Frozen shoulder for past year - post Trigenics OAT procedure

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In March 2017 I went to gym after a lengthy hiatus and was doing pretty good, gradually increasing the weight levels. While doing overhead pull downs I felt a sharp pain in my left shoulder, so decided to lay off that exercise for a day or two. But when I tried it again I once more had the pain in my shoulder. Now, it seems I added too much weight to the pull downs.

Roll forward 2 months an my shoulder starts to freeze on me. So my doc diagnosed a rotator cuff tear and injected with cortisone which worked and I got back 90% mobility. But, he didn't refer me to physio. Instead, I went to a chiropractor on my own and he used a machine call 'shockwave therapy' which did not help and he then used accupuntcture, again with little success.

But I got through the summer, developing my front and back yards and continued playing golf.

Come October my stiffness and pain had returned, so my doc once again injected cortisone. This time I got about 80% function return. But again, no referral to physio. The shot wore off in January, about 6 weeks ago and the pain and stiffness came back, this time worse than before. SO, I once more saw my doc, who said I had my maximum for cortisone in that shoulder for a 12 month period. He then said he would refer me to an orthopedic surgeon who specializes in shoulders and knees. 

So, still waiting for the appointment my pain became almost unbearable. I had no sleep for days on end.

I heard about the Trigenics OAT procedure and signed up, having my procedure done last week in Toronto. So, this is day 6 and I have about 70% restored function. The exercise are every 3 hours and in some ranges are still really painful, but I knew to expect this.

Along with the exercises, there is dietary advice and vitamin/mineral supplements. The cost of the procedure was very expensive for me, a retiree with no added insurance.

So, it is a case of waiting it out and doing the exercises as prescribed. But they guarantee success, so I am very hopeful.

But, now that I am exercising and using my good arm as a support I am concerned of the good arm also freezing. Other than doing the exercises, is there anything else I should do to prevent freezing of the good arm?

I am a 68 year old type 2 diabetic and fairly well controlled on oral hypoglycemics and exercise.

Has anyone tried Serrapeptase to breakdown forming adhesions and also to dissolve existing adhesions? If so with what success?

 

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  • Posted

    Watching the videos on the OAT procedure it looks extremely painful. In one video it almost looked like the patient had been tortured and then coerced into saying the treatment was successful lol. How was that for you? I have FS in both shoulders so the cost would be too expensive but am interested to hear more. Hoping I don't have to go a full 2 years and it will somehow only be 9 months or so.

    What are the injections you speak of?

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  • Posted

    Yes, the procedure is painful, but only for a short period of time as the shoulder is manipulated to break down the adhesions. Some people have little pain while others a lot of pain, depending on the degree to which adhesions have set in. An injection of Marcaine is made into the shoulder bursa and if you haven't had cortisone in the previous 6 months or more that is added to the injection. The Marcaine did help reduce pain a bit for me.

    And for the first week there is a lot of exercising to be done, every hour for first day. Every hour during waking hours on day two and every two hours overnight (yes you have to set your alarm) Day three it is every hour daytime and every three hours overnight.

    For days 4-7 the exercises are every 3 hours day and night. I am now on day 7, so tomorrow my exercises are every 6 hours. It takes a lot of commitment in doing the exercises and of course, financially, as mentioned this is not cheap.

    The Serrapeptase is not an injection, it is in capsule form and is an enzyme that helps breakdown scar tissue and adhesions. I wonder if there has been any research on this enzyme and what outcomes can be expected?

    Even in the absence of empirical evidence I am willing to give it a try as according to what I have read, there are no risks associated except possibility of diarrhea initially.

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  • Posted

    I am a 54 year old athletic female.

    I had an overhead tennis incident 12/2016.  Hurt in front of my shoulder.  Torn labrum in the MRI.  Took it easy for a month.  Didn't get better.  Started PT and got frozen shoulder.  Had the Trigenics procedure 4/22/2017.  Then lots of home therapy, chiropractic PT and more PT.  November after resuming tennis and raking the leaves, got FS again.

    ?

    Went straight to arthoscopic surgery.  11/30/2017.   Had the capsule released, the cartlidge cleaned up, the bicep snipped, and microfractures done to my humerus.  Did not repair the labrum.

