Frozen shoulder, also known as adhesive capsulitis, is a condition characterised by pain, stiffness, and restriction of motion in the shoulder joint. It usually starts with pain, especially with the movement of the shoulder. Read on to find out more about the stages of a frozen shoulder and physical therapy exercises to improve your shoulder mobility.
You may have difficulty executing simple daily actions like combing hair, wearing clothes, or reaching for something on a high shelf.
Frozen shoulder often occurs with no associated injury or discernible cause. It usually affects patients between the ages of 40 to 60 years old and it is twice as common in women than in men.
The smooth tissues in the shoulder capsule become inflamed, thickens and tightens around the capsule of the shoulder joint. Scar tissues develop over time and your range of motion becomes restricted.
Any shoulder injury like rotator cuff injury, tendinitis, or long-term immobility of the shoulder joint can lead to a frozen shoulder too.
Stages of Frozen Shoulder
Frozen shoulder develops slowly through three stages. Each stage can last for a couple of months.
- You slowly experience more and more pain
- You feel pain (sometimes severe) with any movement of your shoulder
- As the pain worsens, you lose your range of shoulder movement
- It typically hurts more at night, affecting your sleep
- Your pain may actually improve but your shoulder becomes stiffer
- The range of motion of the shoulder is very limited and it is difficult to get through daily activities
- Your range of motion of your shoulder begins to improve
- Complete return to normal strength and motion typically takes from 6 months to 2 years
TCM perspective of Frozen Shoulder
Kidney and Liver Deficiency
In TCM theory, the kidney dominates the bone, and kidney energy is progressively depleted with age. The liver regulates the circulation of qi throughout the body, stores blood, and regulates blood volume in the body. As one ages, the kidney and liver energy decline through a weakening of yang qi and cannot nourish the collaterals of the body as before.
Stagnation of Qi and Blood
Long-term exposure to excessive wind, cold and damp can lead to stagnation of qi and blood in the meridians of the shoulders. Some examples are accumulative exposure to air-conditioning, wind or daily consumption of icy cold drinks. There is a common saying in TCM: If there is free flow, there is no pain; if there is no free flow, there is pain (通则不痛，不通则痛). Overtime, these factors causes qi and blood stasis (气滞血瘀), resulting in shoulder pain and subsequently frozen shoulder.
TCM Approach to Frozen shoulder
Depending on the cause, symptoms and duration as diagnosed by the TCM practitioner, the following combinations of methods are used to treat frozen shoulder:
- Cupping/Tuina massage
- Herbal medication
The key to recovery and preventive care is doing physical therapy exercises at home daily. You need to be actively involved in treating your shoulder too!
Physical Therapy Exercises to improve shoulder mobility
Note: Do the exercises at your own comfort level. Gently and slowly increase the range of motion as much as possible, on a daily basis.
Climb the wall (Finger Walk)
- Facing a wall, reach out and touch the wall with your fingertips starting at the waist level and slowly walk your fingers up the wall, until you have raised your arm as far as you comfortably can
- Lower your arm slowly
- Repeat this exercise 10 to 20 times a day
Note: Your fingers, not your shoulder muscles should be doing the exercise.
Comb the hair:
- Slowly raise your affected shoulder till above head level and do a combing hair action
- Repeat this 10 to 20 times
- Interlace your fingers behind your back
- Use your good arm to pull the affected shoulder upwards to stretch it
- Repeat this exercise 10 -20 times a day
Cross- body stretch
- Use your good arm to lift your affected arm at the elbow, bring it up and across the body
- Stretch the shoulder and hold it for 10-15 seconds
- Repeat this exercise 10 to 20 times a day
Acupoint Massage to relieve frozen shoulder
Massage 阳陵泉穴 (Yang Ling Quan, GB34) and gently abduct your shoulder.
Location: In a depression anterior and inferior to the head of the fibula
- Massage the 阳陵泉穴 (Yang Ling Quan, GB34) point on the opposite side of the body from the shoulder pain. If the left shoulder hurts, massage the point on your right knee.
- Massage the point with the tip of your finger till you feel soreness.
- Maintain that pressure while making very small circles.
- Gently raise and lower your shoulder while stimulating the acupoint. You should slowly begin to notice a decrease in shoulder pain and an increase in your shoulder range of motion.
Note: Information provided is not a substitute for a physician or any form of medical care. Individual symptoms differ due to different body constitutions and diagnoses. One should consult a licensed TCM practitioner for accurate diagnosis and treatment.
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