Woman presents with frozen shoulder
New Female Patient presents with frozen shoulder. Has seen her primary doctor and basically told to rest it. I did a work up on her and found a few hypertonic (tight) muscles in her back and rotator cuff. The scapula is moving with the humerus on the frozen side and she is unable to lift it over 90 degrees. I put it through a range of motions and adbduction is the most limited, there is minimal flexion and extension.
A course of treatment recommended is Hydroculator Packs to ease the muscular tension, Pin and Stretch or ART to tight back muscles, specifically Teres Major and Teres Minor and Latissimus Dorsi. Deep Trigger point therapy into the armpit in attempt to get the subscapularis to relax was attempted on first visit. I set the shoulder up for an adjustment (which can be very painful on a frozen shoulder) with no intentions of really adjusting, I really wanted to see the fear avoidance factor and the patient tolerance to CMT. So, no adjustments. Not saying I won’t ever deliver that adjustment, she just wasn’t ready. I did some deep tissue work, and used Graston Myofascial Technique to the rotator cuff, deltoids, Latissimus, Teres Major and even tried to get deep onto the Subscapularis. I had no idea how much progress we were going to get, but the patient called me several days later and said it was sore for one day and then it felt so much better. She was going in for surgery for something else and didn’t want to feel the pain of her shoulder. I felt like she would of benefitted from regular treatment, recommended treatment would be 2x per week for 6 weeks with aggressive rehab using theraband or tubing during the final sessions. She will be ready for the adjustment near the last treatment.
2nd treatment came about 3 weeks later, she had a slight increase in range of motion. Frozen shoulder are tricky, you want to get aggressive, but that is counterintuitive. A nice progressive treatment with deeper work with each visit is the best alternative to just wanting to fix it in one visit. She allowed me to really dig in her arm and stretch and Graston every single muscle in her shoulder. I swear, she will either love me or hate me when these 12 sessions are over. I am confident we will have a progressive lessening of symptoms as time go by. She has already referred me a patient with the same symptoms. Referrals are the best compliment and allow my practice to grow. I just want to get everyone better as quickly as possible, is that too much to ask?