    ?After 30 years of playing volleyball and now playing tennis and golf, much of my cartiledge was gone.  The rest was a mess.  My long head of the bicep was damaged from the original injury(??).  I had lots of artheritis on the head of my humerus that was ripping at the cartiledge.  So they chisel into the bone to get bone marrow to come out and create a scar to hopefully substitute for my lack of cartiledge so i don't have to have shoulder replacement like my brother.

    ?3/5/2018 still in PT twice a week trying to regain my ROM and strength.  I'm probably 75-80% after 3 months.

    ?My point, my trigenics procedure was a waste of time.  It might be great for those that have idiopathic FS with no real injury.  I needed to find the right Dr to correctly diagnose my problem.  I've been out of my favorite sports for 15 months and counting.

    ?The point being, my FS was being caused by an underlying shoulder injury that was not diagnosed by the DR with the MRI.  My trigenics procedure was just a temporary fix that required months of rehab to regain what very rapidly atrophied.  

    ?Just keep it moving and watch those overhead exercises.   They are brutal on the joint.   You may want to have a friend immobilize your joint and rotate your arm to get as much movement out of that joint as possible.

     

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    • Posted

      Wow you have had one heck of a time. My doc diagnosed me as a rotator cuff tear and says that the gap between the head of the humerus and the outer part of my clavicle has narrowed. As a result when I raise my arm I get wearing of the head of the humerus. He said that I will need the outer 1/3 of my clavicle removed. But, in the meantime the frozen shoulder set in. 

      I understand from the OAT procedure that there is a 98% success rate, but I guess you fit in the 2% that are not successful.

      So far my recovery has gone almost by what they said would happen and I only hope it will get rid of frozen shoulder symptoms permanently.

      The overhead exercise do cause a lot of strain and effort. Now I am on 6 hourly exercises, it hopefully allows for more recovery time between each exercise session. I did find my shoulder more stiff this morning which they say is 'normal'

      Did the Trigenics people offer to do the procedure again for free? It is my understanding that in cases where the adhesions re-occur they will do it for no new charges.  They said they have only  had to do this once in 7 years. But that may just be a marketing ploy.

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    • Posted

      No sense in repeating it.  It did release the shoulder, just took forever to regain strength and Rom 100% .  If i did the procedure again, I still could get FS again because of the other shoulder problems that was the cause of the FS.  Just hoping the repairs done prevent me from getting FS again.  

      Hoping your spacing issue doesn’t cause you to get FS again.  

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    • Posted

      Hi there,

      I may be going through a similar situation as you. I believe I have frozen shoulder, but I am not sure. You sound like you have good experience since you're one of the few athletic ones on here. Can you help me?

       I've been active all of my life playing pickup basketball and golf.  Every week I used to do something active 3-5 times/week. It was my stress reliever, but being in my 40s now, basketball has really taken its final toll. 12 years ago I had rotator cuff surgery. It went OK, not great but I recovered fully with about 90% range of motion. 4 years ago I had ankle surgery and that was a great success. Both were basketball related.

      About 3 months ago I had shoulder soreness.i couldn't specify what happened but I can presume it's basketball related. I remember coming home from the courts and I couldn't turn the steering wheel with my dominant arm. It just felt weak. I took it easy for 3 days, tested it hitting golf balls then I was back on the court by day 4. It felt great, and then bam, the shoulder was sore. This cycle repeated itself for 2-3 months. At the 3rd month, the soreness now became pretty debilitating pain where it zings up the arm and neck. It felt like the shoulder is dislocating even when I caught like a hard bounce pass.

      The next day after excruciating pain I went to urgent care where they referred me to a specialist. I had x rays done. The orthopedic doctor said I have tendinitis. He gave me a cortisone shot. I felt great for 2-3 days. I didn't want to rehurt it playing basketball so I just stuck to golf. That was 2 weeks ago. Since then, I lost range of motion to basically just 20-30 degrees of active frontal/upward motion with my arm. At 20 degrees it just gets stuck with some pain. Beyond 30 degrees I can do passive motion (assisted with my left arm) to just about 100 degrees before pain level is unbearable. My active lateral movement is about 75 degrees before pain sets in. I think I can move it passively to about 125 degrees with pain.

      2 weeks ago the pain was bad and was affecting sleep. The past few days the pain is only there when I'm trying to move it beyond its new limits. Passive movement seems ok as long as it doesn't go pass those limits. I'm sorry for writing so much. Does this sound like the freezing stage or am I frozen? Do you think this might also be a torn labrum? I have a feeling that regardless, I may need another surgery because there is no way I can wait 2 years. Anything helps. Thanks for sharing your plight.

