When Physio Doesn't Work for Frozen Shoulder and other musings
Posted , 6 users are following.
Hello Everyone. This is my first post on these forums.
There seems to be much controversy as to whether PT works for frozen shoulder and if so, during which phases. This should come as no surprise to those of us suffering from this plague given the medical community overall, in my humble opinion, is clueless regarding just about everything related to this disease. Same applies to lower back and other musculoskeletal issues.
For example, you may have noticed that the description of the 3 FS phases repeats itself verbatim from website to website - a classic example of content being stolen, borrowed, and recycled. Any errors and inaccuracies are thus perpetuated throughout the web - possibly forever and certainly to the detriment of sufferers. Having said that there are a few reputable sites (Harvard Medical, Mayo Clinic) and clinical papers that do support the role of PT in this horrible disease.
Ok more to the point. Hopefully others can share there experiences to date so they might help fellow sufferers, focusing on the positive rather than the dramatic, and avoiding platitudes like "be patient, it will get better".
Before we go, what exactly is PT? Hearing another patient saying they did PT is unfortunately useless because it is not one exercise or one approach. In fact, during the last 7 months I have discovered and cataloged (i created my own resource library) over 300 different exercises for impingement and/or frozen shoulder. These can all be put in categories such as range of motion (ROM, itself broken down in active and passive), misc stretching, and strengthening etc. They can be further supported and varied by the use of equipment: therabands, towels, pulleys, yoga belts, canes/poles, dumbbells, braces, etc.
There is also evidence that brachiation/hanging from bars can be helpful (Dr. Kirsch), if we consider this as PT.
Here are three general and one specific things I've found along this journey.
- Most exercises quickly cause severe pain. It's frustrating to hear "don't go thru the pain" when just being alive with FS hurts like hell.
2: Try different exercises
There is no one size fits all here. If those prescribed don't work, try something else as long as they don't cause significant pain. As mentioned above you can find hundreds of distinct and/or variations of exercises.
3: Gauge your progress
There is a saying, there is no progress without measurement. The only way you can tell if something is working is by measurement. This can be height reached lifting shoulder, increasing angle or ROM, or pain. I use marks on the wall to see my progress with ROM.
For example, I woke up exhausted and with severe pain (like most of you I"m sure). I was about to get some ice packs when i tried something else instead. First I did a wall walk and noticed my ROM was less than day before. So I did pendulums, passive, with a 3 lb weight for about a minute. Repeating the wall walk resulted in less pain and increased ROM. It was that simple, not a miracle, but evidence pendulum had indeed helped.
- What works for me with minimal pain: simple wall walks, pendulums with weights, and assisted ROM using a pole or cane (flexion, abduction). Very slow and deliberate movements with a very gentle stretch (a few seconds max). Do them, if possible, throughout the day. At work you can easily do wall walks frequently, hourly would be optimal. I also find, for pain relief, that breathing slowly and deeply actually does help. Hot shower or hot pad before working out is a good idea. Ice afterwards if you overdid it.
Would love to hear from others what actually works for them realizing our conditions are different. I don't believe you can do a damaging exercise for a very simple reason. Anyone here with FS knows clearly that if they do the wrong exercise they will swiftly be reminded by pain which can be off the scale.
Please don't share your failures, let's focus on success here and specific exercises. In particular would love to hear from anyone with success regarding be able to move your hand behind your back (internal rotation). This is where many of us have the least ROM and the most pain.
1 like, 5 replies
ColdShoulder
Posted
There is one thing i forgot to mention. Although I wrote I'd love to see a focus on PT success here rather than failure, there is one factor that has seriously impacted my own progress.
Energy, or lack of it.
I can't sleep at night (I normally would sleep on the injured shoulder, so that is no longer possible).
