Impingement Sydrome v. Frozen Shoulder

March 6, 2011
Impingement Syndrome and Frozen Shoulder are very similar because they effect the shoulder joint but there are some differences.  Lets look at both and see what we can do about them.

Impingement Syndrome (I.S.):

We become more at risk for shoulder can happen as we get older because we become tighter and less mobile.  This condition can sometimes become a problem after bouts of shoulder bursitis or rotator cuff tendonitis.  Injuries to the shoulder inflame the tissues and can cause long term damage.  The rotator cuff muscles become tight and do not function properly leading to decreased movement of the shoulder.

What are the Symptoms?

Difficulty lifting a straight arm over your head or behind your back.  There can be tightness, pain and tenderness on the shoulder area. If this problem is not taken care of, chronic muscle tightness and atrophy can pull or rupture the bicep muscle or tendon limiting ability to bend the arm and elbow as well.

What can be done?

1. Stretching exercises

2. Proper alignment of the shoulder in the joint space

3. Muscle and tissue loosening with massage or sastm (a Graston Technique)

4. Ultrasound, Tens machines can also be used to stimulate the area

Frozen Shoulder (Adhesive Capsulitis)

What is a frozen shoulder?

Frozen Shoulder is similar to Impingement syndrome but the capsule of the arm is affected with loss of movement in all directions (over the head, to the side, backwards).  It happens during active motion (patient does it) or when the doctor moves it and the patient is relaxing the arm.

What causes a frozen shoulder?

Repetitive movements or injury to the shoulder which causes inflammation, scarring, thickening, and shrinkage of the shoulder’s  joint capsule which surrounds the shoulder joint and keeps muscles and tissues in place.

If you are diabetic, have chronic Rheumatoid Arthritis or have recently had chest or breast surgery you are at a higher risk of getting Frozen Shoulder.  Also, long term non-movement of the arm in its normal range of motion can develop frozen shoulder.

How do we know you have frozen shoulder?

During examination we will move your arm and see where its limitations are.  Orthopedic tests will be administered to test strength and neurological testing will be performed.

If necessary, an x-ray with contrast dye injected (Arthography) into the shoulder joint can show problems with the capsule.   Also an MRI can be taken to see soft tissue damage.

In order to help with this problem, proper stretching of the arm and rehabilitation is required.  Stretches must be done everyday to keep good blood flow, movement and mobility.  Here is the bad news….once you have frozen shoulder or impingement sydrome, you have to keep stretching.  It can and will come back.

Both of these problems need a lot of time for rehabilitation.  It can sometimes take be 6-8 months to get back to full function.  Be patient, it will happen, just a lot of hard work to get you back in the swing of things again.

Hope this makes sense to you.   If not, email me or blog back and I will clarify!
By Dr. Amie Gregory | Posted in Chiropractor Redwood City, Redwood City Chiropractor, San Carlos Chiropractor | Tagged , , , , , , , , , , | Comments (0)

Tips for Adhesive Capsulitis (frozen shoulder)

March 24, 2010

Causes:

The bones, ligaments and tendons around your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule swells and thickens tightening the shoulder joint, restricting its movement and causes pain.

Frozen shoulder is often initially ignored when symptoms first occur because the pain subsides within a few days so people think it is just a short term problem.  It will come back and when it does it is more painful and lasts longer.  Scar tissue and inflammation re-occur and continue to restrict the shoulder from moving properly.

This problem takes a long time to see full results but it can be alleviated.

Frozen shoulder has three stages:

  • Stage one: The “freezing” or painful stage, which may last from six weeks to nine months, and in which the patient has a slow onset of pain. As the pain worsens, the shoulder loses motion.
  • Stage two: The “frozen” or adhesive stage is marked by a slow improvement in pain but the stiffness remains. This stage generally lasts four months to nine months.
  • Stage three: The “thawing” or recovery, when shoulder motion slowly returns toward normal. This generally lasts five months to 26 months.

Risk Factors:

  1. Age: People 40 or older are at risk
  2. Repetitive jobs especially jobs which require raising the arms over the head
  3. Injuries to the shoulder which causes improper movement of the shoulder adding to inflammation.

Treatment:

Inflammation must be decreased before exercises can really be beneficial.   Scar tissue must be broken and new healthy tissue must take its place.  Sound Assisted Soft Tissue Mobilization can decrease scar tissue and increase mobility.  We can also train your shoulder to move properly to prevent further injury.

By Dr. Amie Gregory | Posted in General Health, San Carlos Chiropractor | Tagged , , , , , , , | Comments (0)