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Adrian MacNair
Boulder climber
Vancouver
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Topic Author's Original Post - Dec 12, 2013 - 03:04pm PT
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Hello all,
I went through the archives and looked up this condition so I'm not being lazy. Just looking for any advice somebody want to add.
After injuring my shoulder rock climbing on Jan. 8, 2013, I've spent 11 months on the sidelines wondering what was wrong. The doc finally confirmed it's adhesive capsulitis.
Good news is no surgery and I only need Cortisone injections. Bad news is he said a minimum 6 more months and up to 3 more YEARS off climbing.
Guys, say it aint so!
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rgold
Trad climber
Poughkeepsie, NY
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Dec 12, 2013 - 03:05pm PT
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Pat Ament knows about this!
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Adrian MacNair
Boulder climber
Vancouver
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Topic Author's Reply - Dec 12, 2013 - 03:07pm PT
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Thanks, I'm just reading about Pat right now. I really sympathize, mine seems much less severe.
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Ward Trotter
Trad climber
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Dec 12, 2013 - 03:08pm PT
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Your Doctor is a climber , has seen you numerous times at the local crag , and seeks to sideline you with a phony diagnosis ---as a way of thinning the herd so he can have more of the routes to himself.
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Jan
Mountain climber
Colorado, Nepal & Okinawa
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Dec 12, 2013 - 03:16pm PT
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Speaking of Pat, he seems to have dropped from sight. Has anyone heard from him lately?
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Jaybro
Social climber
Wolf City, Wyoming
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Dec 12, 2013 - 04:57pm PT
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He's around on Facebook and has a new cd!
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Fritz
Trad climber
Choss Creek, ID
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Dec 12, 2013 - 06:15pm PT
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Heidi went through Adhesive Capsulitis aka Frozen Shoulder a few years back. It was a little tough to get a correct diagnosis during the very painful "freeze-up" stage because of course shoulders are not well-designed and a lot can go wrong in there. She went to one orthopedic specialist, who gave her a steroid shot, with only slight positive effect. Then acupuncture achieved nothing. The second orthopedic specialist was highly recommended by friends and somewhat of an outdoor injury specialist. After x-rays and another steroid shot, he really wanted to do surgery for a possible shoulder defect, but then discovered frozen shoulder from Heidi's loss of range of motion and prescribed physical therapy.
Like you, she also did a lot of internet-study on the subject and was somewhat enthusiastic about physical-therapy. She had lots of pain, (but it was pain with gains) during three & one/half months of two or three times a week therapy-sessions to "un-freeze" the shoulder, but she didn't have the longish recovery time usually expected with surgery.
Symptoms started in Jan, therapy, started in May, home muscle stretching followed physical therapy, and she was back to normal by Dec. That appears to be somewhat faster than normal recoverery time.
Turned out her mother had also suffered Adhesive Capsulitis 20 years earlier, had opted for surgery, and was years getting back to normal. For Heidi, the whole course of Freeze-up to thaw-out took about 11 months.
Heidi is willing to share most effective therapy details, just shoot me a PM.
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neverwas
Mountain climber
ak
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Dec 12, 2013 - 07:35pm PT
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I had this a couple years ago, with severe pain on accidentally moving the arm too far, assumed it was some kind of serious problem needing surgery, but finally was diagnosed with 'frozen shoulder syndrome', adhesive capsulitus. My impression, really just a guess, is that this maybe occurs after some other injury limits range of motion, and eventually the connective tissue grows in, effectively knitting some muscles or other tissues together.
Had physical therapy, painful but effective, where the task is pretty much to rip the rogue connective elements apart. I think the trick might be to do that without causing too much collateral damage, but it's pretty much going to hurt.
Don't overlook massage therapy for this; a good therapist can identify the various muscles and such by feel, and breaks the connected stuff apart using fingers and elbows. Exquisitely painful, but very noticeable improvement with each session. Before those sessions I figured massage was just sort of general rubbing and kneading, but this was very focused attention for an hour on my left (or was it right?) shoulder to free the stitched-together bits.