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    • Posted

      It does sound like frozen shoulder because of the limitations. FS often sets in after shoulder surgery due to reduced movement. It is not so much the lack of movement, but the inability too maintain full range of movement after surgery. As you say, passive movement to help get the arm fully raised is pretty much what many with FS experience, but also can be present in rotator cuff tear.

      In my case it seems that a rotator cuff tear led to frozen shoulder. 

      I am hopefully in early recovery after having had the OAT procedure. Some days I achieve 80% active movements with minimal discomfort while other days I really need assist my arm to raise beyond 45 degrees to the full 90 degrees.

      My hope after the OAT was that I would have full range restored with minimal pain by now, but not so. They do say it may take up to 3 months and that by then almost 100% will have full use restored. My fear is that I will be one of those who may not fully benefit from the OAT and end up with permanent loss of full mobility.

      I am in my 60's and still active. Last year I developed 2 lawns, built a patio deck, built a garden shed in the summer as well as playing golf 3-4 times a week. In the fall I developed our basement, installing drywall, laying flooring, painting and hung 9 doors, installed trim etc. All of this kept my shoulder moving and helped (along with cortisone shot) prevent my shoulder from totally freezing. 

      After all the work was complete I took it easy without realizing I had opened the door for FS to establish itself.

      If I had better advice, I would have had physio and got on an exercise regimen after the basement development was finished.

      Diagnosing a torn labrum is best made by your ortho and an MRI otherwise it tends to be guesswork, even by highly competent MD's

      Realize you are not alone in this and for most there is light at the end of the tunnel, only for some as in my case the tunnel is long. But at your age I would expect a faster recovery from what I have read.

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    • Posted

      Hey Jim, is your rotator cuff tear any particular tendon? Like I stated I had repair done on the same shoulder 12 years ago. It was semi-successful surgery in that I regained additional strength and ROM after surgery. It just never got back to pre-injury level. I didn't state this earlier but I dislocated the shoulder when someone landed on top of me with all of his weight slamming me onto a padded basketball pole. It was one of the most painful experiences of my life. It took 3 hours to put the shoulder back in. I'm sure the trauma shredded a bunch of tendons. If you had or going to have surgery, I may be able to give you some pointers.

      What is OAT? It's funny that you think 43 is young because I feel old after this injury. I can still run with 18-25 year olds on the court, but these injuries linger and come so much more frequently. I'm pleased to hear that in your 60s, you're able to do so much around the house and still play so much golf. You are what I strive to be. I'm a late daddy with a baby and a young toddler. It's no fun to have this injury when your kids want to play. Because of them, my golf outings are now just once a week with a couple range sessions during the week. I'm trying to keep my single digit handicap which is getting harder to do with little time to play.

      How is your injured shoulder affecting your golf? Are you able to still be active or is the shoulder pain too much? I was in denial a few weeks ago trying to fight through the pain. Maybe that was my mistake that led to this frozen shoulder or tear. My doctor is now referring me to a FS specialist. I'm surprised he hasn't ordered my MRI.

      Thanks for chiming in. Hope to hear from you.

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    • Posted

      Hi Jim, I am flying to Toronto this Sunday to have the OAT procedure done on Monday!!  I'm so scared  and nervous of it being painful.  However, I am in so much pain today that I am looking forward to it.  Do you have any advice??  I've had FS now since Feb....hoping since I havent had it that long that the adhesions will be easy to break up..   

      Thanks,

      Lisa

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    • Posted

      Hi Jim, I am flying to Toronto this Sunday to have the OAT procedure done on Monday!!  I'm so scared  and nervous of it being painful.  However, I am in so much pain today that I am looking forward to it.  Do you have any advice??  I've had FS now since Feb....hoping since I haven't had it that long that the adhesions will be easy to break up..   

      Thanks,

      Lisa

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    • Posted

      Hi Lisa,

           Like you, I was also nervous. It was really fear of the unknown. I expected pain, but not sure how bad it would be.

         The anesthetist injected local anesthetic to front and back of the shoulder about an hour prior to the procedure. As it was less than 6 months since I had cortisone, he didn't give any of that.

         He gave me a prescription for an anxiolytic to take prior to the procedure and a 3 day supply of a strong pain killer.

