Frozen shoulder – diagnosis and treatment


To assess the condition of the shoulder, it is best to take an X-ray in three projections (from the top, AP, axillary), which is usually sufficient to assess the bone parts of the shoulder joint. When the X-ray image is in doubt, an RMI examination of the shoulder should be performed, which may show the cause of the appearance of a secondary form of frozen shoulder.

Frozen shoulder is a disease that resolves itself, but the initial form of this disease is treated conservatively. Acute inflammation along with inflammation of the synovial membrane leads to the appearance of pain, which appears in all settings of the shoulder, including bringing to rest. In an acute condition, you can apply anti-inflammatory and analgesic drugs to the joint, and after it subsides, you can proceed to the inclusion of physiotherapy.

Since the movement of the entire shoulder is limited, it is important to restore the proper glide of the shoulder blade. This can be achieved by relaxing the tissues around the shoulder joint and scapula, as well as through exercise. It is also necessary to pay attention to the glued fascia, which limits the mobility of the shoulder and strongly loosen it. When working with the fascia, the patient should keep the shoulders completely relaxed, and the therapist so to guide the movement of the shoulder, so as not to cause additional muscle tension. Since the shoulder joint has a large range of motion, mechanical pulling of the fascia should be avoided. The goal is to provide an impulse for the key fascia beam while observing its effect on the ligaments near the joint.

As for the exercises, they must restore the correct shoulder-shoulder rhythm with the help of gentle movements with the whole body with a steady hand. Such exercises restore the correct pattern of movement.

About precision and working with the fascia – In the treatment of the shoulder joint restoration of its mobility requires precision. Imprecise impact on the joint fascia can contribute to an immediate change in tension, but also cause destabilization of the joint.

In addition to precise and detailed work with it, it is necessary to take into account the overall context of the body structure into which the joint is integrated-the way the chest as a whole rests on the column of the abdominal organs, the position of the axes of the hip joints and shoulder girdle relative to each other, as well as the preferred movement patterns of the hands and hands, reflected in the fascia network. In some situations, the problem in the shoulder area is nothing more than a reaction to the structural weakness of the transitional area between the abdominal cavity and the chest cavity.

Since the shoulder girdle is located between the relatively stationary chest and the mobile neck, it must be able to adapt to dynamic rotational forces acting from the side of the head, but also from below. Additional examination and treatment of the transitional areas between the abdominal cavity and the thoracic cavity is not sufficient. Attention should be paid to the way in which the curvature of the sacrum connects to the lumbar spine, how the upper part of the lumbar spine connects to the thoracic spine and how the upper part of the spine passes into the neck.

Frozen shoulder is a painful condition that requires appropriate diagnosis and appropriate, precise work with tissues. Treatment is not only pharmacology, but above all finding its cause.


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