Adhesive Capsulitis (Frozen Shoulder)

Adhesive capsulitis, commonly referred to as frozen shoulder, is a condition where the range of motion of the shoulder is extremely limited. Frozen shoulder affects the joint capsule – a water tight compartment that holds the synovial fluid of the glenohumeral joint. A build up of scar tissue forms within and around the joint capsule, and restricts the shoulder's physical ability to move without pain. Some of the tissue that surrounds the capsule forms two ligaments called the coracohumeral ligament and the glenohumeral ligament.

As the name suggests, frozen shoulder is usually identified by a significant amount of stiffness in the shoulder. This is one of the least understood conditions by health care professionals and it is often connected to some kind of shoulder condition or injury. However, the cause can sometimes be difficult to determine. For example, frozen shoulder can result from shoulder surgery or having your arm in a sling for an extended period of time; it can result from a soft tissue injury within the rotator cuff such as tendinitis or a SLAP tear; it can follow an ongoing condition like impingement syndrome or shoulder bursitis.

When you injure your shoulder you experience pain and stop moving it. However, this lack of movement is thought to allow the scar tissue to accumulate within the joint capsule as the damaged tissue heals. This is the reason that physical therapy and other means to reduce scare tissue are so important in recovery of all shoulder ailments or surgeries.

What confuses medical professionals is that some people who develop frozen shoulder have no other conditions. It starts as a stiffness in the shoulder, and progresses into pain and loss of ROM (range of motion) within the shoulder joint. Because of the pain and stiffness, the sufferer uses the shoulder less making the condition worse.

Symptoms of Frozen Shoulder

There are three distinct phases of frozen shoulder that can all be identified by their symptoms:

Stage 1: The freezing or painful phase

During this stage you develop pain and stiffness in the shoulder joint. As the pain increases, movement becomes more difficult and the shoulder is used less. Often your back and neck muscles start to ache as they work harder to compensate for fewer shoulder movements. This stage can last from a few weeks to a few months.

Stage 2: The frozen or stiffening phase

In the next stage, you will notice that the stiffness remains but the pain does not become worse and may even start to decline. This stage usually lasts anywhere from 4 months to nearly a year.

Stage 3: The thawing phase

Finally, you will find that the full range of movement begins to return to the shoulder joint. This stage usually takes a minimum of 5 more months but may take as long as 2 years.

Who's at Risk?

The following factors and conditions are common among people who suffer from frozen shoulder:

• If you have poor posture, especially round shoulders.
• If you are 40 years of age and older.
• If you are a women - 70% of frozen shoulder sufferers are women and a large portion of them suffer frozen shoulder around the time of menopause.
• If you have conditions such as diabetes, hyperthyroidism, hypothyroidism, cardiovascular disease, tuberculosis, Parkinson's disease, or have had a stroke.

Frozen Shoulder Treatments - What You Can Do!

The trick to treating your frozen shoulder, improving your range of motion, and getting your shoulder back in the best possible condition you can is removing the scar tissue in and around the shoulder joint capsule - something ultrasound therapy is great at!

If you heal your frozen shoulder properly and treat scar tissue build up, your chance of recurrance or chronic shoulder conditions later on is greatly reduced. Therapeutic Ultrasound and Blood Flow Stimulation Therapy (BFST^®) will treat scar tissue and promote blood flow to heal your labrum, ligaments, and tendons in the rotator cuff and glenohumeral joint faster and more completely than any other methods available.

Freezie Wrap^® Cold Compression Therapy

To decrease inflammation and relieve the pain of frozen shoulder doctor's recommend cold compression therapy. Treating your shoulder pain with cold compression as needed will relieve pain and will reduce, or even eliminate, the need for pain medication that affects your entire body and can cause problems is used for a long period of time.

The Shoulder Freezie Wrap^® is the cold compression tool you need to treat your frozen shoulder pain in an effective and convenient way.

The deep cooling effect provided by the Shoulder Freezie Wrap^® gently numbs your nerves to reduce pain naturally!

The Shoulder Freezie Wrap^® uses a supercharged cooling gel pack, that chills in the fridge, not in the freezer like ice or other freezer packs, giving you deep cold therapy without the risk of 'cold burns' or cryoburn. The medical-grade wrap keeps the cold directly off your skin preventing cryoburn while delivering cold right where you need it.

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Once the pain of your frozen shoulder has been reduced it is important to begin ultrasound and BFST^® to soften scar tissue and begin to loosen up the area. BFST^® will improve blood flow and relax muscles that have become stiff and tense because you are not using your shoulder properly.

Ultrasound Therapy

Ultrasound therapy is a great therapeutic option to soften scar tissue, decrease inflammation, reduce pain, and improve the tissue healing process. Therapeutic ultrasonic waves increase tissue elasticity while increasing blood flow to your glenoid cavity. This cleans the joint by getting rid of damaged tissue and reducing the inflammation while opening up the blood vessels to begin healing.

Ultrasound therapy is safe, easy, and convenient and generally requires between 10-15 minutes per treatment. It is based on a form of deep tissue therapy, which is generated through high frequency sound waves (that we can not hear). By treating your rotator cuff and glenoid cavity with ultrasound these sound waves bounce against the scar tissue. The tough, fibrous tissue causing your shoulder to stiffen and/or no longer move becomes softer and the labrum, ligaments and tendon tissues become stronger reducing the risk of chronic problems in the future.

Ultrasound waves penetrate deep to relax your muscles, decrease inflammation and accelerate your recovery rate, so you can return to your daily activities as soon as possible. Ultrasound can also be used to administer therapeutic medicines into the body. This is a process known as phonophoresis. Ultrasound with phonophoresis is rapidly becoming more popular than ultrasound therapy alone.

