It is not known exactly what causes this condition. Immobilization of the shoulder (after an arm injury, for instance) can lead to a frozen shoulder. Inflammation of the muscles and/or tendons, as with rotator cuff tendinitis or bursitis, can also cause the shoulder joint to become frozen. The glenohumeral joint is surrounded by muscles and tendons and held together by ligaments. When the balance between the ligaments, tendons, and muscles is interrupted the tissue form what are called adhesions. Adhesions turn fascia, the covering of the muscles into raisins. Raisins? Are you crazy?
Adhesive Capsulitis? What’s am Adhesion?
Adhesions are easy to visualize as raisins. Muscle tissue should resemble grapes. When the fascia becomes irritated the covering shrivels up and causes pain that would limit motion. The more something hurts the less likely you are to use it. Adhesions in my estimation are a big cause of adhesive capsulitis. Like any muscles that are not used they will atrophy. So now when I mention atrophy the raisin-to-grape analogy would make more sense. There are many nerves in the fascia which is another reason shoulder pain due to adhesions is so painful.
If you have had trauma to your shoulder there can be other muscles involved. What I am going to tell you is that there are 4 primary muscles involved in adhesive capsulitis. By addressing these muscles first we find the most success in treating shoulder pain.
Subscapularis
The Subscapularis the muscle found in front of your scapula internally rotates the humerus and brings it closer to the midline of the body. It also protects the shoulder from moving out of place in a forward direction.
The Latissimus Dorsi
The latissimus dorsi is responsible for a lot of things. It helps to stabilize your pelvis, it goes all the way down from your shoulder to your lumbar spine. The lats play an extremely important role in stabilizing the neck, shoulder, back, and hips. Think of the latissimus as the anchor of your back. An unstable shoulder needs to be rectified when you have a frozen shoulder.
The Middle Deltoid
Of the three Deltoid muscles, the Middle Deltoid is the one we see most often involved with cases of frozen shoulder. There are three heads of the deltoid muscle group. They help lift the arm front, side, and backward. The anterior and posterior portions are stronger and are usually safe from strains. It is interesting to note that the deltoid muscle is the largest arm muscle there is, even larger than the pectoralis muscles.
The supraspinatus is most commonly injured because there are three different positions where it can become compressed. Overuse of the shoulder can cause the muscle and tendons to become inflamed. The supraspinatus stabilizes the shoulder joint by keeping the head of the humerus firmly pressed medially against the glenoid fossa of the scapula. The supraspinatus moves the shoulder inwards and allows you to lift the arm. When we treat frozen shoulder we typically start by working the supraspinatus.
Core Health Darien treats frozen shoulders by lengthening and strengthening the muscles we mentioned in this article. We also use shockwave therapy to break. down adhesions that prevent proper motion and can cause serious pain. We are able to see results much faster than non-specific physical therapy. Call us at 203-656-3636 if you would like to be evaluated for your shoulder problem.
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