(Meghan) - Welcome to this episode of JINGTV! We're going to deal with one of the biggest things that lots of massage therapists have dealt with, which is how to treat frozen shoulder (adhesive capsulitis). Sadly, Andrew had frozen shoulder and some of you might know it's one of my places of expertise. Andrew lives in Liverpool. (Andrew) - I do. (M) - and through our correspondence around design at some point Andrew said to me "I've been diagnosed with frozen shoulder" and I said "WHAT! we can deal with that!" So we thought we'd just talk a little bit about Andrew's experience with frozen shoulder and certainly how I went about treatment and what you feel like made a difference. Can you tell the viewers when/how it first presented? (A) - It started off, because I'm glued to my computer all the time, it started off as a bit of an ache and I just thought Jing have had me working on things far too long. I thought it would pass.
I've just strained something. But it didn't pass. It started to get quite painful and then it started inhibiting movement. (M) - The locking down, the freezing stage. (A) - I thought "ooh" I should see my doctor about this. He said, just see how it goes, it might pass and it didn't it got worse.
But I didn't go back to the doctor, I should have gone back at that point and said it's got worse. By the time I eventually went back it, I'd basically lost all movement down my left side. (M) - It was really kind of fully inhibited wasn't it? (A) - Yeah, it couldn't go beyond that point there. (M) - What we see here is a 30/40 degree abduction was all Andrew was able to do. He lost his lateral and medial rotation completely. (A) - Yeah to the point where to put my hands in my pocket I would have to lift that hand up and tuck it in.
Almost paralysed really. (M) - Can you remember how long it was from the ache to the loss of ROM? (A) - 4-5 months (M) - That's really classical presentation. If we go through that. Clinical frozen shoulder is the loss of lateral rotation, abduction and medial rotation within a period of time.
Usually takes about 6 months. Then the classic, when the GP or anybody says it's going to get better but it's going to take 18months - 2 years. Is that what you were told? (A) - I was and I was referred for physiotherapy, which involved some stretching exercises, trying to walk up walls and things. Look, I can do this, it's great! But at that point I'd be literally straining to get beyond this point. That didn't do a great deal. (M) - The physiotherapy? (A) - It didn't really help.
(M) - Effectively they gave you exercises? (A) - Yes, but it didn't feel like it did anything. It was very painful. I remember thinking that saying "no pain, no gain", but it was just pain, no gain. I didn't feel like I was getting anywhere. (M) - Just pain, no gain - right! (A) - I was just starting to feel really hopeless about it, went back to the doctor and explained (M) - It affected your work right too? (A) - Well yeah, it meant I couldn't drive a car, because I couldn't do the gear stick, you can't keep doing that to do the gear stick.
There were just loads of things, cooking. I'm mainly right handed but I do a lot with my left hand. I'm left handed when I eat, so that was really hard. I was in a bad way! (M) - No, it wasn't good. It wasn't pretty. (A) - It was terrible and then they said right you need surgery.
I was then put in the system to have surgery and that would've come about about 4 months down the line. I just thought I don't want surgery. (M) - So we kind of said to Andrew, well look, lets deal with this. There is a great massage therapist, that is of course one of the Jing teachers, Tracey and she did some treatment work on you. At some point I just came up and it was actually one of the times which I was able to do block treatments. I think it was 3 days and we did 20 minutes 3 times a day and what did we, what can you remember from that? We actually video taped it! (A) - We did! I remember crying, because it was so painful, but it was pain with gain on this occasion. It was stretching exercises so it was about trying to apply pressure and I pushed into the pressure.
Which wasn't nice, but I did feel like I was getting somewhere. Then there were some overnight exercises around stretching, trying to get some movement back. (M) - Effectively what I did was the Jing protocol for the treatment of the glenohumeral joint. We did 20 minutes which meant I did some myofascial release, I went in and did the four SITS muscles - supraspinatus, infraspinatus, teres minor and subscapularis - in particular subscap (A) - Of course. (M) - Of course, I know you remember this well. Mostly what Andrew's remembering, which is the thing that he had to be more engaged with, was PNF stretching around the movements that were the most difficult. Resisted stretching for abduction, medial rotation and lateral rotation. What we did was video taped his ROM before, we did some PNF, and then we video taped it afterwards and the increase of ROM was startling.
It was quite impressive. Where we were starting with 30/40 degrees, when I left at the end of 3 days you were definitely above 90 degrees. You were definitely around here. I think, I was only there for a short period of time and I think what happened also through that time and you can say, is just knowing it could get better through manual therapy made a huge difference.
Even if it didn't stay, it psychologically means I don't have to have my whole shoulder ripped out or keyhole surgery or whatever was going to happen. (A) - Yeah. I mean, to the point where eventually, because I carried on doing the exercises afterwards, the stretching. What it felt like was happening was I'd get so far and then the next day I'd have lost a bit. Then I'd get a bit further, and lose a bit more again. It was a gradual thing, but what happened was by the time the surgery came around I'd got sufficient movement back to not warrant having to go through it.
It was probably only another 10% needed before I was back normal. (M) - So we avoided that? (A) - I never ended up having surgery. (M) - Great success! This is really key: Andrew's dedication to his own treatment made a difference, him continuing to do the exercises I gave him. Having general massage therapy and clinical massage therapy 6-8 sessions and then this block work which was really just PNF work and this is something if you can suggest to your clients can make a real difference in all aspects, because part of breaking the cycle of pain is empowering people to know a difference can be made. We just thought this might be a good case study for JINGTV! and anybody whose interested out there.
All these things are taught on the Jing 2 day Shoulder Girdle pain course. Give us a call call if you're interested 01273 628942 and would like to know more. Get involved in the conversation on Facebook or Twitter. We looking forwards to seeing you soon!.
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