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3 Cards in this Set
- Front
- Back
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Pathophysiology |
It is believed that inflammation of the synovium and subsynovial tissue is the underlying pathological process in frozen shoulder (Neviaser 1945, Lundberg 1969). The cytokine-induced increase in fibroblast activity causes an increase in deposition of collagen fibrils. An increase in the percentage of connective tissue within the muscle can lead to a relative ischemia, causing further fibrotic change within the muscle. Muscles therefore become less extensible and investing fascia more extensive and less elastic. It is believed that inflammation of the synovium and subsynovial tissue is the underlying pathological process in frozen shoulder (Neviaser 1945, Lundberg 1969). The cytokine-induced increase in fibroblast activity causes an increase in deposition of collagen fibrils. An increase in the percentage of connective tissue within the muscle can lead to a relative ischemia, causing further fibrotic change within the muscle. Muscles therefore become less extensible and investing fascia more extensive and less elastic. |
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Phases of Frozen Shoulder |
Frozen shoulder has 3 phases of freezing, frozen, and thawing (painful, stiff and resolving) lasting an average of 30 months (Reeves 1975, Tizk 1982). Without treatment, the freezing (painful) phase lasts between 2-8 months, followed by the frozen (stiff) phase, which lasts between 4-12 months, and the thawing (resolving) phase between 12-40 months or even longer. With NMT treatments, the pre-freezing phase would take between 1-5 sessions to recover mobility. The freezing stage, 7-13 sessions, the frozen stage 5-8 sessions, and the thawing stage 4-7 sessions |
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How Will It Help |
Traditional approaches to the frozen shoulder either address the inflammation (steroid tablets, steroid injections and hydrodilatation) or the stiffness (physical therapy, exercise therapy and surgical manipulation). Physical therapies attempt to improve the range of motion by forcing the shoulder through the blockage; this in our opinion can make the condition considerably worse. NMT works differently. I keep the arm still whilst applying a sequence of pressure points to specific tissues. The treatment can still be painful, especially in the early freezing phase, but it is no worse than the pain of the frozen shoulder (you will know what I mean if you have had one of those nasty spasms). The first few sessions of the technique initially address the inflammation in the rotator interval. After this the emphasis is on improving the range of motion. Depending how long you have had the problem and which phase you are in, results can be seen in as few as 4 sessions (range 4 -13). |