I'm probably close to 100% over it now, but think that it's up to me to maintain the range of motion and not let it happen again.
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bhilden
Trad climber
Mountain View, CA/Boulder, CO
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Dec 12, 2013 - 08:44pm PT
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I got this in 2009 from a fall on El Capitan. My doctor said it was a one year cycle. The first four months it gets progressively worse. The next four months it is really bad. The last four months it gets progressively better and then back to normal. Luckily for me, the problem only lasted about 6 months total. YMMV.
I didn't take any drugs or shots. It was really hard to sleep for about five of the six months. I just waited it out and it eventually went away which is exactly what my doctor instructed me to do. Again, YMMV.
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Patrick Oliver
Boulder climber
Fruita, Colorado
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Dec 12, 2013 - 11:13pm PT
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Here I am again. I took a break will I immersed myself in
drawing. I think I did about 300 charcoal drawings in three
weeks, still at it strong. And yes my new album just came out.
I suppose I should start a thread just to announce the album.
But on the subject of adhesive capsulitis. We are talking about
a degeneration of nerves in the shoulder that often will precede what
is called frozen shoulder, a nasty effect of adhesive capsulitis.
I used to be able to pump out slow, free-standing handstand pushups,
and one day as I came out of doing a few I hard a very sharp pain in
my left shoulder. It was a fierce jolt. Then some days later, as I
walked a trail, I simply moved my hand a little, or maybe it was
little finger, and the same horrid jolt hit, with unbelievable power,
almost twice the power of the initial nasty shock. I thought I would
pass out but caught my breath and continued down the trail. It was
almost as though I had been hit by lightning. The pain then began
to come on, quite bad, though not as terrible as that big jolt. I
realized if I moved my arm or hand just so, I would have one of
those awful jolts. But the steady pain now was bad enough, and I
could not sleep for almost two months. I finally went to an
orthopedic surgeon who, after a lot of tests and examining me,
said I had adhesive capsulitis.
Basically there are all sorts of nerves in your shoulder, and they
are like a string mop. They are all different lengths, so that
they will have enough slack when your shoulder/arm moves around
into a vast variety of different positions. What happens is that
the big mop of strings (nerves) begins to adhere to the bone,
almost as though to melt into the bone. No surgery is effective,
because you would have to cut through too many things that would
not grow back. More damage would be done than good. The only
real treatment is physical therapy (along with some specialized
treatments such as high heat (special heat devices placed under
your arm, in your arm pit), and various injections into the
shoulder, etc. etc.)
I was not sure what to do, but suddenly I could not move my left arm
at all. I had gotten that nasty effect of adhesive capsulitis, what
they call frozen shoulder. The scapula presses down inward into the
back, as though it has a mind of its own and as a protective
mechanism. If you can't move your shoulder, you won't get that
awful jolt, or so your scapula "thinks." In fact I still had a
few of those big awful shocking jolts, though, after my shoulder
was immobilized by the scapula clamping down. The pain was always
there, though, to a high degree (but just not quite as bad as the
jolt).
So now therapy was the logical next step. Twice a week for almost a
year I went to a lady who worked on me, often with an assistant.
Together they did all sorts of prying things, levering my arm up
by tiny increments and forcing their fingers under the sides of
my scapula to try to pry it out from its lock on my back. Each visit
they would measure how much progress had been made, and it would
usually be about the distance of the width of a hair! They used
a measuring device that told us how far I could lift my elbow out
and away from my body. It was hideously slow progress, and I still
had a devastating lack of sleep. I had to be on pain meds much of the
time but certainly during the therapy. Through the course of this
year of therapy, I was unable to do much of anything (as for my
karate class I simply went and instructed, and I could do kicks,
but I did not move my left arm).
At last I reached a point where I could move my arm quite a bit
again (I had lost all strength, however, and probably will never
again do a handstand pushup or a one-arm mantel). It was at this
time, when the arm seemed on the mend, that the jolt hit violently
again, but in the other arm!!! So now I had it in the right arm, and
I had to go through the whole therapy again, for a full year,
much to my dismay. Months and months, but I got to where I could
move both arms again. My arms were weak, though, very weak.
