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STRETCHING EXERCISES
It is important to remember when you start exercising the shoulder joint after the painful phase of the condition has passed, that you must start slowly. If you put too much stress on the joint, you risk further inflammation and more pain. When you begin stretches, hold them for the shortest recommended time an repeat them only two or three times. You can increase this gradually over the subsequent days and weeks. Always stop if the pain troubles you. Here are three good stretches for the shoulder:
Most cases of frozen shoulder will get better by themselves within two years--however, each individual is different. Some people will have their symptoms resolve completely in 12 months whereas others might still have pain and stiffness well beyond the two-year mark. It is impossible to predict which category you will fall into but there are treatments that can help ease the pain and improve the movement in your shoulder.
>Will it recur?
A frozen shoulder tends not to recur--once you have recovered from a frozen shoulder, that's usually the end of it. However, at least 30% of affected people have been shown to experience a similar type of problem in the other shoulder. Unfortunately there are no preventive measures that have been
proven to work. But the good news is that the condition doesn't appear to affect any other joints besides the shoulder.
Treatments
Your first option once you have been diagnosed is to do nothing. The vast majority of cases do get better by themselves and simply waiting for nature to take its course is definitely the preferred course of action if the condition is causing only mild symptoms.
But in more severe cases medication for the pain is often the initial treatment. Analgesics and anti-inflammatories are usually used at this stage. Over-the-counter medications, such as aspirin, ibuprofen (Nurofen, Actiprofen), paracetamol (Panadol) and Panadeine, are often tried first but if stronger pain relief is needed you might need a doctor to prescribe this for you.
If the pain in the shoulder continues to be severe despite these medications your doctor might offer you an injection of corticosteroid into the joint. Sometimes this is done under the guidance of ultrasound to ensure the injection goest to exactly the right spot. You can have this injection in the doctor's consulting rooms and it takes only a few minutes.
Many people find this brings considerable relief from the pain and stiffness; however, research has shown that corticosteroid injections are not always a permanent solution to a frozen shoulder.
One other form of injection therapy you might be offered involves the shoulder joint being injected with saline (salt water) as well as the corticosteroid. This treatment is called hydrodilatation and has been shown to be very successful in some people. However, in others it has had no effect at all.
Once the painful phase of the frozen shoulder starts to improve, treatment should focus on regaining movement in that shoulder.
Local heat such as a warm heat bag is often used to relax muscles and promote movement when commencing exercises to mobilise the shoulder.
PROMISING DEVELOPMENTS
A London osteopath, Simeon Niel-Asher, has pioneered a new technique for the treatment of frozen shoulder that is drug-free and not invasive.
According to a recent randomised, placebo-controlled trial, it has a very high success rate in achieving painf-free shoulder movement within a few weeks.
The technique uses a specific pattern of massage of all the tissues of the shoulder over the course of between five and nine sessions.
Physiotherapy, acupunture, massage and chiropractic treatments that concentrate on restoring movement and strengthen to the shoulder joint can all be helpful.
Often the best results are seen from a combination of treatments such as corticosteroid injection, physiotherapy and massage.
Surgery is an option that is considered if the immobility in the shoulder is severe. This can involve either manipulation under anaesthetic or arthroscopic capsular release.
Procedures
Manipulation of the joint under anaesthetic is often more effective than manipulation of the joint when you are awake. This is because when you are conscious, the muscles surrounding the shoudler goes into a spasm in order to prevent pain when the joint is moved. When this happens, it makes the manipulation even more painful and can even damage the muscles. Under anaesthetic the muscles are paralysed and therefore the shoulder capsule can be stretched without any tearing of the muscles.
Arthroscopic capsular release is an operation performed under general anaesthetic and done through keyhole incisions at key access sites around the shoulder. The aim of the operation is to divide the scar tissue which is restricting the movement of the capsule of the shoulder joint. In the past, this scar tissue was divided by scissors but these days surgeons usually use laser for this purpose. Laser has the added benefit of sealing blood vessels once they are cut, reducing the amount of bleeding associated with this procedure. Consequently people who have this procedure done usually recover very quickly.
Natural methods
Simple measures such as local heat and massage are very effective when trying to mobilise the join in the 'thawing' phase of frozen shoulder. Mobility restoration is also helped by methods such as acupuncture, phsyiotherapy and chiropractic treatments. All these therapies are focused on improving movement in the shoulder and strengthening the muscles surrounding the joint, which may have become weak during the painful stage of frozen shoulder.
STRETCHING EXERCISES
It is important to remember when you start exercising the shoulder joint after the painful phase of the condition has passed, that you must start slowly. If you put too much stress on the joint, you risk further inflammation and more pain. When you begin stretches, hold them for the shortest recommended time an repeat them only two or three times. You can increase this gradually over the subsequent days and weeks. Always stop if the pain troubles you. Here are three good stretches for the shoulder:
- Initially, when the shoulder is still very stiff, sit sideways in a straight-backed chair and hang your affected arm behind the chair (with your armpit resting over the back of the chair). Swing your arm slowly in circles--small ones at first, but gradually increasing in size. Be sure to make the circles in both directions.
