Frozen Shoulder

[Physioindeed]

ginger,
just had a look at the website you suggested.
There are 10 thousands of messages in the forum. How are we supposed to find your previous entries about your fantastic method?
I think that if you want to help and have something to say: just say it here and now. Or give us a defenitiv link. Otherwise to claim that you have the ultimative answer but to not make it easy for everybody else to access it is a little unhelpful and frustrating.

[ginger]

As much as I would like to enroll you and others here into a more elegant and successfull method and perspective , on shoulder and other MSK issues , I have been doing this very thing on Re for some years and feel somewhat reluctant and time pressured at the moment to go over this territory from the beginning. It is possible , with careful orientation to the RE site , to find previous posts under headings. I suggest you begin with key words , such as Continuous Mobilisation ( CM ) , frozen shoulder, Ginger etc .
I have also posted many times with similar p.o.v. on somasimple.
I am happy to contribute to your considerations on shoulder pain here , though cannot commit to a exhaustive and detailed response. Should you be willing to follow my guidance and sugestions, I am certain you will find access to a quiet revolution in the manner to which shoulders ( and other MSK) problems are easily solved.
I have just returned from a lecture series I conduct twice a year here in victoria on these matters and am just a little exhausted. A few days in the hammock watching cricket should see me back on top. Go the aussies.
Ask questions by all means, I'll do my best for you.
Cheers

[Physioindeed]

had a nother look on rehab edge.
first tried to type in key words on their home page, which is why I didn't get anywhere. you of cours need to go to the forums first, then in manual therapy, scroll down and type in key words. there is also an option to look for entries by one specific user. I guess the threat "Mobilisation of facet joints, the continuous method - July 2, 2006 7:34:00 PM " is the one I was looking for.
sorry for being impatient and a bit slow...
now bussy reading in there. thanks ginger

[estherderu]

dear colleagues,
to add to the confusion....
how about this one??

Some, not all, but some of the patients I have treated ( especially if they were woman in their late 40´s and 50´s ) reacted very well to magnesium supplements.
I learned this from a chinese physician (who was also trained in western medicine and especially complementary medicine ).

Do not ask me why....
esther

[nasde]

Personally, I've never found too much success with much physio treatment for a "true" frozen shoulder. I say "true" because in my experience, a lot of stiff shoulders with full capsular movement (or almost full passive movement) - have been referred over as "frozen shoulder".

IMO Mobs and stretching exercises seem to irritate the capsule, and not provide much in the way of improvements (esp when compared to the amount of pain/irritation it causes). I find that educating a patient to use their shoulder (pain free range), not sleep on it, timeframes to recovery etc, to be the most effective. Soft tissue stuff is good short term.

Ginger - I'm also quite interested to hear more about this CM type stuff. I've searched your posts on those websites you suggested, but the whole topic is very vague - except for the fact that it works, it's very simple and effective etc ... What lectures do you do and where did you speak at? Are any of these talks coming up? What university do you lecture at? Is it at physiotherapy conferences that you talk at? Do you teach at a university, lecturing to physiotherapy students?

If you would prefer not to say on the forums as a matter of privacy or whatever, send me a PM.

Thanks

[Laura01]

A colleague of mine has just worked on a review of the literature in relation to Physio Mx of adhesive capsulitis. The finding of which swayed neither way basically supervised neglect showed the same outcome 2 years on so all the aggressive mobs to the shoulder- theres no point! The evidence was in agreement with the scapular stability and pain relieving modalities however.

[soranidinesh]

hi ginger
i think i agree to your thought on spinal mobs for frozen shoulder
what i have seen in a few patients is thoracic spinal mob (at the level of around t567) may help to improve extension with medial rotation
although this is not seen in every one
i would like to try your trick on my patients
some new things i ve heard is that the pain on shoulder may be due to suprascapular nerve irritation and is resolved by block by injection of analgesic TENS over shoulder...
can u give a hint on this

[estherderu]

like Ginger,
I also had problems working on the "frozen-shoulder" when I started, having been trained to look and work locally. I have since then made it a point to ALWAYS look at the whole spine when treating people with shoulder (upper & lower extremity) disorders. More often than not, treating the cervical and thoracic spine gave much better results than treating the shoulder only.
I also used the german(massage) technique called bindegewebsmassage a lot to help treat many so-called musculoskeletal problems.

It really helps to look at the whole picture, the patients posture, his/her response to pain and most importantly, what is happening/has happened in his/her "muscle train and/or meridiaan.

the more you learn, the more you realize you know so little

Esther

[mIrAge]

I believe the most recent inclination to manage adhesive capsulitis is early steroid injection (during painful phase) and exercise therapy, which yield a siginficant improvement in short term functional outcomes and pain level, and some long term benefit over steroid only and exercise therapy only group.

[112inky]

A colleague of mine has just worked on a review of the literature in relation to Physio Mx of adhesive capsulitis. The finding of which swayed neither way basically supervised neglect showed the same outcome 2 years on so all the aggressive mobs to the shoulder- theres no point! The evidence was in agreement with the scapular stability and pain relieving modalities however.

[sanagupta1]

Hi all,
I have been reading some intresting things in relation to the treatment of Frozen shoulder.I was just wondering if there is any evidence based study on effectiveness of using cervical facet mobilisation(C456) in frozen shoulder.

Sana

[Hallamshire Physiotherapy]

I would agree with 'nasde', most 'frozen shoulders' are not 'true' frozen shoulders (one in ten of all the 'frozen shoulders' probably are true frozen shoulders from my clinical experience) and repeated mobs just aggravates the problem. I think you get them functional by a home exercise programme and review them if they show signs of distress or anxiety.

Most of the true frozen shoulders I see seem to have a neck component and I suspect this is the origin of the problem, but by the time they have developed the shoulder limitation it is too late to influence the outcome and treating the neck does not change the movement.


Hallamshire Physiotherapy
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[sanagupta1]

hi,

Neck may be the reason for frozen shoulder..but I was wondering that how early in frozen shoulder, one should think of giving facet joint mobilisation..Are there any studies examining the link between frozen shoulder and neck..it seems intresting and very much possible explnation for frozen shoulder.
But the relation to neck does not seem to support the self limiting / self healing behaviour of frozen shoulder(approx 2 years. If there is pathology at the facet joint..will we call it a referred problem?


sorry too many qusetions..?

Sana gupta

[Hallamshire Physiotherapy]

Frozen shoulder is not self limiting from the research that I have seen. After 2 years the patient returns to some function but problems persist in some form. I can't remember the author but it was presented at a British Shoulder and Elbow Surgeons Conference a few years ago.

Hallamshire Physiotherapy

[sanagupta1]

hi,

Thats what I have always experienced but i have come across various cases in my experience who responded well to mobilisation and improved in less than 3 months. I think there are instances when mobilisation works or its just chance?? I am not sure. At present I am seeing a lady with restricted shoulder movement only 4 weeks old..do u think facet joint mobilsation will work on her??

Sanagupta

[Men At Work]

hey guys i've recently started my practice wherein i have a frozen shoulder case which is responding at a slow pace with passive range coming in flexion ,abduction and ext rotation coming in 3 weeks.now the problem lies is the still lower range in external rotation with elbow in 90 deg flxn at the side of body.and also the movement pattern for external rotation starts with arm going into slight abduction first.im giving grade 2 glides with strengthning of shoulder girdle till 90 degrees of flexion.please help in improvement for the range and strength.thank you.also the active range is coming till 80 degrees in flexion and 70in abduction.any guidance will be appreciated.the pt had a fracture greater tuberosity humerus 3 months back.