Fortunatly in karate we don't use strength but technique. But my
climbing was done, unless I were to train seriously for a long time,
in a very specialized way. Only then would I be able to get even
a tiny bit of my former strength back. I just did not have the will
at this time, because other health problems were starting to hit,
more serious problems than the adhesive capsulitis.
It sounds as though your situation is at the beginning stages. If I
could make any recommendation, it would be to carefully move your
arm as much as possible, not using strength but rather trying to
keep it as mobile as possible. You might be able to avoid the next
stage, where the pain starts to come on in a massive way, and you
can't sleep, and then the frozen shoulder. I honestly do not know if
there is a way to avoid those next steps, but I assume people
have gotten adhesive capsulitis and not gone to the condition of
frozen shoulder. Not a very hopeful thought, but at least you can
try to keep moving your arm, reaching and extending. It may or may
not help.
I am told that people with diabetes, and the virulent kind I have,
tend to be more susceptible to adhesive capsulitis. It is
entirely possible you do not have it. It seems, to some degree,
to be a convenient diagnosis for what actually might be a host of
other possibilities. The good orthopedic surgeons can make the
best calculated guess, so be sure not simply to talk to your
normal doctor.
How was that, for a... trip report?
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neebee
Social climber
calif/texas
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Dec 13, 2013 - 12:19am PT
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hey there say, pat... wow, i always wondered how the end results of all that was... or is...
hard core trip report, for sure, :O
very good to hear you share for any that might be on this hard trail...
was just going to share with jan, as to 'where you be'... :)
but jaybro did... and now, here you are, :)
edit:
ooops almost forgot...
say adrian... prayers and hope for all to get well...
and a good share from fritz, as well...
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Kalimon
Social climber
Ridgway, CO
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Dec 13, 2013 - 12:31am PT
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Beautiful grammar Pat.
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Fritz
Trad climber
Choss Creek, ID
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Dec 13, 2013 - 12:36am PT
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Pat! That was a very gripping & eloquent discription of what you, Heidi, and others here went through, or are going through.
Thank you for posting the details.
The whole time Heidi was suffering, she knew a significant percent of those afflicted in one shoulder also then had it hit the other shoulder.
She figured out that the drug companies are not working on a cure, since people don't die from Adhesive Capsulitis.
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bhilden
Trad climber
Mountain View, CA/Boulder, CO
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Dec 13, 2013 - 02:40am PT
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Pat's posts might be eloquent, but Adhesive Capsulitis is most commonly caused by some sort of traumatic injury and is basically an inflammation of the shoulder joint capsule. It is not caused by nerve degeneration.
Because it is an inflammation of the shoulder joint capsule, one of the prescribed treatments is injecting the area with cortisone.
Having said all that, please do not make any medical decisions based on what you read here or on any other forum. Find a qualified doctor and use their extensive training in medicine to properly diagnose and treat your problem.
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Patrick Oliver
Boulder climber
Fruita, Colorado
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Dec 13, 2013 - 05:36am PT
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I hope I said as well that one should see a good orthopedic surgeon.
My adhesive capsulitis was not preceded by an injury, at least not
one of which I am aware. I did not say it "starts" with nerve
degeneration, I don't think. I said when it hits, the nerves
kind of meld to the bone -- and thus don't have their normal length.
So when you move your arm, you pull a nerve, and thus the bad jolt.
Therapy supposedly works that stuff loose, but it's not a total fix.
I still have a milder version of adhesive capsulitis. I hurts still,
though not nearly as bad as before. And I have that weakness of which
I spoke. I am not trying to say what any person should do, just
my one recommendation to try to keep mobile, hopefully to inhibit
that process of the nerves melding to the bone....
One thing I've found is that there is indeed a lot of misinformation
out there about adhesive capsulitis.
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Bluelens
climber
Pasadena, CA
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Dec 13, 2013 - 10:18am PT
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I developed frozen shoulder in my dominant arm. Had 2 1/2 months physical therapy including at home, daily stretches and weight training followed by icing to reduce inflammation. I got professional ice packs that are flexible and wrap the whole shoulder. Get on Amazon or buy from the PT. Worth it as I did 3-4 sets of exercises daily. Used a Thermarest on the floor for the 15 minute ice sessions and listened to podcasts on my iPod. What else can you do while flat on your back 3-4x daily for 15 minutes?
