By Dr. Scott E. Rosenthal
Don’t you just love to watch a great rivalry between epic foes? The Yankees vs. the Red Sox, Superman vs. Lex Luther, Rocky vs. Apollo Creed? Many of us can relate to battling a nemesis, that one opponent who pushes us to our very limits. I must admit, in my 22 years of chiropractic practice, I’ve had a few. I would like to introduce you to a true adversary that has caused me to stretch my abilities beyond almost all others. I am referring to the villainous frozen shoulder!
Frozen shoulder is commonly thought to be caused by inflammation in the shoulder joint. It is characterized by loss of range of motion, stiffness and pain. Medical treatment often involves nonsteroidal anti-inflammatory medications (NSAIDs), steroid injections and/or physical therapy. Although these approaches can produce results, for many they do not. I tend to meet those interested in a natural approach without the use of drugs or those who failed to gain results from the above treatments.
Throughout the years I have had varied success with frozen shoulder. Many patients improved, but others left me bewildered, frustrated and intrigued. Always thinking of the underlying cause, it became apparent that this mysterious condition was like a safe that could only be cracked after revealing its full combination. I felt like I had only 4 of the 5 digits and was tired of being bested by this common malady with its secret secure inside!
Early this fall a women came into the office complaining of her shoulder. Hers was a typical case that I have seen before many times. She explained that she did not do anything that she knows could have caused it and that it started months earlier. She was unable to lift her arm past 90 degrees and when she tried it was very painful. The difficulty and pain brought on from getting dressed, doing her hair, and performing other daily activities caused her great concern.
After treatment with the normal array of techniques that I use, she had gained only about 15 degrees of flexibility. It was more improvement than she’d experienced to date, but I felt stuck again knowing the secret of her frozen shoulder remained locked in the proverbial safe. On the fifth visit I tried adding a soft tissue technique to a seemingly unrelated part of her body. After applying it for about 15 seconds, it was as if I heard the final click of the internal gears. The safe door flung open. The elusive prize that I sought was finally revealed and she lifted her arm straight up towards the ceiling. There was no restriction and the tension was absent.
Was this the new breakthrough for frozen should that I’d been seeking for years? Was this the full combination? Thankfully, it was for this patient and three of the four who immediately followed. The one shoulder that did not improve belonged to a man who had a previous shoulder surgery for a separate issue. Although necessary, the surgery left him with a permanent loss of mobility.
After some refinement, I found that the best results come from applying four different techniques. Each is very important and necessary for the shoulder to unlock. Below is the full combination:
Biostensegrity Restoration Technique
This method addresses and corrects muscular weaknesses. Just like when you overwhelm and blow a circuit in your house with too many appliances, you can overwhelm the nerve that controls a muscle. In this case, the function of the nerve feeding the muscles does not fully switch off, but appears diminished. The muscle is left stuck in a weakened state. Joint instability and dysfunction ensues. When left with one or several weak muscles, the shoulder joint loses its proper mechanics. Compensating muscles over-contract and inflammation develops. With the use of a special type of laser therapy, the weakness is painlessly corrected. To learn more about this method, please go to RosenthalChiropractic.com and read the article: TENSEGRITY 101: UNDERSTANDING THE BONE-MUSCLE RELATIONSHIP.
Chiropractic Spinal Adjusting
The segments of your spine house and protect the spinal cord and the delicate nerve conduits (carrying thousands of nerve fibers) that exit between the bones. Misalignment of these bones can cause interference to the nerve fibers. The lower half of your neck contains the wiring harness of nerves that feed and control the shoulders and the rest of the upper extremity to the finger tips. Clarity here is vital for normal shoulder function. Gentle chiropractic adjustments realign the bones and allow for normal control to be restored. Interestingly, I have found that proper hip bone alignment is also essential for normal shoulder mechanics to exist—it really is all attached!
Chiropractic Extremity Adjusting
Again, gentle adjustments are used. The focus is on the joints of the shoulder and shoulder blades. Please do not confuse this with manipulation under anesthesia which is an invasive procedure used in medicine to tear adhesions while the patient is under moderate to deep IV sedation. I use an instrument that applies gentle pressures to the bones of the shoulder. Although receiving chiropractic adjustments tends to be relaxing, my patients are all awake.
Soft Tissue Percussion
With the use of a percussion instrument, tensions in the muscles and torsions in the fascia (connective tissue) are released. The procedure feels a bit like a vibrating massager, but more powerful. Administering it is comfortable for the patient, easy to use, and takes only seconds. The real trick is in finding the exact points and vectors of correction. I have used this technique for the shoulder over the years. This step was the final part of the combination that eluded me, but not when used in the shoulder region. Soft tissue tension and torsion needed to be released in the patient’s pelvic areas in order for the safe to finally open. The most common spots were around the junction of the hip bone and tailbone (called the sacroiliac joint) and above the crest of the hip where your belt sits. Again, it’s really all attached and the body is one giant interconnected functional unit.
A frozen shoulder can be a complex and difficult condition to overcome. Improvement often requires a unique combination of techniques, multiple visits and some time. I have found that most people will respond to some degree in just the first visit. This is helpful, because if I find that a shoulder remains unchanged, it is revealed early on and the commitment to finding out is minimized. Although I still have much respect for this notable foe, I believe this new approach will allow patients to see more triumphs than ever before!