          The total procedure lasted about 30 seconds and for me there definitely was some pain, but only during the last part when the arm went fully back. But, to be honest it wasn't the worst pain I have ever felt. The pain is instantaneous and last 20-30 seconds, but after the arm is released by the Dr all I had was an intense aching.

      Knowing now what the pain felt like, I would be prepared to go through the procedure again, knowing what it has done for me.

         Certainly my recovery has been a full 3 months and I still have some restriction in movement. I had a surgeon assess me a couple weeks back and he says the restriction is due to the original condition that brought on the frozen shoulder i.e. torn rotator cuff.

         I am having bilateral ultrasounds of shoulders in a couple weeks and he will decide from that if I need surgery now, or if it can wait.

         I still need a mild sleeping aid to get me to sleep, but now I get a full nights rest with no real pain. I still wake up with an ache in the shoulder, but that I am told is due to the torn rotator cuff.

         My advice is go in there expecting some pain, but that it will only be for less than a minute. Everyone has a different level of pain. I spoke to one lady who felt more pain than I did and another gentleman who said it was minimal for him.

        Be assured that the pain you are having now will soon be gone after the procedure. You will be able to look back and say whatever pain you had during the procedure was worth getting your shoulder working again without the pain you experienced prior.

          During the first couple weeks it is normal to have pain when doing the exercises, as the shoulder is still recovering. But follow the exercise schedule faithfully and you will gradually have less and less discomfort.

        Let us know how you get on.

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  • Posted

    Hi Jim, thanks for responding....  I have not had any cortisone shots so hopefully the doc will give me that also.  I also just have strictly frozen shoulder..  No  rotator cuff tears or injuries, so that's a plus, right??  LOL..   Again, I'm in constant pain that I just want it all to be over with.   Will let you know how it goes.  Thanks again.

     

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  • Posted

    Hi, Ok....on day 6 post OAT procedure and boy was that painful.  I am almost regretting it.  I was about 2 weeks into the frozen stage where I had no paid during the day and only at night and when moved the wrong way.  However, I was dealing with that and actually happy that the chronic pain was gone.  Now I'm back to pain pretty much all day, especially during the exercises every three hours.   Doc said my case was really bad... A 10 out of 10 for being frozen.  Said I will probably be in pain for weeks, while exercising.  Great!  I almost regret I had it done.  Wish I was more patient.  Although the pain is different now, it still hurts to the point of being miserable throughout the day.  I don't know.....ask me in another week if I would recommend it.

     

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    • Posted

      Hi Lisa,

                         Sounds like you weer at the top end of the scale,for pain. I must admit that over the first few days I was also feeling like it wasn't what I should have done. The pain in daytime continued right up to 3 months for me. But, thankfully I was able to sleep well at night after I finished the 4 hourly exercises. 

         Some days my pain was better than other during daytime, but it depends on what I was doing that caused it. I found that if I napped too long without using a pillow to support my are, i would wake up with pain. Likewise, If I reached too high to get something off a shelf, I would have pain.

         I am stuck on about 90 % recovery in range of movement, but that is due to the rotator cuff tear. My ultrasound is on Tuesday, after which I will know exactly what damage has been done. Prior to the OAT all I had was an X-ray report to show I had wear of head of humerus and narrowing of the A/C joint. The Ultraound will be more specific.

          My biggest fear is will this re-occur and I still do the set of exercises once daily, particularly as my other should is showing the same symptoms as the one where i had the frozen shoulder.

        My biggest fear prior to the procedure was not being able to do what I enjoy doing, gardening, household repairs and golf. I'm glad to say I can do all of these again, although I do have to work within limits.

       Stick with the exercise, they are a chore and they do hurt, but for me that hurt did improve over time and the end result was worth it.

       

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    • Posted

      Hi Lisa - 

      I was wondering how you were coming along after the surgery? I am having similar issues, of course. I am just doing some research to see what my options are. Thank you!  Kelly

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    • Posted

      Hi Jim - how did your ultrasound go a couple of months ago. I think I have a similar issue of rotator cuff fraying that caused my initial problem (had Xray and ultrasound). Followed with PT where I plateaued after a few weeks. Now it seems to be freezing on me due to other health issues that arose that took first priority - I will start PT again at another location.  I am also going to go back to Ortho and request MRI to tell us more as my other arm is giving me issues as well. I am wondering if OAT would be worth it. Thoughts?  Thank you, Kelly
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    • Posted

      Hi Kelly,

      I am doing fantastic!! I have no pain what so ever.  I can raise my arm above my head and out to side.  Can tie my bathing suit top behind me.  Doing great.. I can finally sleep on my left side again.  I went back to the gym yesterday for the first time.  I can do yard work, house work and even painted my shed doors yesterday, using both arms.   My claim keeps getting denied but at this point I dont even care because I just feel great.       At first I dont think I would have recommended it because it was so painful but I do now..   If I didnt have the procedure done, I would be in the frozen stage for another 4 months or so I'm guessing.    Good luck to you..   

