Massage and frozen shoulder

[Bloke501]

I have a new client coming for a treatment in a couple of days, she has been recommended by her doctor to try massage to ease her frozen shoulder. I have no experience in this with other clients and not too sure of the best way to carry out her treatment. Can anyone help give me a bit of advice of how to deal with this, please........... I need some help

 

[noiniusiapire]

In my experience with a friend who I suspect has a frozen shoulder, though undiagnosed, she is very very sensitive to pain during massages in this area, so I would keep it gentle and then build up, guaging your pressure with the client's reaction. The problem I found was that you can feel a huge amount of tension in the client, and no matter how much pressure you apply, it doesnt seem to go away.
Also, it is partly a psychological reaction in the client and they are aware that after resting in certain positions (eg sitting or lying down) that when they go to move their shoulder or neck that it really hurts and siezes up. So even after a nice relaxing massage, as soon as they get up to move the problem may come straight back. How disappointing!? But they do experience some degree of relief for the following few days. I would recommend two to three short sessions focused on the shoulder, back and neck, within two weeks of eachother to begin with.

Hope this helps! It is not official advice, it is just my personal experience based on one client. Let me know if you make any new discoveries!

Alex

PS - you're not Cas I know in sunny Draycott are you??? I just clocked the cat picture and began to wonder...!

 

[TrishARoo]

Hi ya Cas

It's really important to massage frozen shoulders on a regular basis - little and often.

Sorry I can't give you specific advice because I tackle each frozen shoulder individually. Just knead the tense shoulder and neck muscles first, then massage the arm, hands and fingers to open up the meridians, then and apply shoulder mobilisation.

Best Wishes

Reiki Pixie

 

[Nameless]

working trigger points on the upper arm can sometimes allow a dramatic improvement with a frozen shoulder.

 

[soisitok]

depends wether it is a true frozen shoulder, usually i would try to achieve 15 degrees moement improvement per session, but apprehension will be the biggest hurdle to overcome. best of luck ,plenty of progressive pressure storkes to all areas of GH joint and girdle.

 

[Warren]

Thanks everyone for your advice on frozen shoulders, I feel a bit more confident about dealing with my client now.
By the way Alex Im not the Cas from Draycott as you thought, sorry.

 

[Willy Wonka]

Hi Caz,

I come across and treat frozen shoulder fairly regulary (I have a practice in London's City, lots of stressed people).

The term frozen shoulder is used as a blanket term for many types of dysfunction. It could be a number of things; fibrosis in the joint capsule (true frozen shoulder), impingement syndrome (where the tendons of one or more of the muscles of the rotator cuff get snagged under the acromion process), trigger points causing dysfunction of the rotator cuff muscles which messing up the timing of the scapulo-humeral rhythm... etc.

In all cases, because the client can't take the shoulder through it's full range of motion, there's a tendency for the muscles of the rotator cuff to shorten (and in long term cases, atrophy) thereby accentuating the problem.

If you don't know how to test to differentiate the cause of the problem, then a solid approach would be twofold:

First, focus on releasing and lengthening the rotator cuff muscles and the other muscles that attach to the scapula and humerus (subscap, lats, serratus anterior, rhomboids etc).

Then, perform traction on the whole shoulder to encourage inferior glide. Translated this means gently but firmly (with consistent pressure) pulling the whole arm inferiorly whilst encouraging the client to relax or "let the arm go" at the shoulder. Then lots of MET to increase lateral rotation to allow the greater tuberosity of the humerus to roll under the acromion during abduction. Then MET to increase flexion and abduction in all planes (coronal, scapula and sagittal) of the shoulder.

It's a tremendous challenge but you CAN make a difference - as indicated by the thoughts of the other therapists who have contributed to this discussion.

Hope this helps. Let us know how you go.

x

Henry

 

[SCAH]

Thanks Henry for your advice, you sound like you know what youre talking about, Im relatively new to this and its good to know that theres therapists out there willing to help. The treatment went very well this morning, better than I could have hoped, and the client phoned back this afternoon to book another appointment next week, so Im well happy with that. Thanks again ,
Caz

 

[Ken]

Hi Caz

You might find this site helpful - it's a really good massage resource:

http://www.sportsinjuryclinic.net/cybertherapist/front/shoulder/frozen_shoulder_adhesive_capsulitis.htm

Good luck!

 

[heartland_hopes]

Hello Melanie,
Thanks for the link, its looks very helpful.
caz

 

[MOON WILLOW]

Hi Caz,

One unusual approach that I found very useful is this. Start with the premise that a frozen shoulder is due to stuck energy (regardless of the physical manifestations). A frozen shoulder could be initially due to accidents, incorrect posture, or repetitive strain. Somehow the body has a memory, and it remembers this trauma as stuck energy, causing the frozen shoulder. So I use techniques to free up the stuck energy whenever a client lets me, and the results can be phenomenal. If you do Reiki, EFT, or spiritual healing in addition to massage, try using the energy techniques on the frozen shoulder and see what happens.

 

[Eic]

Hi Caz

just like to add that in my experience in dealing with true frozen shoulder (adhisive capsulitus) it will help to pay specific attension to releasing any triggerpoints you find in subscapularis.

When using mobilization techniques use strain and counter strain as this offers the client a good element of controll in increasing range of movement and helps stabilize the joint. Dont try to use passive movement mobilization as this will be counter productive.

Regards steve

 

[Void]

Steve, it may be a very dumb question, but pls can you explain why passive movement would be counter productive? I am not sure I understand why as I would typically use passive movement to increase ROM

Many Thanks, InTouch

 

[idnyktai]

Hi Guys,
I've come across a lot of frozen shoulder cases as well. I find MET's useful and don't forget to treat the client supine as well, getting in to the pectoralis and doing MET's on those as well because they are usually tight.

 

[Bragger S]

Hi all,
Thanks for all your replies, I will bear it all in mind when my client comes for her next appointment.
Suzanne, as a matter of fact I am a trained healer, so there was a bit of that going on too. What I did must have done some good as she was pleased and has made a regular weekly appointment, so Im well happy with that.
caz

 

[Newell]

Hi intouch

when someone has been in alot of pain for a long time (many times with emotional events linked in) its very often to much to ask of the client to relax and let go of the joint.

Using strain and counter strain places a small load through the joint which helps to stabilize it and keeps them in controll of the increases of range of movement allowed.
Demonstrate the technique on the good arm before applying to the arm of the effected joint.

Passive mobilization is generally a good technique but I do not use it in the early sessions when treating frozen shoulder (adhesive capsulitus).

Regards steve


Regards steve