38 Questions
What is the primary treatment for frozen shoulder?
Stretching
What is the goal of manual manipulation in frozen shoulder treatment?
To manually break free restrictive adhesions and restore motion
What is the risk of manual manipulation in frozen shoulder treatment?
Tearing the shoulder joint capsule or causing a disruption of internal structures
Who typically performs manual manipulation in frozen shoulder treatment?
A chiropractor or osteopath
What is the purpose of corticosteroid injections in frozen shoulder treatment?
To reduce inflammation in the affected shoulder
What is the purpose of mobilization in frozen shoulder treatment?
To restore motion to the affected shoulder
What is the last resort in frozen shoulder treatment?
Surgery under anesthesia
What is the purpose of non-steroidal anti-inflammatory drugs in frozen shoulder treatment?
To reduce inflammation in the affected shoulder
What is the purpose of myofascial release in treating frozen shoulder?
To break adhesions that limit motion and create pain
What is the primary goal of interventional procedures in treating frozen shoulder?
To break free adhesions that limit motion
What is the difference between myofascial release and surgery?
Myofascial release is a non-invasive treatment, while surgery is an invasive treatment
What is the purpose of sedation in manipulation-under-anesthesia (MUA)?
To reduce pain and muscle resistance
What is the outcome of not following an intensive regime of physical therapy after MUA?
New adhesions will form
What is the primary benefit of steroid injections compared to MUA?
They have fewer dangers associated with anesthesia and sedation
When is surgery usually reserved for in treating frozen shoulder?
Cases resistant to other treatment
What is the primary purpose of myofascial mobilization of the shoulder?
To break adhesions that limit motion and create pain
What is the medical term for frozen shoulder?
Adhesive Capsulitis
What is the primary cause of frozen shoulder?
Unknown, but more common in females and people over 40
What is the typical timeframe for frozen shoulder to stabilize and regress?
Six months to three years
What is a common residual effect of frozen shoulder?
Permanent reduction in shoulder motion
What is a sign of frozen shoulder?
Reduced arm swing while walking
What is the purpose of exercises in managing frozen shoulder?
To maintain motion
What is an adhesion in the context of frozen shoulder?
Fibrotic bands of scar tissue
What is the typical age range when frozen shoulder is more common?
After 40
What is the initial step in performing the Internal Rotation Cane Exercise?
Hold the cane behind your back, with palms up
How many seconds should you hold the cane in the Internal Rotation Cane Exercise?
1-2 seconds
What is the purpose of slowly raising the cane in the initial cane exercise?
To lift the cane above the head
How many repetitions are recommended for the Internal Rotation Cane Exercise?
10-20 repetitions
In the Shoulder Shrug Cane Exercise, what should you lift directly upwards?
Both shoulders and cane
What is the initial position of the cane in the initial cane exercise?
In front of your body at shoulder level, parallel to the ground
What is the recommended stance for the stretch exercise?
Use a staggered stance
How long should you hold the stretch for in the internal rotation exercise?
10-30 seconds
What is the eventual goal for holding the stretch in the internal rotation exercise?
60 seconds
What should you do if you experience pain while performing the internal rotation exercise while lying on your side?
Discontinue the exercise
What should be the position of your elbow in the internal rotation exercise while lying on your side?
Bent at 90°
What should you do with your unaffected hand in the internal rotation exercise while standing?
Gently pull the towel in a downward and forward direction
How many repetitions should you perform for the internal rotation exercise?
5-10 reps
What should be the state of the musculature of the affected shoulder during the internal rotation exercise?
Relaxed
Study Notes
What is Frozen Shoulder?
- Frozen shoulder, also known as Adhesive Capsulitis, is a condition where the shoulder joint capsule has adhesions and inflammation, limiting shoulder motion.
- The condition is more common in females than males, and the non-dominant shoulder is more affected than the dominant shoulder.
- The prevalence of frozen shoulder increases after the age of 40.
- It takes between six months and three years to stabilize and regress, but often leaves a residual permanent reduction in shoulder motion.
Signs and Symptoms of Frozen Shoulder
- Decreased shoulder motion
- Reduced arm swing while walking
- Holding the arm in a protective manner near the body
- Stooped, rounded shoulders
- Neck and back pain
Treatment Options for Frozen Shoulder
- Stretching is the primary treatment for frozen shoulder.
- Other treatments include:
- Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin
- Corticosteroid injections into the affected shoulder
- Manipulation
- Mobilization
- Friction massage
- Therapeutic modalities
- In persistent cases, manipulation under anesthesia or surgery may be required to restore shoulder motion.
Shoulder Manipulation
- Manual manipulation is performed by a skilled manual practitioner to break free restrictive adhesions and restore motion.
- The goal is to manually move the shoulder in a way that opens the joint and places tension on the adhesions and contractures.
- Quick impulses may be used to mobilize the restrictions.
Myofascial Mobilization or “Release”
- Myofascial release is a stripping massage that attempts to break adhesions that bind shoulder motion.
- It involves a slow stretching of soft tissues while applying a sustained pressure to connective tissue of the involved structures.
Interventional Procedures
- Steroid injections
- Manipulation-under-anesthesia (MUA)
- Surgery (usually reserved for more resistant cases of adhesive capsulitis)
Exercise
- Internal Rotation - Standing: uses a towel to gently pull the affected arm in a downward and forward direction.
- Internal Rotation – Lying on Side: uses the unaffected hand to apply gentle downward pressure on the affected forearm.
- Internal Rotation Cane Exercise: uses a cane to raise the affected arm and hold for 2-5 seconds.
- Shoulder Shrug Cane Exercise: uses a cane to lift both shoulders and hold for 1-2 seconds.
Learn about the treatment options and exercises to prevent the downward spiral of frozen shoulder, including maintaining motion and preserving range of motion.
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