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Physical Therapy for Frozen Shoulder
The anatomy of the shoulder joint is fairly complex, due to the high mobility of the ball and socket joint, but fairly complex and small muscle groups involved in its articulation. The shoulder joints are also under the highest demand aside from the hands, especially due to the nature of the modern work environment. The shoulders tend to be under-mobilized, under-supported, deconditioned, and overused. When you add in recreational activities, exercise and sports, its easy to understand why this joint complex is so often the site of pain and injuries.
The shoulder complex involves the sternum, clavicle, scapula, humerus, and also the ribs. But the actual attachment to the axial skeleton is only through the sternum and clavicle. Other than those two points, the shoulder is essentially hanging, and it's all up to the soft tissue to both hold and articulate the joint. Since the hip joint is also a ball and socket joint, it’s often compared to the hip. While they are functionally similar, the stability and strength of the shoulder pales in comparison to that of the hip. There's a lot more range of motion happening in the shoulder, but in most cases, the strength and range of motion is lacking when it comes to safely allowing for it.
The joint articulation can occur in any direction and movement plane, it encompasses all three planes of motion. The sagittal plane, which refers to forwards and back movement. Abduction and adduction occur in the frontal plane. And then there’s the transverse plane, which covers rotation and crossing movements, where you have your horizontal adduction and rotation, and internal external rotation. As a whole most movements in the body cover all three planes of motion, but unlike the hinge joint of the elbow, or even the sliding hinge joint of the knee, the shoulder is not limited to simple flexion and extension. So this high mobility also comes with a high propensity for injuries, especially in deconditioned individuals.
It's medically known as adhesive capsulitis, but different names are used all across the spectrum of medical specialties. The most common term used is frozen shoulder. Physical therapy in NYC can help. This issue most commonly occurs secondary to chronic injuries, or injuries that are left untreated for a long time. It is also something that people deal with after surgery. Its referred to as a post-operative complication. It is not only limited to shoulder surgeries, but can occur following breast cancer surgery, or even “simple” surgical repairs of old tears.
What usually happens is, the shoulder capsule becomes tight, either anteriorly or posteriorly. The beginning stages of frozen shoulder, this really restricts the movement of the humeral head on glenoid fossa. Most of the time this limited range effects the primary muscles that involve shoulder flexion and abduction. If left untreated, it keeps getting worse and rotation gets affected. So eventually all pains of motion are limited and the shoulder becomes “Frozen.”
Usually for routine shoulder impingement treatment, recovery time for frozen shoulder isn’t as extensive as most people would think. According to the American Physical Therapy Association, research indicates that treatment can take anytime between 6 to 24 sessions of physical therapy. However, in our practice, in non-extreme cases, we see people feel much better by 8 to 10 visits. This does not indicate full recovery, but it can often mean a return to light activity. More importantly it can mean a very noticeable reduction in pain and an increase in range of motion.
In a fair amount of cases, we can have patients return to athletic activity after 10 sessions of physical therapy. Once they’re back to working out, while continuing therapy, the pain usually continues to decrease after an additional few sessions. We can start treatment for frozen shoulder with some therapeutic exercise, always with stretching to improve flexibility. Most of the time there are many issues with over and under-active muscles, so we balance it out by strengthening and stretching. Once we see an improvement in flexibility, we also address posture, and then add strengthening. With respect to strengthening, we always start strengthening the scapular muscles so it stabilizes entire shoulder complex.
We can help treat almost any shoulder injury with physical therapy, whether it is chronic, or acute. In extreme cases where surgical intervention is required, we also work with an orthopedic surgeon. We also use a wide variety of ancillary therapies such as kinesio taping, Graston technique, class 4 laser, cold laser, ultrasound therapy, and the percussor massage tool.
For more information about physical therapy for frozen shoulder treatment NYC, contact Living Well Medical at 212-627-8149. We're located in the West Village near Soho at Broadway and Houston Street.