It’s not uncommon to have clients who come for a massage session as a result of adhesive capsulitis (commonly known as a frozen shoulder). In nearly all cases this is painful and causes restricted movements. This is a condition characterised by stiffness and pain in the shoulder joint. Signs and symptoms usually start gradually, worsen over time, and over time resolve – usually between one and three years.
Dr. Peter Jones presented a workshop at the recent Massage Therapy Association’s (MTA) AGM.
He talked about the risk of developing frozen shoulder increasing if a person is recovering from a medical condition or procedure that prevents them from moving their arm — such as a stroke or a mastectomy.
Frozen shoulder typically develops slowly, and in three stages. Each stage can last a number of months.
Freezing stage includes:
- Gradual onset of shoulder pain at rest
- Sharp pain at extremes of motion
- Pain at night with sleep interruption
- 2/9 months
- Aggressive treatment should be avoided
- Activities that cause pain should be avoided
Frozen stage. Pain may begin to diminish during this stage. However, the shoulder usually becomes stiffer, and using it becomes more difficult.
- Pain starts to subside
- Shoulder becomes stiffer/ progressive loss of glenohumeral motion
- 9/15 months
- Spontaneous, progressive improvement of range of motion
- 15 to 24 months
It’s important to take a proper case history in order to establish an effective treatment protocol. This includes asking
- As well as any red flags
Besides regular massage of the affected areas, the therapist might suggest the following:
- Heat (before/during), packs, shower
- Freezing – pain free = low intensity +short duration
- Frozen -> aggressive stretching to improve ROM = load bearing + prolonged stretches
- Thawing – increase stretch frequency & duration