years ago, I hurt my left arm when trying to force a window open. I didn’t realize I was unconsciously favoring that arm since I spend so much time at my computer. When I was away from the computer doing other things, I must have been developing alternative methods of moving around that gradually changed the way I did things.

For about five months or more, I didn’t pay attention to the fact that I was losing mobility in my left arm. Because of my habit of injuring myself often by accident, I developed a way of ignoring pain and waiting patiently for it to go away. It’s not that I learned to become numb towards pain, because I can know when it’s there. I learned to trust my body to heal itself. It always did before, so I thought when my shoulder kept hurting more at night over the months, I was just losing my skill at it.

However, in this case with my arm, it was quite a strange experience to be losing my ability to move it. My first thought was that I’d try getting a professional massage. I knew I wanted something resembling Shiatsu; something like maybe deep-tissue therapy. Fortunately I did find someone skilled at this profession. He was amazed over my high tolerance to pain¹ when he tried to get my arm to move. But, try as he did, he couldn’t get it unstuck. So, I went to visit his friend who is a chiropractor. The chiropractor couldn’t get it to move either. He suggested I go for an MRI. As soon as I walked out of his office, I thought “Forget that! I’ll figure something else out (but I would give in if God insisted, but He never did).”

Convenience would have it that a deer tick bit me again and I got another lyme rash. That gave me a good excuse to ask a doctor his opinion of my arm while I went in to ask him his thoughts about my rash (that I already knew what to do about — Hi, Ho . . . Colloidal Silver to the rescue!). By that point in time, my arm was almost completely immobile. It was like having a 2 by 4 board nailed (with two nails, not one) to your shoulder with the arm strapped tight to it. He knew I didn’t have insurance, so he wasn’t so quick to make the same suggestions right away as the chiropractor did. Instead he wrote me a prescription to try physical therapy. He told me he had the same thing happen to his arm. He also said that he couldn’t endure the pain that physical therapy brought, so he opted for for surgery instead. He also claimed to have seen some people suffer permanent immobility because of not seeking treatment for such severe cases of frozen shoulder as what I had. After I left his office, I went straight to the nearest physical therapy office. I knew I could at least ask what it would cost. That was enough to say, “Forget that!” again.

So, back to my computer I went; this time to see what physical therapists do in cases like this. I read about people having success with acupuncture. Fortunately my sister-in-law (a chiropractor) was coming to visit and she was into doing acupuncture. Plus, she didn’t charge anything for giving it a try! We only had a few days to see what acupuncture could do. It did manage to get my arm to move about ½ of an inch or so. At least my son learned then I wasn’t faking it to get attention. He tried to move my arm with all his strength but got nowhere. Anyone for a little arm wrestling?

My husband didn’t believe anything was going to work (other than surgery). I told him he wasn’t going to cop out that easily from helping me. I had an idea. He only had to agree to help me out for a 40-day trial period involving 10-15 minutes of his time in the morning and the evening. I rigged up a rope and pulley system where I could sit in a chair and greater force on my arm could be used by having it tied and pulled on.

For the first week, hardly any noticeable improvement could be seen. I knew I could see tiny bits of change, but hubs kept insisting it was futile. It was when we were into the second week of my do-it-yourself at home torture chamber that progress was becoming obvious. Darn, now I wish I could have made videos of this and put it on youtube.com (but I didn’t have a camera back then)! You’d have to cut the volume down though if I did that because that’s when I did some daily screaming. Even Oliver tried to console me during these moments by gently placing his paw on my leg while hubs pulled and pushed on my arm. Master mister isn’t no weakling. He’s a carpenter who is built like a rock, so if anyone could get my arm to move, it had to be him. I told him to tap into that part of his brain where the memories were that held his desire to inflict pain on me and put it to good use. It must have worked — because in 40 days time, I got back about 95% of my arm movement! The other 5% was easy for me to get back on my own even though that part took another month or so before it happened.

Now when I look back about what’s written and said about the length of time people have to endure such crap with a frozen shoulder, why can’t I go into some record book for getting rid of something like this as fast as I did? I guess I’ll just need to remain content with what I did get and not complain.

One last note about my left arm: That was the same arm I recently injured again. This time I’m not going to baby it! Maybe that’s why I felt like I had to write today about my frozen shoulder experience that happened a few years ago. I needed the reminder.

¹Some aspies, such as myself, can be both hyper and/or hypo sensitive to pain. Read about Asperger’s Syndrome and Unequal Reaction to Pain.

[Edit Added 12-13-8] Here are a couple of posts by others sharing their frozen shoulder experience:

Pain continuing — Splitpea’s Weblog.

Just What Is a Frozen Shoulder Anyway?? — It’s A Kat’s Life