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Patrick Oliver
Boulder climber
Fruita, Colorado
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Dec 13, 2013 - 04:59pm PT
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The strong connection to diabetes is what leads me to believe
for some people there can be and is some sort of nerve
degeneration. Maybe call it another name. Nerve malfunction.
It's the same with the feet. The circulation is bad, and the
nerves start to get aggravated and painful.... I do think,
at least in my case, that
some type of lasting damage was done by the adhesive capsulitis.
Everyone here seems to say theirs cleared up after a spell. That's
great. I wish it had, for me.
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klk
Trad climber
cali
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Dec 14, 2013 - 12:39pm PT
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"frozen shoulder adhesive capsulitis" is a catchall phrase folks use to describe a range of symptoms associated with shoulder problems that often show up in middle-aged athletes. but most of them probably don't involve adhesions. if you can push your arm through a normal range of motion with a stick, then it's highly unlikely that you have actual adhesions in you shoulder joint capsule. adhesions usually follow extended periods of immobilization (i.e., post-op casting), although as pat points out, diabetes is often associated with structural changes to connective tissue including joint capsules.
truth is, they have no real idea about what is going on in most of these cases. probably a lot of different things that just tend to produce similar symptoms. so a typical rx now is a shot of cortisone (mostly to ease the pain associated with daily tasks and pt) and then give you a set of exercises to try and at least keep the range of motion you have left.
i've been dealing with frozen shoulder for almost two years now. in that 1st 6 mos., sudden movement could produce this huge flash of lightning. i actually passed out twice, very briefly each time. then, as is usually the case, that kind of pain went away, and it became a more normal kind of durable discomfort that comes and goes. not sure ill ever regain a functional rom.
mine is clearly nerve-related, and it's located on the side with previous t- and c-disc injuries from gymnastics and climbing.
getting old sucks.
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DMBARN
Trad climber
Modesto
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Dec 14, 2013 - 01:05pm PT
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neverwas said: 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 . . . Exquisitely painful, but very noticeable improvement with each session. Before those sessions.
And Patrick oliver said: I am told that people with diabetes, and the virulent kind I have,
tend to be more susceptible to adhesive capsulitis.
I have diabetes and I am scheduled for surgery next week. A couple comments.
I've been told by a few Surgens that diabetics have a tendency to accumulate protein deposits in their joints either leading to or exacerbating the condition.
Second, I went to a massage therapist for about 6 weeks and got good improvement. I would take 2 Norcos and she would go at it.Before that I couldn't touch my finger behind my back and since then I can and then some.
But the ROM is still very limited and so I decided on the surgery. I am hopeful that since the massage got results that "manipulation under anesthessia" is all I'll need. If that doesn't work, then the surgeon will do a "Capsular Release" procedure.
I was told this could resolve on its own but after waiting about 3 years, its time for "the knife". I just got tired of not being able to put my arm around my wife......
Regards,
Douglas
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klk
Trad climber
cali
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Dec 14, 2013 - 01:26pm PT
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good luck with the surgery.
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Jan
Mountain climber
Colorado, Nepal & Okinawa
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Dec 14, 2013 - 01:35pm PT
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Yes good luck and please report back with your results.
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ron gomez
Trad climber
fallbrook,ca
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Dec 14, 2013 - 01:52pm PT
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What ranges are you most effected? Flexion, abduction, external/ internal rotation? Was this caused by an injury or just creep up slowly? Any other pains in the shoulder other than pain with range? Neck symptoms? Adhesive CAPSULITIS is a tightening of the capsule that surrounds the joint. For what ever reason it sensed injury or insult and progressively tightened up and adhesions are forming causing the loss in range and pain with movement, the adhesions break up a bit and that's what hurts. You have to do aggressive range exercises, but my belief is to the point of still being able to hold a long stretch under relative comfort so as not to bombard the receptors(Golgi tendon and muscle spindles) into causing even more tightening sensing injury. Get to a good hard stretch with enough pain to not cause muscle guarding, hold for about a minute, then progressively add more stretch maintaining the non guarding response. Also of critical concern to to maintained or restore scapular mobility, because without normal scapular rhythm, the shoulder will NEVER function properly. If you're seeing an Certified Athletic Trainer or physical therapist have them check scapular function through your range of motion, if compromised, get some soft tissue work on the subscap, infraspinatus, upper trap and rhomboids to free up the scapula, and have them mobilize the scapula. It's gonna take a while and be somewhat painful, but should do ya some good. Of course a proper diagnosis is critical.
If ya wanna talk feel free to PM me via Supertopo. Good luck with it
Peace
Edit: hey Kerwin......and you use to be entertained by my limp arm dislocations???? I'd die laughing watching you pass out from the flash pain!!! Just kidding of course, come on down for a visit, be glad to take a look at you and do some work. Good luck with Buddy
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Skywonger32
Trad climber
Long Beach, Ca
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Dec 14, 2013 - 02:16pm PT
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Hello Adrian,
I am currently a Physical Therapy student and have some information that might help you. The Journal of Physical Therapy released a 30 page report regarding guidelines for adhesive capsulitis with a review of all of the different treatments (rom exercises, joint mobilizations, manipulation under anesthesia, home exercise programs, etc). If you send me a message I can email you a pdf of the review. Its always nice to be aware of research behind the various options you have so you can make an informed decision about your health.