- Hold one end of a bath towel in the hand of your affected arm and drape it behind the shoulder that is stiff. Grab the other end of the towel behind your back with your with your other hand--as though you were about to dry yourself. Gently pull the towel upwards. You should feel the pull in your shoulder. You can then pull the towel downwards, exercising pressure on the shoulder in the opposite direction. Remember start with small movements and increase them gradually over time.
- Stand and clasp your hands behind your back. while keeping your arms straight, slowly lift your hands upwards. Hold this stretch for about 15 seconds and repeat it a number of times--as many times as you can comfortably tolerate.
If these stretches are repeated daily you should find you can gradually increase the length of time you can comfortably hold each stretch, and the number of repeats, not to mention the increased movement you should notice in the shoulder itself.
---------------------------------------------------------------------------------------------------------------------------------Most cases of frozen shoulder will get better by themselves within two years--however, each individual is different. Some people will have their symptoms resolve completely in 12 months whereas others might still have pain and stiffness well beyond the two-year mark. It is impossible to predict which category you will fall into but there are treatments that can help ease the pain and improve the movement in your shoulder.
>Will it recur?
A frozen shoulder tends not to recur--once you have recovered from a frozen shoulder, that's usually the end of it. However, at least 30% of affected people have been shown to experience a similar type of problem in the other shoulder. Unfortunately there are no preventive measures that have been
proven to work. But the good news is that the condition doesn't appear to affect any other joints besides the shoulder.
Treatments
Your first option once you have been diagnosed is to do nothing. The vast majority of cases do get better by themselves and simply waiting for nature to take its course is definitely the preferred course of action if the condition is causing only mild symptoms.
But in more severe cases medication for the pain is often the initial treatment. Analgesics and anti-inflammatories are usually used at this stage. Over-the-counter medications, such as aspirin, ibuprofen (Nurofen, Actiprofen), paracetamol (Panadol) and Panadeine, are often tried first but if stronger pain relief is needed you might need a doctor to prescribe this for you.
If the pain in the shoulder continues to be severe despite these medications your doctor might offer you an injection of corticosteroid into the joint. Sometimes this is done under the guidance of ultrasound to ensure the injection goest to exactly the right spot. You can have this injection in the doctor's consulting rooms and it takes only a few minutes.
Many people find this brings considerable relief from the pain and stiffness; however, research has shown that corticosteroid injections are not always a permanent solution to a frozen shoulder.
One other form of injection therapy you might be offered involves the shoulder joint being injected with saline (salt water) as well as the corticosteroid. This treatment is called hydrodilatation and has been shown to be very successful in some people. However, in others it has had no effect at all.
Once the painful phase of the frozen shoulder starts to improve, treatment should focus on regaining movement in that shoulder.
Local heat such as a warm heat bag is often used to relax muscles and promote movement when commencing exercises to mobilise the shoulder.
PROMISING DEVELOPMENTS
A London osteopath, Simeon Niel-Asher, has pioneered a new technique for the treatment of frozen shoulder that is drug-free and not invasive.
According to a recent randomised, placebo-controlled trial, it has a very high success rate in achieving painf-free shoulder movement within a few weeks.
The technique uses a specific pattern of massage of all the tissues of the shoulder over the course of between five and nine sessions.
Physiotherapy, acupunture, massage and chiropractic treatments that concentrate on restoring movement and strengthen to the shoulder joint can all be helpful.
Often the best results are seen from a combination of treatments such as corticosteroid injection, physiotherapy and massage.
Surgery is an option that is considered if the immobility in the shoulder is severe. This can involve either manipulation under anaesthetic or arthroscopic capsular release.
Procedures
Manipulation of the joint under anaesthetic is often more effective than manipulation of the joint when you are awake. This is because when you are conscious, the muscles surrounding the shoudler goes into a spasm in order to prevent pain when the joint is moved. When this happens, it makes the manipulation even more painful and can even damage the muscles. Under anaesthetic the muscles are paralysed and therefore the shoulder capsule can be stretched without any tearing of the muscles.
Arthroscopic capsular release is an operation performed under general anaesthetic and done through keyhole incisions at key access sites around the shoulder. The aim of the operation is to divide the scar tissue which is restricting the movement of the capsule of the shoulder joint. In the past, this scar tissue was divided by scissors but these days surgeons usually use laser for this purpose. Laser has the added benefit of sealing blood vessels once they are cut, reducing the amount of bleeding associated with this procedure. Consequently people who have this procedure done usually recover very quickly.
Natural methods
Simple measures such as local heat and massage are very effective when trying to mobilise the join in the 'thawing' phase of frozen shoulder. Mobility restoration is also helped by methods such as acupuncture, phsyiotherapy and chiropractic treatments. All these therapies are focused on improving movement in the shoulder and strengthening the muscles surrounding the joint, which may have become weak during the painful stage of frozen shoulder.
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