With phonophoresis, MendMeShop^® ultrasound therapy sends micro vibrations into your body and carries medicated molecules within the ultrasound gel deep into your soft tissue to enhance the ultrasound therapy, resulting in even healthier tissue.

Using MendMeShop^® Lavender Infusion Ultrasound Gel during your ultrasound therapy gives you 2 therapies in 1. You get the benefit of the regenerating sound waves from the ultrasound device itself AND the added bonus of the therapeutic ingredients inside the gel being delivered into the labrum, coracohumeral and glenohumeral ligaments, tendons and other soft tissue where it is most effective. 1 FREE bottle of MendMeShop^® Lavender Infusion Ultrasound Gel comes with every MendMeShop^® Ultrasound Therapy System and it contains the therapeutic essential oils of natural Bulgarian lavender, peppermint, eucalyptus, and menthol.

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Complimenting your ultrasound therapy with Blood Flow Stimulation Therapy BFST^® nourishes and strengthenes your shoulder joint tissue and surrounding area. Using BFST^® will speed your recovery and heal your rotator cuff more completely preparing it for strengthening exercises. Talk to your doctor or physical therapist to find out which exercises are appropriate for your situation.

Inferno Wrap^® Blood Flow Stimulation Therapy

The shoulder joint naturally receives a limited blood supply. When it's stiff and difficult to move the blood flow is reduced even further, limiting your body's natural ability to heal itself.

By treating your rotator cuff with BFST^® you can increase your body's blood supply to the shoulder and increase your body's natural healing power.

An Inferno Wrap^® for your shoulder is the tool you need to treat your sore shoulder because it speeds healing and relaxes the surrounding muscles. With BFST^®, tissues are safely and gently stimulated. Your body responds with a rapid increase in blood flow to the area, increasing the supply of oxygen and nutrients to injured tissue to promote healing. Our Inferno Wrap^® gives you the most effective, non-invasive, non-addictive, pain relief and healing with no side effect.

In addition, the improved blood flow whisks away dead cells and toxins that have built up from injury, scar tissue, and lack of blood flow. When you stop moving your arm and shoulder, your muscles and other tissue can become weak and dead cells and toxins in the area can cause further tissue deterioration - this can lead to atrophy (muscle weakness and/or deterioration). By clearing the area of toxins and increasing the amount of oxygen and nutrients to your muscle and other tissue, the risk of atrophy is greatly reduced. Keeping your upper arm, shoulder and rotator cuff tissue as healthy as possible throughout the healing process will allow you to improve shoulder strength again once your pain has gone and your tear has healed.

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With these 3 easy therapies, cold compression, ultrasound and BFST^®, you will notice significantly reduced pain, faster healing, and an incredible improvement in your rotator cuff range of motion.

We recommend that you consult your doctor and/or physiotherapist before using any of our outstanding products, to make sure they're right for you and your condition.

During your recovery, you may have to modify and/or eliminate any activities that cause pain or discomfort in your rotator cuff area until your pain and inflammation settle, and you gain more mobility and strength in your shoulder. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!

Surgical Procedures for Frozen Shoulder

Manipulation Under Anesthesia

In rare cases, if the usual treatment options have been unsuccessful, manipulation under anesthesia may be required. Athough this procedure requires anesthesia, no actual surgery involved, meaning incisions are not made when a manipulation is performed. The doctor moves the arm to break up the scar tissue within and surrounding the joint. This is a painful procedure as it requires tearing of the scar tissue, but you will be able to move your shoulder joint more after the manipulation.

Follow up the manipulation with cold compression therapy immediately. Continue with cold compression until the pain and inflammation has been reduced. Use ultrasound therapy as well to reduce the amount of scar tisue that will reform as the torn tissue heals. This will help prevent your shoulder from becoming frozen again. Once inflammation, swelling, and bruising has been calmed you can begin BFST^® treatments to maintain healthy tissue in your arm and shoulder, reduce the risk of atrophy, and improve the health of the tendons and ligaments that have been damaged during the manipulation procedure.

Arthroscopic Capsular Release

Alternatively, or in conjunction with a manipulation, an arthroscope can be inserted into the joint to cut through the scar tissue. This procedure is called an arthroscopic capsular release. Surgical capsular release of a frozen shoulder is rarely necessary, but it is extremely useful in cases of frozen shoulder that do not respond to physical therapy or regular exercises done at home. If surgery is performed, immediate physical therapy following the capsular release is of utmost importance. If rehabilitation does not begin soon after arthroscopic capsular release, the chance of the frozen shoulder returning is quite high.

Diagnosing Adhesive Capsulitis

There are several range of motion movements that can help diagnose adhesive capsulitis. Your doctor may ask you to:

• raise both your hands straight up in the air towards the ceiling.
• reach across your chest to touch the opposite shoulder.
• reach behind you and put your back of your hand against the lower back.
• reach your hand up towards your shoulder blade.

If there is limited range of motion for one or more of these movements, your doctor will probably recommend further diagnostic testing.

Your doctor may ask for an x-ray to look for fractures, a loss of joint space in the shoulder, bone spurs or calcification in the tendon. He or she may do an MRI to be able to see the soft tissue in your shoulder. This will give a clear picture of the muscles, tendons and ligaments in the shoulder, and will allow him or her to assess any damage. This assessment will determine the treatment options available to you. Treatment options will likely include Physical Therapy, stretching and targeted exercises, therapeutic ultrasound, and Blood Flow Stimulation Therapy (BFST).

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