I am also conducting my Doctoral research on suprascapular nerve injuries in overhand athletes. Suprascapular neuropathy has lead to misdiagnosis of other disorders at the shoulder and neck, such as cervical radiculopathy, subacromial impingement syndrome, rotator cuff pathologies, and even adhesive capsulitis. Currently the only standard we have for diagnosing suprascapular neuropathy is Electroneuromyography, so my research is focusing on developing a clinical screen for the condition. We wont have our results in until late 2014 so the study probably wont be much help to you now.
Hope this will help!
-Laura
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klk
Trad climber
cali
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Dec 15, 2013 - 02:58pm PT
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I am also conducting my Doctoral research on suprascapular nerve injuries in overhand athletes. Suprascapular neuropathy has lead to misdiagnosis of other disorders at the shoulder and neck, such as cervical radiculopathy, subacromial impingement syndrome, rotator cuff pathologies, and even adhesive capsulitis. Currently the only standard we have for diagnosing suprascapular neuropathy is Electroneuromyography, so my research is focusing on developing a clinical screen for the condition. We wont have our results in until late 2014 so the study probably wont be much help to you now.
that's clearly a big part-- maybe most --of my issue.
but it's not clear to me that there's a whole lot of therapeutic options. good massage therapy makes a huge difference for me, although it's short-term. but i can't afford a daily cmt session, even if my plan would pay for it. which it doesn't.
nice of you to send folks the topt rig. i have it already, but a lot of folks here prolly can't get behind the paywall.
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klk
Trad climber
cali
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Dec 15, 2013 - 03:01pm PT
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hey Kerwin......and you use to be entertained by my limp arm dislocations????
no, i was entertained by the fact that you could reduce it yourself. did i ever tell you about the football game i was working where one of the big linemen dislocated his shoulder? dude was huge, freakin nightmare. took four of us to get it back in.
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Adrian MacNair
Boulder climber
Vancouver
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Topic Author's Reply - Dec 19, 2013 - 06:56pm PT
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I know I'm bumping this four days late but I've been pretty busy at work.
With respect to my range of motion, I can get my arm extended outward perpendicular to my body in a 90 degree angle without any pain. But as I increase that range of motion by trying to lift my arm above my head the pain begins and gets worse.
I cannot actually succeed in lifting my arm much higher than a foot above my head. In a crude and offensive analogy, I could probably do a slow motion Seig Heil salute but that's it. :P
My doctor told me to continue trying to stretch the shoulder and not baby it as I have been doing since last January because I thought I tore something.
The symptoms described by other people on this forum seem to indicate my doctor's diagnosis was correct... except for the fact I'm 39, don't have diabetes and thyroid issues or any medical history of shoulder problems.
Still, I'll try a sports therapy clinic in the New Year. More uncertainty for a while I guess. Would be nice to sleep on my right side for the first time in a year though.
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crunch
Social climber
CO
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Dec 19, 2013 - 07:44pm PT
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With respect to my range of motion, I can get my arm extended outward perpendicular to my body in a 90 degree angle without any pain. But as I increase that range of motion by trying to lift my arm above my head the pain begins and gets worse.
I cannot actually succeed in lifting my arm much higher than a foot above my head. In a crude and offensive analogy, I could probably do a slow motion Seig Heil salute but that's it. :P
My doctor told me to continue trying to stretch the shoulder and not baby it as I have been doing since last January because I thought I tore something.
OK. Sounds like you maybe need a second opinion. That's a pretty crude exercise. Try this variation:
Try this same movement while lying on the floor (a large-ish floor) on your side. If your bad shoulder is the right one, lie on the left side. Right arm perpendicular, hand on floor, relaxed. Now slowly sweep this arm "up" along the floor. This will create the same "lifting-the-arm motion as you were doing standing but you will not be involving any muscles; the arm and shoulder will stay relaxed. This way you can work on range of motion without issues from contracting/spasming muscles. You can better identify sore/painful areas and try to work around them
This might, just maybe, work a bit smoother and be less painful?
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DMBARN
Trad climber
Modesto
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Dec 20, 2013 - 01:40am PT
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My update;
I was correct in predicting I may only need the "manipulation" and got out of there with not having to face the "knife". It went well and now I'm going to be popping Norco's and doing lots of stretching exercises at home and three Physical Therapy appointments a week. The difference in my ROM is significant and I can now raise my arm up and place it around my wife's shoulders without any difficulty.
Yesterday was a complete trip. I felt like I had a 15 pound sausage hanging off my left shoulder all day as the nerve block didn't subside until last nite as I slept. The weirdest thing is now I know what the term "phantom pain" refers to. For those not familiar with it, that's when amputees can still "feel" the extremity that was amputated. I grabbed my left wrist with my right hand and touched my face with my left hand. I could feel my left hand in the position it would have been in if I had kept my arm straight. Got it? If my eyes were closed and you had done that for me I wouldn't have known you had put my hand to my face. I would have thought you touched my hand as it still hung down straight at the end of my arm. Really weird sensation.
Thanks laura for sending me that pdf. I'll try and read it this weekend.
Regards,
Doug
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mike m
Trad climber
black hills
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Apr 22, 2014 - 11:12pm PT
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Man got a super sore shoulder thinking of going to the doctor. Something I rarely do but I can hardly move my arm without major pain in the joint area of my shoulder. Always had a little pain there but this is somewhat severe without taxing it much.
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healyje
Trad climber
Portland, Oregon
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Apr 23, 2014 - 04:08am PT
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With your elbow against your side, and your hand extended in front of you as if to shake someone's hand, try to sweep your hand outward so it now points straight out from your side. If that causes you a lot of pain or you simply can't do it then you might consider getting to an ortho immediately.
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