Frozen shoulder is a relatively common condition, affecting roughly 1 in 20 people at some point. It presents with long term shoulder pain and stiffness. Three movements are particularly restricted:
abduction: taking your arm out to the side
internal rotation: the movement needed to put your second arm in a coat sleeve, or reach up your back
external rotation: as required to wash your hair
Symptoms of Frozen Shoulder
Symptoms vary in the three different stages: freezing, frozen, and thawing. Freezing is characterised by increasing pain in the shoulder. Following this, the shoulder is at its stiffest (frozen), but the pain does not increase. Symptoms begin to subside anywhere from a year to 2.5 after onset. This is the thawing phase. Unfortunately, it is a long and slow process to go through. The total time to resolution may be sped up with manual therapy and exercise.
Even in the frozen stage, we don’t expect the shoulder to be completely immobile. Restriction is mainly isolated to the three movements mentioned above: abduction, and internal and external rotation. Muscular tightness may be more wide reaching, however. In order to keep the rest of the shoulder moving as well as possible, your osteopath will want to work on the muscles of the shoulder, neck, and upper back.
These three stages may not be so marked in cases where the onset was not insidious. This includes traumatic onset, or patients who have any of the risk factors listed below.
How it Happens
The formal name for frozen shoulder is Adhesive Capsulitis. This literally means “sticky, inflamed capsule”. The capsule is a fibrous layer that encompasses the ball and socket joint of the shoulder. Its role is to keep fluid within the joint and provide some stability. When it becomes inflamed, it loses mobility, causing the characteristic stiffness.
There are risk factors for developing a frozen shoulder. Poorly controlled diabetes is a common association, and there are links with heart disease and Parkinson’s disease too. In the 7 years after the original episode of frozen shoulder, it is more likely to reoccur in the other side. This is more likely to affect diabetic patients, so preventative management is particularly important for this demographic.
Prolonged immobilisation of the shoulder, such as after an injury or local surgery, is another cause of frozen shoulder. Even after a shoulder replacement, you are expected to perform some movement before discharge from hospital. If something happens to you that means you are inclined to keep your shoulder still, get in touch to see what we can do to keep you moving. Proper rehabilitation for other shoulder problems may help to prevent the development of adhesive capsulitis.
Relatively frequently, a case of frozen shoulder will not follow any of these risk factors. There is still a lot we don’t know about why it develops.
Treatment and Management
Osteopaths are qualified to identify and treat your frozen shoulder, so you don’t need a referral to make an appointment with us.
In addition to his osteopathic training, Andrew has trained in the Niel-Asher Technique. This is a specialist technique for managing frozen shoulder. It involves working into the soft tissues and joints around the whole shoulder. Although the ball and socket joint is most affected, there are secondary effects on the other joints of the shoulder. These include where the shoulder blade articulates with the ribs, and where the collar bone meets the scapula.
Osteopathy is built on the principle of treating the body as a whole. At your appointment you can expect your osteopath to look at the relationships between your shoulders, upper back, and neck. Therefore, treatment rarely isolates to the joint causing the problem- we look at the effect it has had elsewhere to keep everything moving well.
The Niel-Asher Technique for Frozen Shoulder
What is the Niel-Asher Technique?
The Niel-Asher Technique (NAT) is a unique, non-invasive approach specifically developed to treat frozen shoulder, also known as adhesive capsulitis. Instead of focusing on the shoulder's range of motion directly, this technique targets the brain's perception and patterns of movement, prompting a natural healing response.
How Does It Work?
At the heart of NAT lies the belief that the pain and stiffness of frozen shoulder result from abnormal neural signals between the brain and the shoulder. By utilizing a sequence of specific manual manipulations and pressure points, NAT aims to reset this faulty communication, allowing the shoulder to heal naturally and regain its mobility.
Benefits of the Niel-Asher Technique
1. Non-Invasive: Unlike surgical procedures, NAT doesn't require any incisions or injections, making it a gentle and non-intrusive solution.
2. Drug-Free: The technique doesn't rely on medications, making it a holistic approach that avoids potential side effects of pharmaceuticals.
3. Self-empowering: Along with the practitioner's interventions, patients are often taught exercises and self-treatments to aid in their recovery process.
Who is it Suitable For?
NAT is suitable for most individuals experiencing frozen shoulder symptoms. However, always consult with a healthcare professional before starting any treatment. Whether it's a recent onset or a chronic case, NAT offers an innovative approach to promote natural healing.
Frozen shoulder can be a painful and frustrating condition. The Niel-Asher Technique offers a unique, non-invasive, and holistic approach to address the root cause and provide relief. By working with the body's natural mechanisms, NAT seeks to restore the shoulder's function and freedom of movement without the need for drugs or surgery.