Every morning I wake up I'm completely drained and often depressed from lack of sleep. This surely explains why many of us don't derive benefits from PT, no?
colin1964 ColdShoulder
Posted
hi cold shoulder
good reading there. as with me i have refined my regime around my job. pendulum weights i use two 2 kg hammers taped together i find the weight pulling the capsule down helped open the joint in the morning.
hanging. i use door architraves. work my hands up to the height and gently pull down from the architrave opening the joint.
even walking down the road you can see me arms out and pushing ALL THE TIME.
as like you. its to the arms limitation. even since hydro dilation i must not stop. i was in london saturday and my wife commented on when holding hands. i was still tense and guarded. its some thing i just cannot help.
i have a question does having a very physical job help in recovery against a person in an office. come on people tell us is there any better job to have to help this nightmare. and does it benifit the problem.
people have followed me for past few months and afraid my job has pulled me back in the second arm recovery.
i just cannot wait for friday pm for PT as by the end of the week my muscles ache. not so much the joints any more.
colin
ColdShoulder
Posted
Hi again Colin.
Would like to hear from others regarding pendulums - seems to be a good way to lubricate and open up the joint. With regards to hanging, during the summer, when this horror show started, I went into the park and tried the monkey bars. Before hanging I could barely lift my arm sideways (abduction). I hung for about 15 seconds with my feet on the ground (i.e. not full weight) and the pain was pretty intense. But right after this brief hanging i was able to lift the arm much higher. Right now I'm in way too much pain to lift high enough to hang and due to the super cold and long Canadian winter I'm in the house. I tried using the door to hang but find it too painful now.
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HDJ2019 ColdShoulder
Posted
Ok -
so I am just one person and I probably have not suffered the worst FS but I will say it WAS PRETTY DARN BAD AND FRUSTRATING!!!!
I was misdiagnosed at first - of course they just called it impingement -
one frustrating thing is the lack of understanding of this problem - and also the lack (at least in the US) to look into alternative methods for treatment - OR just realize this is something that follows a process - and let's just encourage and help people get through the time-frame (roughly a year) without unnecessary money and interventions (medicines and painful therapies) which quite possibly have long-term BAD affects...
I feel like I could talk for a while about my experience and I have noticed that is the same for most people - because it really is an experience and lasts for quite a while - but there are common features.
I also get frustrated when people say "here is how you can keep this from happening" - or "this happened because you didn't exercise or stretch or use your shoulder...." blah blah - NOT TRUE.
Now -
I did get an injection (steroid - which I wish I hadn't!!!!) but I did.
I also did therapy - finally quite that - wasn't getting any better and as I was researching also just realized that I needed to let it run its course - but also not just do NOTHING (which is exactly what I wanted to do!!!!).
Here is a link to an "exercise" I WOULD recommend.... also I would recommend heat and not ice. And no NSAIDS (slows healing).
Also "Pot-stirrers" helped some - but if something was really painful I just didn't do it. As much other exercise as possible is good bc bloodflow is good - but you can get your heart-rate up without moving your arm (although moving any part of your body hurts I know - but to be real just sitting or lying still also hurts like heck - so.....)
In researching the issue there are videos that claim to FIX this is one simple exercise etc... that is a bunch of nonsense.
It does get better. I have good mobility now and literally had NONE when it was at the frozen stage. My therapist said it was probably the worst case he had seen.
I have heard that in Canada and UK and probably other places they will do hydrodilation - but good look getting anyone to take that seriously in the US - I think I probably would have tried that if available - but I also don't think I would trust in it as a miracle.
Prolotherapy is another thing to look into. I did not have it but I do know that there is good research that is helps and I have had two of my adult kids with muscular skeletal problems who have had it done and it was helpful. It is just very hard to find someone reputable and also it is expensive and covered by almost no insurance companies.
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ColdShoulder HDJ2019
Posted
It' sad to see my link and yours removed by a mod. You try to help fellow sufferers but you are shutdown. This isn't a surprise however because this site, like surgeons, chiros, physiotherapists, and charlatans all put their self interests first. Im going to look for another forum which allows freedom of information