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    • Posted

      Hi Kelly,

          Yes, I had the ultrasounds and following that I saw the surgeon. The U/S showed a complete tear of the left rotator cuff and a partial tear of the right. The surgeon wants to hold off on surgery and see if there will be some more healing take place as he felt from the U/S that some healing was happening. He said there is a strong possibility of a complete healing of the right side and hopefully some more healing of the left.

      At this point I actually have more pain on the right (partial tear side) than on the left, O am not sure why.

      I would urge you to ask your doc for either an U/S or and MRI before considering OAT. I wish I had, as I think the intense exercises required after the OAT may have been the cause of the partial tear in my right shoulder getting worse..At least then you know exactly what caused the F/S to develop. 

      Where I am now with the rotator cuff tears is that I am able to have almost complete range of motion with my right shoulder, but I still am stuck on 85% with left shoulder.

      Things I find is that weather or at least atmospheric pressure seems to have an impact on my levels of pain and range of motion. Also, I have good nights rest for 4-5 days then got 2-3 nights with poor sleep as again the weather seems to be the culprit. When my shoulder feels good, I can even sleep on my right side, but when it has more pain I can only sleep on my back with 2 pillows.

      Another thing I have learned is that NSAID's although helping with the pain actually prevent the inflammatory response that healing tissue needs. So I have discontinued using NSAID's and only use Acetaminophen when needed or at times when pain is really bad I use Tramacet.

      Next week I am having both shoulders injected with Dextran in a procedure called Prolotherapy as I have heard that it can bring about an acceleration in healing of torn rotator cuff. There is also another therapy call Protein Rich Plasma which uses your own plasma to also bring about healing, but the cost is 4 times as much as the Prolotherapy.

      But to get back to your question, for me OAT did release my F/S however, it didn't tackle the issues that caused the F/S in the first place. Talk to your doctor and have him or her find out what is causing the F/S, then talk to the OAT people. BTW, the Prolotherapy and PRP Therapies are both used in treating F/S although I am not sure to what degree of success.

      As for P/T, I didn't find it to be of great help to me. What I did find was that the exercises recommended by the American College of Orthopedic Surgeons has helped and are gradually strengthening my shoulders again.

      It is kind of opportune that I was watching a documentary on TV a few days ago about John McCain and how he couldn't raise his arms above his shoulders and had been that way for over 40 years. I know that my issues pale compared to what he endured and I feel inspired by him and how he coped with his pain and his limitations. I feel I have developed a whole new perspective on pain and personal endurance from hearing about him

      Good luck and hopefully it doesn't progress to become frozen.

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    • Posted

      Hi Jim,

      How did you make out with the Prolotherapy?

      I'm curious because I did prolozone therapy (prolo with ozone) for my right shoulder last year, and i'm now doing it on my left. Ughhh. Right shoulder started in July 17' - I started prolozone in Sept., and did a shot each month through Dec. Started unfreezing in Jan. 18'. It thawed very slowly but by summer I was 90% back to normal with very little pain. Then in August 18' the left one started up. I immediately started prolozone in Sept. Not exactly sure what brought all this on. No diabetes, thyroid, or Parkinsons (that I can tell). Best I can come up with is I fell on my right shoulder and the trauma caused the frozen shoulder. Once that healed the left shoulder got tendonitis from overuse (since my left was doing everything for my right), which triggered the FS. Now my right is starting to ache again because its doing everything for the left. So, I'm going to start doing prolozone on the right to try and fend off a relapse. Is starting to feel like a never ending cycle. My husband is a firm believer in Prolo and PRP. He did both to heal a torn tendon in his elbow. Now, his elbow is stronger than ever. That's the only thing that convinced me to do it. It supposed to regenerate the tissues and heal instead of just reducing inflamation (cortizone shot). But, its hard to tell with Frozen Shoulder; it just seems like a totally different beast. Did Prolo help your FS?

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