I recovered near full range of motion but my insurance cut off the PT a few sessions early, and I had already been required to get re authorized for the last few weeks of PT.
Learned frozen shoulder is more common in women age 40+. Men have more upper body strength to protect the shoulder, but climbers are likely more at risk?
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troutboy
Trad climber
Newark, DE
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Dec 13, 2013 - 01:47pm PT
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You might look into a physical therapist who specializes in Muscle Activation Technique. After 3 orthopedic guys and 2 other PTs it is what finally fixed my wife's capsulitis issue
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Adrian MacNair
Boulder climber
Vancouver
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Topic Author's Reply - Dec 13, 2013 - 02:26pm PT
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Thank you all for your replies, and especially Pat for the description of your ordeal.
I also appreciate the caveat of getting a second opinion! I am to see a sports specialist in January to see if they also believe it is adhesive capsulitis.
Having said that, it all makes sense with the diagnosis, even though I'm not diabetic and only 39 years old and not the more normal range of 50+.
Long story short: I hurt it last January. Like most tendon injuries I've had in the past I just rested and iced it because I had a climbing trip in Bishop in April and wanted to totally be ready. I wasn't :(
So I babied it until June and tried climbing in the gym. First route seemed fine, so I jump on a 5.10 and reach for a gaston and blamo! Intense pain.
I took 3 more months off and it's September at this point. I'm changing a light bulb above my head and I push the sconce in hard and my shoulder feels like somebody ripped my friggin arm off.
I had to bury my mouth in a pillow and scream for about 2 minutes. Then 10 more minutes of writhing in pathetic agony.
That's when I FINALLY decided to seek professional help. An X-Ray was negative so the doctor tried freezing the shoulder and then came up with this diagnosis.
Anyway, thank you all for your support and advice and of course I will follow professional medical help but it feels better to know I'm not alone!
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Adrian MacNair
Boulder climber
Vancouver
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Topic Author's Reply - Dec 13, 2013 - 02:30pm PT
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Also, a bunch of the adhesive capsulitis symptoms matched:
1. Worst time at night while trying to sleep
2. Pain when trying to elevate arm
3. Stiffness
Also the strange stages of mild pain early on with worsening pain later and a lingering difficulty with movement.
Oddly, my doc told me to stop babying the shoulder and start using it normally in an attempt to break up what he thinks is scar tissue in the shoulder caused by non-treatment.
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crunch
Social climber
CO
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Dec 13, 2013 - 02:58pm PT
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Here's another thread with some more info and a diagram, on my old post, of a good exercise for opening up the shoulder:
http://www.supertopo.com/climbing/thread.php?topic_id=2084020&msg=2084138#msg2084138
Basically what Pat specifically suggested, and you in your last post, quoted from your doc, is likely correct:
Keep moving the shoulders, not with weights or strength, but with a view to range of motion. There will be scar tissue to work through and this will cause some pain. Be careful with pain. Variable pain in biceps is probably referred pain, to be ignored. Pain around where biceps and shoulder meet, in front, to be expected, for a while. A professional doc, PT guy, etc, will give better guidance--sounds like you have that now.
About 6 months of 2xdaily exercises really opened up my shoulders to where they seem stable, strong in all positions, and pain-free.
When exercising, rotations, etc, listen for clicks and pops; try to eliminate these by careful, slow movements, changing muscle tensions, etc
The lying on the floor, 90-90-90 (from the thread I linked to, see diagram) may be impossible but is very important (unless you have a good program of range-of-motion exercises already). Move slow. Slowly work into it in tiny increments, using a stick so both arms work together, and if you cannot keep your elbows on the floor use a pillow or similar spacer under each elbow. Took me a couple months to be able to do this at all. Several months to be able to do this smoothly, pain-free. Now I'm doing these exercises maybe once a week.
Do you have specific exercises?
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